June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Diabetic Macular Ischemia In Type 1 Diabetes
Author Affiliations & Notes
  • Zaman Durani
    St George's Student Union, St Georges Univ of London, London, United Kingdom
    Pharmacy, Moorfields Eye Hospital, London, United Kingdom
  • Dawn Sim
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Pearse Keane
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Michael Karampelas
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Javier Zarranz-Ventura
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Marcus Fruttiger
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Praveen Patel
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Adnan Tufail
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Catherine Egan
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Londno, United Kingdom
  • Footnotes
    Commercial Relationships Zaman Durani, None; Dawn Sim, None; Pearse Keane, None; Michael Karampelas, None; Javier Zarranz-Ventura, None; Marcus Fruttiger, AstraZeneca (F), Novartis (F), Novartis (C), Amakem (F); Praveen Patel, Allergan (R), Bayer (C), Novartis UK (C), Heidelberg UK (R), Topcon UK (R), Thrombogenics (C); Adnan Tufail, Allergan (C), Bayer (C), GSK (C), Oculogics (C), Pfizer (C), Thrombogenics (C), Amakem (C), Heidelberg Engineering (R), Novarits/Alcon (C), Sanofi/Genzyme (C); Catherine Egan, Bayer (S), Oculogics (S), Novartis (S), Allergan (S), Novartis (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2418. doi:
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      Zaman Durani, Dawn Sim, Pearse Keane, Michael Karampelas, Javier Zarranz-Ventura, Marcus Fruttiger, Praveen Patel, Adnan Tufail, Catherine Egan; Diabetic Macular Ischemia In Type 1 Diabetes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2418.

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

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Abstract

Purpose: To investigate the relationship between fundus fluorescein angiography (FA) derived measurements of retinal vascular morphology and visual acuity (VA) in Diabetic Macular Ischaemia (DMI).

Methods: Data were retrospectively collected over a period of 6 months. FAs were analysed using the Early Treatment Diabetic Retinopathy Study (EDTRS) protocol for DMI. The Foveal Avascular Zone (FAZ), capillary non-perfusion areas- temporal to the fovea, and the overlying the papillomacular (PM) nerve fibre bundle were quantified using custom software.

Results: 51 patients with type 1 diabetes (DM) who had undergone a FA were included in the analysis. The mean age of 40 years (SD:13.2) with a 3:2 male to female ratio. 17 eyes (33.3%) had “no DMI”, 10 (19.6%) “questionable”, 13 (25.5%) “mild”, 8 (15.6%) “moderate”, and 3 (5.9%) “severe” ischemia. Median FAZ area (mm2) was 0.15mm2 (IQR: 0.10-0.17) in no DMI, 0.25mm2 (IQR: 0.19-0.30) in questionable, 0.30mm2 (IQR: 0.23-0.37), and 0.44mm2 (IQR: 0.35-0.52) in severe DMI (p<0.001). VA was reduced moderate and severe (0.2 LogMar [IQR: 0.10-0.55]) compared to those with none, questionable, and mild ETDRS-DMI grades (0.0 LogMar [IQR: 0.0-0.2]) (p=0.03). Temporal and PM ischemia was observed both in eyes without DMI (35.3% and 17.6% respectively), as well as across all ETDRS-DMI grades (67.6% and 47.1%) (p=0.16, p=0.82).

Conclusions: The prevalence of DMI in patients with type 1 DM (66.7%) was greater than in type 2 DM (54.6%), observed in a previous study. The pattern of DMI in type 1 DM also differs to that observed in type 2 DM. Temporal and PM ischemia was present across all ETDRS-DMI grades, unlike type 2 DM, where it was present only in more severe ETDRS-DMI grades. Functional outcomes of both DM types are similar, where a reduction of visual acuity was only observed in eyes with moderate to severe ETDRS-DMI grades.

Keywords: 499 diabetic retinopathy • 688 retina • 754 visual acuity  
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