Abstract
Purpose :
To assess the correlation between peripheral non-perfusion from ultrawide field fluorescein angiography (UWF FA) and Early Treatment Diabetic Retinopathy Severity (ETDRS) level from color fundus photographs (FP) of eyes with diabetic retinopathy (DR).
Methods :
Capillary non-perfusion was evaluated from UWF FA (Optos) images in three regions: within the macular ETDRS grid (green), the 7 standard field grid (blue) and within the visible Optos image. Corresponding fundus photographs were evaluated for ETDRS severity level and classified as moderate non-proliferative DR (NPDR) (ETDRS levels 35 and 43), severe NPDR (ETDRS levels 47 and 53) or proliferative DR (ETDRS level > 60).
Results :
Paired UWF FA and FP were evaluated on eyes of 53 individuals. The mean area of capillary nonperfusion was 0.63 mm2 (SD 1.6) in the ETDRS grid, 15.85 mm2 in the 7 standard fields and 32.02 mm2 (SD 47.00) in the entire UWF FA image. The ETDRS severity level was distributed between moderate NPDR (13), severe NPDR (44) and proliferative diabetic retinopathy (5). When comparing the moderate to severe NPDR groups there was significant difference between mean area of capillary non-perfusion within ETDRS grid (0.07mm2 vs 0.81mm2), 7 standard fields (6.63mm2 vs 16.86 mm2) and entire UWF FA image (15.77mm2 vs 31.88mm2) (p< 0.0001). The proliferative DR group was too small to test for meaningful differences.
Conclusions :
Ultrawide field fluorescein imaging allows for an expanded view of the peripheral capillary network. The area of peripheral capillary non-perfusion increases with severity of diabetic retinopathy, both in central and peripheral retina. Non-perfusion may be an important biomarker of retinal health in diabetic retinopathy prevention studies.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.