July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Classification of Regions of Nonperfusion on Ultra-widefield Fluorescein Angiography in patients with Diabetic Macular Edema
Author Affiliations & Notes
  • Mengyuan Fang
    Doheny Eye Institute, Los Angeles, California, United States
    Opthalmology, University of California, Los Angeles, Los Angeles, California, United States
  • wenying fan
    Doheny Eye Institute, Los Angeles, California, United States
  • Yue Shi
    Doheny Eye Institute, Los Angeles, California, United States
  • Michael S Ip
    Doheny Eye Institute, Los Angeles, California, United States
    Opthalmology, University of California, Los Angeles, Los Angeles, California, United States
  • Charles Clifton Wykoff
    Retina Consultants of Houston, Houston, Texas, United States
  • Kang Wang
    Doheny Eye Institute, Los Angeles, California, United States
  • Khalil Ghasemi Falavarjani
    Doheny Eye Institute, Los Angeles, California, United States
  • David M Brown
    Retina Consultants of Houston, Houston, Texas, United States
  • Jano van Hemert
    Optos PLC, United Kingdom
  • Srinivas R Sadda
    Doheny Eye Institute, Los Angeles, California, United States
    Opthalmology, University of California, Los Angeles, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Mengyuan Fang, None; wenying fan, None; Yue Shi, None; Michael Ip, Allergan (C), Astellas Institute for Regenerative Medicine (C), Boehringer Ingelheim (C), Genentech (C), Omeros (C), Quark (C), Thrombogenics (C); Charles Wykoff, Adverum Biotechnologies (F), Aerpio Therapeutics (F), Alcon Laboratories (C), Alcon Laboratories (F), Alimera Sciences (C), Allergan (C), Allergan (F), Apellis Pharmaceutical (C), Apellis Pharmaceutical (F), Bayer AG (C), Clearside Biomedical (C), Clearside Biomedical (F), D.O.R.C. International (C), Genentech (C), Genentech (F), Novartis International AG (C), Novartis International AG (F), ONL Therapeutics (C), Ophthotech Corporation (F), Regeneron Pharmaceuticals (C), Regeneron Pharmaceuticals (F), Regenxbio (C), Regenxbio (F), Roche (C), Santen (C); Kang Wang, None; Khalil Falavarjani, None; David Brown, Aerpio (C), Alcon/Novartis (C), Allegra (C), Allergan, Clearside Biomedical (C), Genentech (F), Genentech/Roche (C), Heidelberg Engineering (C), Optos/ Nikon (C), Regeneron/Bayer (C); Jano Hemert, None; Srinivas Sadda, Allergan (C), Amgen (C), Carl Zeiss Meditec (F), Centervue (C), Centervue (F), Genentech/Roche (C), Heidelberg (C), Nidek (F), Novartis (C), Optos (C), Optos (F), Oxurion (C), Topcon (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2805. doi:https://doi.org/
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    • Get Citation

      Mengyuan Fang, wenying fan, Yue Shi, Michael S Ip, Charles Clifton Wykoff, Kang Wang, Khalil Ghasemi Falavarjani, David M Brown, Jano van Hemert, Srinivas R Sadda; Classification of Regions of Nonperfusion on Ultra-widefield Fluorescein Angiography in patients with Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2805. doi: https://doi.org/.

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

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Abstract

Purpose : To classify retinal nonperfusion regions (NPR) in patients with diabetic macular edema (DME) and assess the relationship with severity of DME.

Methods : Forty eyes of 29 patients with treatment-naïve center-involved macular edema secondary to diabetes mellitus were included (The DAVE study, NCT01552408) in this analysis. Ultra-widefield fluorescein angiography (UWF FA) images were transmitted to the Doheny Image Reading Center, where they were montaged and corrected using stereographic projection to adjust for peripheral distortion. Two independent, certified graders manually evaluated the NPR and classified the nonperfusion as being associated with leakage, or without leakage. The size of these two subtypes of NPR were computed in mm2 and assessed over the entire retina and within specific retinal zones. The relationship between subtype of NPR and the severity of DME was assessed.

Results : In forty eyes with treatment-naïve DME, visual acuity was significantly correlated with central macular thickness (CMT) and macular volume (MV). The NPR with leakage was positively correlated with CMT (R=0.408, P=0.009) and MV (R=0.399, P=0.011), whereas the NPR without leakage was negatively correlated with CMT (R=-0.468, P=0.002) and MV (R=-0.473, P=0.002). The NPR with leakage in the posterior region was significantly greater compared to the mid-periphery and the far-periphery (P=0.000), whereas the NPR without leakage was significantly greater in the mid-periphery compared to the far-periphery or the posterior region (P=0.001).

Conclusions : In patients with DME, the severity of DME appears to be positively correlated with NPR with leakage, but negatively correlated with NPR without leakage. These findings may have implications for the pathophysiology of DME and the design of protocols for targeted laser in these eyes.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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