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H. Ito, T. Horii, T. Murakami, K. Nishijima, A. Sakamoto, K. Takayama, M. Ota, N. Yoshimura; Fluorescein Leakage is Associated With Capsular Structure of Microaneurysms Depicted by Spectral-Domain Oct in Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4697.
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© ARVO (1962-2015); The Authors (2016-present)
Microaneurysm (MA) in diabetic retinopathy (DR) often shows vascular hyperpermeability, and exacerbates diabetic macular edema (DME). We herein investigate the association between fluorescein angiography (FAG) findings of MAs and their structural characteristics delineated by Spectral-Domain OCT (Spectralis HRA+OCT; Heidelberg Engineering).
Thirty-four eyes of 25 patients suffering from DR (mild nonproliferative diabetic retinopathy [NPDR] 6 eyes, moderate NPDR 13, severe NPDR 13, PDR 2), who had color fundus photograph, FAG and Spectralis OCT obtained on the same day, were participated in this study. Eighty-nine MAs were well delineated by all of these examinations, and applied to further evaluation. Fluorescein intensity in their own contents and focal fluorescein leakage were documented, and their association with morphological characteristics depicted by SD-OCT was investigated.
Focal fluorescein leakage was observed in 49 MAs, and SD-OCT demonstrated that 28 (57.1%) of such MAs did not at all have the capsular structure, whereas only 2 MAs (4.0%) were demarcated by complete capsular structure (p<0.01). SD-OCT further delineated hyperreflective spots in 42 of 49 MAs with focal fluorescein leakage. We next evaluated the location of 89 MAs, and found few innerve fiber layer and most in inner nuclear layer, although we could not find the significant correlation between the location and focal fluorescein leakage (p=0.11). Additionally, the fluorescein intensity in their contents was not related to these OCT characteristics.
We found the significant association between focal fluorescein leakage and morphological features delineated by Spectralis OCT, which would provide the useful information concerning the pathogenesis of diabetic macular edema.
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