Abstract
Purpose :
To analyze the vitreo-retinal interface in eyes of diabetic patients with non-proliferative diabetic retinopathy (NPDR) with or without diabetic macular edema (DME) using ultra-wide field swept source optical coherence tomography (SS-OCT).
Methods :
Retrospective study of SS-OCT images collected in 22 diabetic patients referred for retinopathy screening to the Ophthalmology Department at University of Kentucky between 9/15/18-11/15/18. An FDA-approved SS-OCT system (Plex Elite 9000, Carl Zeiss Meditech, Dublin, CA) was utilized to obtain a 16x16 high-definition volumetric scans of 51 b-scans centered at the macula. Medical records were reviewed to collect information on whether posterior vitreous detachment (PVD) was present or not and the retinopathy status. Patients with no retinopathy and NPDR with or without DME were included. Eyes with proliferative diabetic retinopathy (PDR) were excluded (n=2). SS-OCT images were evaluated with vitreous windowing for the presence or absence of PVD and if present, it was classified as complete (c-PVD) or partial (p-PVD).
Results :
A total of 42 eyes were included. SS-OCT images revealed complete, partial or no PVD in 11 (26%), 4 (9%) and 22 (52%) eyes respectively. In 5 (12%) eyes, the vitreous border could not be visualized. 28 eyes had no DME (median age 53, range 25-68) and 14 had DME (median age 63.5, range 53-84). In eyes with visualized vitreous, in the no-DME group, the majority (18/26, 69%) had no-PVD followed by equal number of c-PVD and p-PVD, n=4/26, 15% for both. Comparatively in the DME group, the majority had c-PVD (n=7/11, 63%), no p-PVD was noted and 4/11 eyes (36%) had no PVD. Of the 14 eyes with DME, 6 (42.9%) had a history of intraocular injections, but in 3 of these vitreous was not visualized. Of the remainder, all (n=3/3, 100%) had c-PVD. In DME eyes without previous injections, half (n=4/8, 50%) had c-PVD noted, and half(n=4/8, 50%) no PVD. Of note, two eyes with PVD noted on clinical exam note were instead found to be attached on imaging.
Conclusions :
Wide-field SS-OCT with vitreous windowing provides visualization of the vitreoretinal interface allowing determination of the presence and extent of PVD. In this study, eyes without DME had lower prevalence of PVD as compared to eyes with DME indicating this technology could be useful in understanding the role of the vitreous in DME.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.