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Joseph Daniel Boss, Alice Jiang, Sunil Srivastava, Jamie Reese, Justis P Ehlers; Correlation of Anatomic Features with Panretinal Ischemic Index in Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1930.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study is to evaluate the association of anatomic features on spectral-domain optical coherence tomography (SD-OCT) with the underlying panretinal ischemic index on ultra-widefield fluorescein angiography (UWFA) in diabetic retinopathy (DR).
An IRB-approved retrospective image analysis study completed for subjects with underlying DR. All eyes underwent UWFA and SD-OCT. Eyes were excluded for previous laser photocoagulation, intravitreal injections within the last six months, poor quality OCT, and/or limited quality UWFA images. SD-OCTs were reviewed for the presence of intraretinal fluid, subretinal fluid, epiretinal membrane, and central subfield thickness. UWFA images were segmented for areas of ischemia on a novel angiography review system. The ischemic index was calculated as the area of capillary nonperfusion divided by the total retinal area. Diabetic retinopathy severity was assessed based on fundus photo review.
A total of 344 eyes of 199 patients were included in this study. The mean age was 62.4 years (SD: 13.3 years) with 116 males (58%) and 83 females (42%). The mean visual acuity was 20/48. HbA1C levels were available for 159 of the patients with a mean of 8.1% (SD: 2.0%). Of 344 eyes analyzed for ischemia, mean ischemic index for degree of DR severity was 0.93% for mild nonproliferative diabetic retinopathy (NPDR), 1.58% for moderate NPDR, 2.81% for severe NPDR, and 9.52% for proliferative diabetic retinopathy (PDR). The presence of intraretinal fluid, subretinal fluid, and central subfield thickness were not associated with ischemic index. The presence of an ERM was significantly associated with ischemic index (p<0.001).
In this analysis, ischemic index was not associated with the presence of DME was but was associated with the presence of vitreoretinal interface abnormalities.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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