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Miltiadis K. Tsilimbaris, Anastasios Anastasakis, Vassiliki Maniadi, Zoi Kapsala, Iliana Maniadaki, Dimitrios Mamoulakis; Comparison Of Digital Color Fundus Imaging And Fluorescein Angiography For The Early Detection Of Diabetic Retinopathy In Type 1 Diabetes Mellitus Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2892.
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To compare the findings from digital color fundus photography and fundus fluorescein angiography in young, type 1 DM patients without known diabetic fundus alterations in an attempt to address the issue of early detection of diabetic retinopathy changes.
Forty one type 1 DM patients were prospectively recruited for this study. Participants had been diagnosed with DM for at least 6 years, had Best Corrected Visual Acuity (BCVA) of 20/25 or better and did not have any other known vascular or structural retinal pathology. Exclusion criteria included patients with documented diabetic retinopathy in previous retinal examinations. All patients underwent a complete ophthalmic examination including BCVA measurement, slit lamp biomicroscopy of the anterior segment and a dilated fundus examination. Additionally, patients underwent digital color fundus imaging, fundus fluorescein angiography (FFA) and Optical Coherence Tomography (OCT). Color fundus images and FFA were evaluated by 2 independent masked retinal specialists. Parameters evaluated also included HB1C levels, and duration of diabetes.
Mean age of the studied patients was 17.7 years (SD.=3.9, range 10-27 years). Mean duration of DM was 10.5 years and mean HbA1C level was 8.3. Eighty-one eyes of 41 patients were analyzed (one eye of 1 patient showed an atrophic macular lesion and was excluded). Of the 81 eyes 79 eyes (97.5%) did not show any retinopathy changes while 2 eyes (2.5%) showed microvascular abnormalities on color fundus images. FFA images did not reveal any microvascular changes in 71 eyes (87.7%) while in 10 eyes (12.3%) abnormalities (microaneurysms with or without late leakage) were detected. Eight out of the 10 eyes that showed abnormalities on FFA, did not show any changes on color fundus images. None of the studied patients showed abnormalities on OCT testing. Mean duration of DM in the group of patients with detectable microvascular changes was 13.3 years, while for those without changes was 9.8 years.
Comparison of the findings from digital Color fundus images and FFA images on the detection of Diabetic microvascular changes in type 1 diabetic patients revealed that FFA shows more retinal vascular pathology. Early detection of microangiopathy in this group of diabetic patients may be crucial for their management and long term prognosis.
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