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gregory stein, Lin James, Ahmet Hondur, Cristina Molero, Tongalp Tezel; Does Vitreoretinal Adhesion Affect Microaneurysm Development in Diabetes?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6321.
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© ARVO (1962-2015); The Authors (2016-present)
The microaneurysm is a hallmark of diabetic retinopathy, yet the mechanism of its formation is unknown. Our hypothesis is that if vitreoretinal adhesion is not associated with microaneurysm formation, the number and location of microaneurysms should not be related to the presence or absence of vitreoretinal adhesion.
This is a retrospective study that was approved by the Institutional Review Board at Columbia University Medical Center. A search of all patients who had both the ICD-9 code for diabetic retinopathy and the cpt code for fluorescein angiography (FA) was performed from 2009 through the present. Subjects with an FA within 1 month of macular cube spectral domain ocular coherence tomography (SD-OCT) (Carl Zeiss Meditec, Dublin, CA) were included. Data including the age, gender and hemoglobin A1C was collected. For each eye an FA image was superimposed over the en face SD-OCT image including the macular cube. Subjects were excluded if there was laser between the arcades or if significant epiretinal membrane was present. To maintain a constant amount of area being compared between eyes, the cube area was standardized based on the size of the peripapillary vein thickness. The vitreous adhesion was mapped and determined to be attached, detached or in a state of schisis at all locations within the cube. An image with the combined FA image and the en face cube with a schematic of the vitreous map was uploaded into the MetaMorph Image Analysis. Eyes were categorized into one group that had partial to total vitreous attachment (attached) and another group (detached) with total vitreous detachment in the area of the cube.
62 subjects and 91 eyes were included in the study. 64 eyes were included in the attached group and 27 eyes in the detached group. The average number of microaneurysms in the attached group was 56(SD=73) and 32(SD=27) in the detached group (p<0.05). The average ages in the attached and detached groups were 55(SD=11) and 65(SD=12) (p<0.05), respectively. The average hemoglobin A1C was 8.8(SD=2.3) in the attached group and 8.3(SD=1.3) in the detached group (p=0.22). The female to male ratio in the attached group was 29:35 and in the detached group was 15:12.
In our study the number of microaneurysms in the central macula was 1.7 times larger in the group with partial or total vitreous adhesion compared to that of the group with total detachment of the vitreous.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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