June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
New software to assess retinal non-perfusion on Optomap® Wide-Field Fundus Fluorescein Angiography in Diabetic Macular Oedema
Author Affiliations & Notes
  • Anna Sala-Puigdollers
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Silvestro Caputo
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Hojr Jaberansari
    School of Medicine, University of Manchester, Manchester, United Kingdom
  • Jane Gray
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Yvonne D'Souza
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Stephen Charles
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
  • Lorna Young
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
  • David Henson
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
    Manchester Academic Health Science Centre and Centre for Ophthalmology and Vision Research, Institute of Human Development, University of Manchester, Manchester, United Kingdom
  • David McLeod
    Manchester Academic Health Science Centre and Centre for Ophthalmology and Vision Research, Institute of Human Development, University of Manchester, Manchester, United Kingdom
  • Paulo Stanga
    Vitreoretinal Unit, Manchester Royal Eye Hospital, Manchester, United Kingdom
    Manchester Academic Health Science Centre and Centre for Ophthalmology and Vision Research, Institute of Human Development, University of Manchester, Manchester, United Kingdom
  • Footnotes
    Commercial Relationships Anna Sala-Puigdollers, None; Silvestro Caputo, None; Hojr Jaberansari, None; Jane Gray, None; Yvonne D'Souza, None; Stephen Charles, None; Lorna Young, None; David Henson, None; David McLeod, None; Paulo Stanga, OPTOS PLC (F), OPTOS PLC (C), OPTOS PLC (R), TOPCON CORP (F), TOPCON CORP (C), TOPCON CORP (R), SECOND SIGHT (F), SECOND SIGHT (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2410. doi:
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    • Get Citation

      Anna Sala-Puigdollers, Silvestro Caputo, Hojr Jaberansari, Jane Gray, Yvonne D'Souza, Stephen Charles, Lorna Young, David Henson, David McLeod, Paulo Stanga; New software to assess retinal non-perfusion on Optomap® Wide-Field Fundus Fluorescein Angiography in Diabetic Macular Oedema. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2410.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To develop new software that takes into account image distortion to assess the location and quantify the area of retinal non-perfusion (RNP) and its relationship with Central Macular Thickness (CMT) in patients with Diabetic Macular Oedema (DMO) on wide-field fundus fluorescein angiography (WF-FFA).

 
Methods
 

Retrospective review of 77 Optomap® WF-FFA images of patients with DMO. A grid was superimposed over the WF-FFA image (each cell being one disc area of 1.77mm2). The image was divided into 3 zones: 1.Posterior Pole (PP): within an ellipse centered on the fovea, passing through a point one disc diameter from the nasal edge of the optic disc (OD) and including the vascular arcades; 2 Mid-peripheral (MP): outside the PP but within a circle centered on the OD and passing along the posterior edge of the vortex vein ampullae on the green-free image; 3.Peripheral (P): anterior to the MP zone. Two independent graders classified each cell within zones 2 & 3 as: 1(>50% perfused), 2(<50% perfused), 3(transition area between 1 and 2), 4(poor image quality) or 5(blockage by eyelashes/eyelids). In case of disagreement of >10 cells scored as 2 or 3 in zone 2 the image was rescored by the two graders together. The coefficient of agreement was used to determine the consistency between the two graders initial scores. Correlation coefficients were calculated to assess the relationship between CMT and area of RNP.

 
Results
 

Coefficient of agreement for the MP was 21 cells. Thirteen images were regraded due to differences >10cells between the 2 graders. Mean CMT was 290µ(range:199-606µ). Average of RNP areas in MP was 4.17(range:0-25). Correlation coefficient with CMT was 0.349, p=0.019. Average of RNP areas in P was 2.01(range:0-29). There was no correlation with CMT and peripheral RNP areas.

 
Conclusions
 

This new software package allows for an easier and faster quantification of the area and location of retinal non-perfusion in the mid and periphery on Optomap® WF-FFA images while, for the first time, taking into account the distortion that occurs in WF-FFA images. Retinal non-perfusion associated with DMO is mainly located in the mid-periphery. We found a weak correlation between CMT and mid-peripheral retinal non-perfusion. Further studies using this new software are required to ascertain the area and role of retinal non-perfusion in DMO and other ischemic retinal diseases.

  
Keywords: 499 diabetic retinopathy • 572 ischemia • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)  
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