March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
The Diabetic Retinopathy Repair Project - Prevalence And Prognostic Significance Of Ischaemia In Diabetic Macula Disease
Author Affiliations & Notes
  • Dawn A. Sim
    Medical Retina, Cell Biology,
    Moorfields Eye Hospital, London, United Kingdom
    UCL Institute of Ophthalmology, London, United Kingdom
  • Pearse A. Keane
    Medical Retina, Cell Biology,
    Moorfields Eye Hospital, London, United Kingdom
  • Elise Platteau
    Medical Retina, Cell Biology,
    Moorfields Eye Hospital, London, United Kingdom
  • Javier Zarranz-Ventura
    Medical Retina, Cell Biology,
    Moorfields Eye Hospital, London, United Kingdom
  • Marcus Fruttiger
    UCL Institute of Ophthalmology, London, United Kingdom
  • Praveen J. Patel
    Research & Development,
    Moorfields Eye Hospital, London, United Kingdom
  • Catherine A. Egan
    Medical Retina, Cell Biology,
    Moorfields Eye Hospital, London, United Kingdom
  • Adnan Tufail
    Ophthalmology,
    Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships  Dawn A. Sim, None; Pearse A. Keane, None; Elise Platteau, None; Javier Zarranz-Ventura, None; Marcus Fruttiger, None; Praveen J. Patel, None; Catherine A. Egan, None; Adnan Tufail, None
  • Footnotes
    Support  Fight For Sight, NIHR - National Institute for Health Research
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 358. doi:
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    • Get Citation

      Dawn A. Sim, Pearse A. Keane, Elise Platteau, Javier Zarranz-Ventura, Marcus Fruttiger, Praveen J. Patel, Catherine A. Egan, Adnan Tufail; The Diabetic Retinopathy Repair Project - Prevalence And Prognostic Significance Of Ischaemia In Diabetic Macula Disease. Invest. Ophthalmol. Vis. Sci. 2012;53(14):358.

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Abstract
 
Purpose:
 

To investigate the relationship between Fundus Fluorescein Angiography (FFA) and Optical Coherence Tomography (OCT) derived measurements of retinal vascular morphology and visual acuity in Diabetic Macular Ischaemia (DMI).

 
Methods:
 

Data were retrospectively collected over a period of 6 months. FFAs were analysed by 3 independent graders using the Early Treatment Diabetic Retinopathy Study (EDTRS) protocol for DMI. The Foveal Avascular Zone (FAZ), capillary non-perfusion areas, and OCT images were quantified using custom software.

 
Results:
 

1298 unique patient attendances were identified. 1534 eyes from 767 Type 2 diabetic patients included in the analysis. 45.4% of eyes had no DMI, 16.5% questionable, 16.4% mild, 7.9% moderate, and 3.7% severe ischaemia. Mean FAZ area (mm2) ranged from 0.21 in no DMI to 0.63 in severe DMI. Visual acuity (VA) was reduced in all grades of DMI compared to those with no DMI (p<0.003). VA reduction was correlated FAZ size in the moderate (r=0.47 p=0.006) and severe DMI (r=0.30 p=0.02) subgroups, and in cases with concurrent temporal ischaemia (r=0.59 p=0.0003) and maculopapillar ischaemia (r=0.52 p=0.002). The ratio of inner:outer retinal volume in ETDRS areas 1-9 was negatively correlated to FAZ size (r=-0.29, p= 0.04). A negative correlation was also observed with inner retinal (r=-0.31 p=0.03) but not outer retinal intensity (r=0.09 p=0.51).

 
Conclusions:
 

The extent and location of diabetic macular ischaemia is associated with a reduction of visual acuity and disruption of Inner retinal architecture. The prognostic significance of macular ischaemia is not well understood. Its characterization is an important first step to determine the time point in which patients may be amenable to future regenerative therapies.  

 

 
Keywords: diabetic retinopathy • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: prevalence/incidence 
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