July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Regional Vessel Caliber, Retinal Oximetry and Predominantly Peripheral Diabetic Retinal Lesions as Surrogate Markers of Nonperfusion on Ultrawide Field Angiography in Diabetic Eyes
Author Affiliations & Notes
  • Alex Umali Pisig
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Konstantina Sampani
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Mohamed Ashraf Elmasry
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Yousef Aldairy
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Gavin Robertson
    Optos plc, Dunfermline, Scotland, United Kingdom
  • Alan Fleming
    Optos plc, Dunfermline, Scotland, United Kingdom
  • Cloyd Pitoc
    Philippine Eye Research Institute, University of The Philippines, Manila, Philippines
  • Jae Rhee
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Jennifer K Sun
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Paolo Sandico Silva
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Lloyd P Aiello
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Alex Pisig, None; Konstantina Sampani, None; Mohamed Elmasry, None; Yousef Aldairy, None; Gavin Robertson, Optos (E); Alan Fleming, Optos (E); Cloyd Pitoc, None; Jae Rhee, None; Jennifer Sun, None; Paolo Silva, Optos (F); Lloyd Aiello, Optos (R), Optos (F)
  • Footnotes
    Support  Massachusetts Lions Eye Research Fund, Balik-Scientist Program of the Department of Science and Technology, Republic of the Philippines; Lions International Sight First Research Grant
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3448. doi:
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      Alex Umali Pisig, Konstantina Sampani, Mohamed Ashraf Elmasry, Yousef Aldairy, Gavin Robertson, Alan Fleming, Cloyd Pitoc, Jae Rhee, Jennifer K Sun, Paolo Sandico Silva, Lloyd P Aiello; Regional Vessel Caliber, Retinal Oximetry and Predominantly Peripheral Diabetic Retinal Lesions as Surrogate Markers of Nonperfusion on Ultrawide Field Angiography in Diabetic Eyes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3448.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate whether predominantly peripheral lesions (PPL), regional differences in retinal vessel diameters and oximetry changes are associated with the extent of retinal nonperfusion (NP) on ultrawide field fluorescein angiography (UWF-FA) in diabetic eyes.

Methods : Vessel diameters, ETDRS diabetic retinopathy (DR) severity and presence of PPL were evaluated on UWF 200 degree images. Retinal oximetry and UWF-FA were obtained at the same visit. Vessel calibers at 1 disc diameter (DD, inner-AVR) and 3.5 DD (outer-AVR) from the center of the disc were measured using a customized semi-automated computer program. Retinal NP (mm2) was measured from UWF-FA images. Venous oxygen saturation (VO2, %) and arteriovenous difference (A-V, %) were calculated within a 2 DD ring centered on the optic disc.

Results : A total of 39 eyes from 20 subjects with mean age 40.7±10.7 yrs, diabetes duration 21.1±10.4 yrs, HbA1c 7.7%±1.1, 65.0% male and 75.0% type 1 diabetes were evaluated. DR severity was no DR 10.3%(4 eyes), mild nonproliferative DR (NPDR) 48.7%(19), moderate 20.5%(8), severe 10.3%(4), and proliferative DR 10.3%(4). PPL were present in 56.4%(22) of eyes and associated with increasing DR severity (p=0.006) as well as increasing NP & VO2, and decreasing A-V. In all eyes, NP was associated with increasing DR severity (r=0.60, p<0.0001) and increasing outer venular diameters (r=0.46,p=0.03). In eyes with PPL (N=22), increasing NP was correlated with increasing inner-AVR (r=0.43, p=0.04) and larger differences between outer- and inner-AVR (r=0.44, p=0.04). In eyes without PPL (N=17), NP was correlated with increasing inner (r=0.45, p=0.0370) and outer (r=0.68, p=0.0021) venular diameters. Correlation between inner and outer AVR was present only in eyes with no PPL (r=0.50, p=0.03) suggesting differences between inner and outer zones in eyes with PPL (r=0.29, p=0.18).

Conclusions : In this cohort, increasing NP was associated with increasing DR severity, venular dilation, increased VO2 and decreased A-V, suggesting greater areas of retinal ischemia, presence of venous shunting and reduced retinal oxygen utility. In eyes with PPL, regional differences in vessel caliber were correlated with increasing peripheral NP and provide further evidence that the risk of progression with PPL is driven by retinal ischemia.

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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