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Daniela Castro Farías, Rodrigo Matsui, Juan Ignacio Bianchi, Ulises de Dios Cuadras, Federico Graue, Benedicte Dupas, Michel Paques; INDOCYANINE GREEN ANGIOGRAPHY FEATURES OF DIABETIC MACULAR EDEMA: CHARACTERIZATION OF TELANGIECTATIC CAPILLARIES. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2617.
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© ARVO (1962-2015); The Authors (2016-present)
During retinal vascular diseases, a spectrum of retinal microvascular abnormalities are commonly observed, including but not restricted to microaneurysms. These lesions have in common that they are better identified on late frames of indocyanine green angiography (ICGA). Convergent clinical evidence suggests that targeted photocoagulation of the largest of these microvascular abnormalities may be beneficial for treating macular edema. Here, we investigated the prevalence and ICGA and OCT features of large retinal microvascular abnormalities in patients with diabetic macular edema (DME).
Retrospective, observational study. The fundus photographs, ICGA and OCT charts of 35 eyes from 25 consecutive patients with DME were reviewed.
Twenty-two eyes (63%) had at least one focal area of microvascular abnormalities showing prolonged (i.e. beyond 10mn) ICG staining. These areas were located at a median distance of 2708 µm from the fovea (range: 1064-4583 µm). Their size ranged from 110 to 307 µm. Microaneurysms were not visible in late frames in 74.3% of cases, while 93% of large lesions were still detectable and even increased their contrast in most cases. The prevalence of late ICG staining within areas of retinal thickening was 4/10 in eyes with dust-like hard exudates (HEs), 9/14 in eyes with moderate HEs and 9/9 in eyes with circinate HEs (p=0.03 for the difference between groups).
Foci of microvascular abnormalities showing late ICG staining are commonly found during DME. The larger the microvascular abnormality, the more delayed and prolonged the ICG staining. Their prevalence is related to the severity of DME, and in particular to the presence of HEs, which suggests their implication in the occurrence of DME. We propose the term telangiectatic capillaries (TelCaps) to describe them.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Comparison of ICG staining pattern of microaneurysms and TCs. Time indicates duration since dye injection. Between the early and late frame, note the fading contrast of the smaller lesions, while the opposite is true for the large lesion indicated by the arrow. Arrow in the upper left panel shows another TC not visible on early frames.
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