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Jennifer J Kang-Mieler, Shaoxian Hu, Carol Yim-lui Cheung, Leanne Horvath, Miranda Poklar, Danny Siu Chun Ng, Fangyao Tang, Wong Ying YIP, William F Mieler, Kenneth Tichauer; Biomarkers of diabetic retinopathy based on dynamic fluorescein angiography. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1879.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose was to demonstrate that the retinal vascular permeability and volumetric blood flow mapping from dynamic fluorescein enhanced fluorescent imaging can detect changes of diabetic retinopathy (DR).
A routine fluorescein angiogram (FA) was performed in three normal control subjects and three diabetic patients. A bolus of fluorescein dye (500mg/5ml) was injected to obtain videoangiograms (30°, 90 sec movie) using Heidelberg Spectralis. The images were obtained immediately after the injection to capture the initial filling of the blood vessels. Additional images were obtained at mid-phase and late-phase. The fluorescein images were loaded into MATLAB. Either plug-flow or AATH tracer kinetic model was applied to obtain retinal vascular permeability and blood flow maps from control and diabetic patients.
Control subjects had no ocular abnormality. Based on the kinetic model analysis, the control subjects had an average volumetric blood flow of 26.2 ± 4.2 ml/min/100g. The average vascular permeability (extraction fraction) for the control subjects was 6.2x10-5 ± 5.5x10-4. The diabetic patients had no DR to mild non-proliferative DR. Two patients also had signs of diabetic macular edema. For the diabetic patients, the average volumetric blood flow was 14.5 ± 5.9 ml/min/100g. The average vascular permeability from the diabetic patients increased to 0.078 ±. 0.037. There were significant differences in vascular permeability and volumetric blood flow between the control subjects and diabetic patients based on the kinetic model analysis.
The current data demonstrated that dynamic fluorescein enhanced fluorescent imaging can detect changes of volumetric blood flow and vascular permeability in diabetic patients. Specifically, an increase in the vascular permeability, in absence of proliferation, may be a sensitive parameter to detect vascular abnormality. This study demonstrated that the vascular permeability and blood flow may be powerful biomarkers for early detection of DR.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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