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Ashley Speilburg, Shaun Ittiara, Yi Pang, Danielle Leong, Ravi Patel, Leonard Messner, Seenu Hariprasad; Is Peripheral Retinal Ischemia Associated with Systemic Atherosclerosis?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):194.
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Previous studies have found that diabetic patients presenting with retinopathy have a higher intima media thickness (IMT) than diabetic patients without retinopathy and patients with severe diabetic retinopathy are more likely to have subclinical vascular disease. The purpose of this study was to investigate whether there was a correlation between peripheral retinal non-perfusion and IMT thickness of the common carotid artery in patients with diabetic retinopathy.
A total of 15 subjects with diabetic retinopathy were enrolled (age ranged from 26 to 78 years). Ultra-widefield fluorescein angiography images on both eyes and common carotid ultrasound scans of both carotid arteries were obtained. Using area measurement function in the V2 Vantage Review Software (Optos, PLC), one of the coauthors decided both the total area of gradable fundus and non-perfusion area seen in the arteriovenous phase of the ultra-widefield fluorescein angiogram. The ischemic index (ISI) was calculated by dividing the non-perfused retinal area with the total retinal area. Pearson correlation was performed to test the association between peripheral retinal non-perfusion and IMT thickness of the right and left carotid artery.
Average (± SD) IMT in the right carotid artery was 0.870 (± 0.182) mm ranged from 0.52 to 1.24 mm, and 0.836 (± 0.213) in the left carotid artery ranged from 0.51 to 1.28 mm. Average ISI in the right eye was 0.145 (± 0.134) ranged from 0.10 to 0.40, and 0.144 (± 0.144) in the left eye ranged from 0.01 to 0.47. There was no correlation between ISI and IMT either in the right side (r = 0.08, P = 0.77) nor in the left side (r = 0.01, P = 0.97).
In this pilot study we were not able to determine a relationship between retinal ischemia and carotid atherosclerosis in patients with diabetic retinopathy. A limit of this study is the small sample size and further investigation with a larger cohort is indicated.
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