July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Synergistic Use of Novel Imaging Technology in Type 1 Diabetes Screenings
Author Affiliations & Notes
  • Loka Thangmathesvaran
    Ophthalmology , Rutgers University- New Jersey Medical School, Monmouth Junction, New Jersey, United States
  • Bernard Szirth
    Ophthalmology , Rutgers University- New Jersey Medical School, Monmouth Junction, New Jersey, United States
  • Albert S Khouri
    Ophthalmology , Rutgers University- New Jersey Medical School, Monmouth Junction, New Jersey, United States
  • Footnotes
    Commercial Relationships   Loka Thangmathesvaran, None; Bernard Szirth, None; Albert Khouri, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1918. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Loka Thangmathesvaran, Bernard Szirth, Albert S Khouri; Synergistic Use of Novel Imaging Technology in Type 1 Diabetes Screenings. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1918.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : Management of diabetic retinopathy has relied on fundus photography. However, ocular coherence tomography (OCT) and ocular coherence tomography-angiography (OCT-A) can help detect early ocular changes in patients with type 1 diabetes mellitus (T1DM). A retrospective, observational study was done to highlight each non-mydriatic imaging modality in the context of T1DM.

Methods : Subjects (n=4) average age 23 years old were included for analysis. Inclusion criteria was having T1DM for greater than 10 years. Color and auto-fluorescence retinal imaging, OCT, and OCT-A images were reviewed. HbA1C, visual acuity, and intraocular pressure were collected over a five year period.

Results : Subject A maintained HbA1C levels of 6.0 over a period of 10 years is our control subject. No signs of diabetic retinopathy were noted. (Fig 1A-C). Subject B has optic nerve head drusens that coalesced, impeding vasculature flow predisposing to glaucoma and flame hemorrhages. (Fig 1D-F). Subject C had a spike in glucose lasting 12 months with HbA1C levels at >13.5 and elevation in blood pressure (140/90) inadequately controlled on ACE inhibitors. He developed 271 hemes in his left eye. However, since his foveal avascular zone (FAZ) was not compromised, anti-VEGF were not used (Fig 2A-B). Subject D had chronically elevated glycemic parameters at HbA1C of 9.0 (with peaks of over 10.5). Macular edema and neovascularization of the FAZ were noted (Fig 2C-E). Anti-VEGF agents were recommended.

Conclusions : These current advances for diabetic retinopathy imaging can be synergistically used in non-mydriatic mode. Consolidation of information from these imaging sources will help dictate appropriate clinical management.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Figure 1:
Subject A: A. (top-left) ONH centered fundus- 2016. B. (top-middle) OCT-2016. C. (top-right) OCT-A- 2016
Subject B: D. (bottom-left) ONH centered fundus- 2013 E. (bottom-middle) ONH Centered Fundus Auto Fluorescence- 2013 F. (bottom-right) ONH Centered Fundus Emboss- 2013.

Figure 1:
Subject A: A. (top-left) ONH centered fundus- 2016. B. (top-middle) OCT-2016. C. (top-right) OCT-A- 2016
Subject B: D. (bottom-left) ONH centered fundus- 2013 E. (bottom-middle) ONH Centered Fundus Auto Fluorescence- 2013 F. (bottom-right) ONH Centered Fundus Emboss- 2013.

 

Figure 2:
Subject C: A. (top-left) macula centered fundus- 2015. Dot hemorrhages, flame hemorrhages, and IRMAs noted B. (top-right) OCT-A image- 2015. Macular edema and neovascularization is not present.
Subject D: C. (bottom-left) macula centered fundus-2016. D. (bottom-middle) SD-OCT- 2016. Macular edema is noted. E. (bottom-right) OCT-A- 2016. Neovascularization of the FAZ zone can be noted.

Figure 2:
Subject C: A. (top-left) macula centered fundus- 2015. Dot hemorrhages, flame hemorrhages, and IRMAs noted B. (top-right) OCT-A image- 2015. Macular edema and neovascularization is not present.
Subject D: C. (bottom-left) macula centered fundus-2016. D. (bottom-middle) SD-OCT- 2016. Macular edema is noted. E. (bottom-right) OCT-A- 2016. Neovascularization of the FAZ zone can be noted.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×