Original articleDiabetic Retinopathy Severity and Peripheral Lesions Are Associated with Nonperfusion on Ultrawide Field Angiography
Section snippets
Methods
This was a retrospective cross-sectional study. An electronic review of the billing records of the Beetham Eye Institute of the Joslin Diabetes Center was performed to retrieve all FA images (current procedural terminology code, 92235) performed between January 1, 2013, and December 31, 2014. Only patients with type 1 or type 2 diabetes mellitus who underwent UWF imaging and UWF FA during the same visit were reviewed. Patients with a history of prior scatter (panretinal) laser photocoagulation
Results
The UWF images and UWF FA images of 68 eyes from 37 patients with type 1 or 2 diabetes mellitus were evaluated in this study. Baseline characteristics for eyes without PPLs compared with eyes with PPLs were balanced in age, gender, ethnicity, diabetes type, and visual acuity (Table 1). The presence of PPLs was associated with longer diabetes duration and more severe DR. All subsequent analyses on PPL presence were corrected for diabetes duration and DR severity.
Discussion
In eyes of patients with diabetes, increasing DR severity was associated strongly with increasing NPA and NPI. Both increasing NPA and NPI were associated with the presence of PPLs in this cohort of eyes. The nonperfusion identified on UWF FA in diabetic eyes with DR was located primarily in the midperipheral retina and progressed posteriorly with increasing severity. Both NPA and NPI were larger in the superior and temporal fields compared with the inferior and nasal fields of the retina.
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Supplemental material is available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have made the following disclosure(s): L.P.A.: Financial support − Optos plc, Dunfermline, United Kingdom
Temporary loan of 2 ultrawide field imaging devices was provided by Optos, plc, to the Joslin Diabetes Center, but the devices were not used in this study.
Supported in part by the National Academy of Science and Technology, Taguig City, Philippines (Outstanding Young Scientist Grant to P.S.S.); the Amelia Peabody Charitable Fund (Boston, Massachusetts); and the Massachusetts Lions Eye Research Fund (Belmont, Massachusetts) to the Joslin Diabetes Center.
Author Contributions:
Conception and design: Silva, Dela Cruz, Ledesma, van Hemert, Radwan, Cavallerano, L.M.Aiello, Sun, L.P.Aiello
Analysis and interpretation: Silva, Dela Cruz, Ledesma, van Hemert, Radwan, Cavallerano, L.M.Aiello, Sun, L.P.Aiello
Data collection: Silva, Dela Cruz, Ledesma, van Hemert, Radwan, Cavallerano,
Obtained funding: Silva, L.P. Aiello
Overall responsibility: Silva, Dela Cruz, Ledesma, van Hemert, Radwan, Cavallerano, L.M.Aiello, Sun, L.P.Aiello