April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The distribution of leakage on fluorescein angiography in diabetic macular edema. A new approach to the aetiology.
Author Affiliations & Notes
  • Bilal Hajnajeeb
    Eye Department, General Hospital of Vienna, Vienna, Austria
  • Christian Simader
    Eye Department, General Hospital of Vienna, Vienna, Austria
  • Gabor Gy Deak
    Eye Department, General Hospital of Vienna, Vienna, Austria
  • Bianca Gerendas
    Eye Department, General Hospital of Vienna, Vienna, Austria
  • Sebastian M Waldstein
    Eye Department, General Hospital of Vienna, Vienna, Austria
  • Ursula Schmidt-Erfurth
    Eye Department, General Hospital of Vienna, Vienna, Austria
  • Footnotes
    Commercial Relationships Bilal Hajnajeeb, None; Christian Simader, None; Gabor Deak, None; Bianca Gerendas, None; Sebastian Waldstein, None; Ursula Schmidt-Erfurth, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4398. doi:
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      Bilal Hajnajeeb, Christian Simader, Gabor Gy Deak, Bianca Gerendas, Sebastian M Waldstein, Ursula Schmidt-Erfurth, ; The distribution of leakage on fluorescein angiography in diabetic macular edema. A new approach to the aetiology.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4398.

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

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Abstract

Purpose: To measure the leakage area in each field of ETDRS grid in diabetic macular edema (DME) patients, and to explain the relationship between the aetiology of the edema and the severity of the leakage noticed in each field.

Methods: 87 consecutive DME subjects were included. Inclusion criteria: patients with diabetic macular edema and good quality fluorescein angiography (FA) images. Exclusion criteria: patients with previous ocular medical or surgical intervention, previous laser treatment in the macular region, vitreomacular traction, epiretinal membrane, accompaying macular non perfusion, other diseases which may cause macular edema like retinal vascular occlusions, inflammation, irvine-gass syndrome. Using octavo program (Vienna reading center, Vienna, Austria) we measured the leakage areas on late phase FA images in each field (nasal, inferior, temporal, superior) of ETDRS grid.

Results: The means of leakage areas in nasal, inferior, superior, and temporal ETDRS fields were : 2335355 µm2, 2843996 µm2, 3026396 µm2,and 3963832 µm2 respectively. The differences between all means of leakage areas were statistically significant (p<0.05), except the difference between the means of leakage areas in superior and inferior fields (p=0.288).

Conclusions: Iin diabetic retinopathy (DR), the gradual increase of leakage areas starting from nasal, inferior and superior, to superior field gets along with the spatial intensity of microaneurysms. In contrast, this increase in distribution of leakage disproportionates to the thickness map of nerve fiber layer (NFL), which shows increase in thickness from temporal, inferior and superior, to nasal field. This finding support the hypothesis that the neural components in NFL may play a remarkable role in preventing the evolution and progression of microaneurysms in DR.

Keywords: 499 diabetic retinopathy • 505 edema  
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