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Tyler Brown, Muneeswar Gupta Nittala, wenying fan, Takao Hirano, Swetha Velaga, Zhihong Hu, Xiaodong Wu, Charles Clifton Wykoff, Michael S Ip, Srinivas R. Sadda; Impact of peripheral non-perfusion on macular retinal layer morphology in subjects with proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1939.
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To evaluate the effect of the extent of non-perfusion on retinal layer thickness measured on optical coherence tomography (OCT) in subjects with proliferative diabetic retinopathy (PDR) with no diabetic macular edema.
In this prospective, IRB-approved study (NCT: 02863354 ), 20 eyes of 20 subjects with PDR underwent diagnostic testing at baseline using ultra-widefield fluorescein angiography (UWF) (Optos 200Tx) , Heidelberg Spectralis OCT. Areas of non-perfusion area were manually-segmented by certified reading center graders using an open source image processing program, ImageJ. The thickness of various layers (from the retinal nerve fiber layer through the choroid) were automatically segmented using graph-based layer segmentation approach from Doheny Image Analysis Laboratory (DIAL) with custom DIAL software (OCTOR) and followed up with manual correction of the automatically segmented layers. Retinal layer thickness was computed following manual correction using OCTOR. Correlation between the total non-perfusion area and thickness of retinal layers were analyzed using bivariate correlation analysis [SPSS 18.0].
The mean age of the 20 subjects was 50 ± 12 years. 18 subjects were female and 2 subjects were male. Mean total non-perfusion area was 198 ± 133mm2. Univariate correlation analysis showed that the total non-perfusion area significantly correlated with the thicknesses of the nerve fiber layer, ganglion cell layer, and inner plexiform layer (p<0.05); Table 1. Specifically, more non-perfusion was associated with a reduction in thickness of each of these inner retinal layers. Multivariate analysis showed that only the correlation between total non-perfusion area and ganglion cell layer thickness (r2 = 0.29 p=0.02), remained significant.
The total non-perfusion on UWF imaging in eyes with PDR, correlates with reductions in the thickness of inner retinal layers in the macula, with no apparent impact on the outer retinal layers including the outer plexiform layer. Interestingly, only ganglion cell layer thickness remains independently correlated with total non-perfusion.
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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