June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Evaluation of Baseline Quantitative Ultra-widefield Leakage Patterns with Angiographic Features, Diabetic Retinopathy Severity and Treatment Response in the PRIME Study
Author Affiliations & Notes
  • Christopher J. Mugnaini
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Gagan Kalra
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Charles Clifton Wykoff
    Retina Consultants of Texas, Houston, Texas, United States
  • Katherine Talcott
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Jamie Reese
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Justis P Ehlers
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Christopher Mugnaini None; Gagan Kalra None; Charles Wykoff Alimera Sciences, Allegro, Allergan, Alynylam, Apellis, Bayer, Clearside, D.O.R.C., EyePoint, Genentech/Roche, Kodiak, Notal Vision, Novartis, ONL Therapeutics, PolyPhotonix, RecensMedical, Regeneron, Regenexbio, Santen, Code C (Consultant/Contractor), Adverum, Allergan, Apellis, Clearside, EyePoint, Genentech/Roche, Neurotech, Novartis, Opthea, Regeneron, Regenxbio, Samsung, Santen, Code F (Financial Support), Regeneron, Code S (non-remunerative); Katherine Talcott Zeiss, Novartis, Regenxbio, Code F (Financial Support); Sunil Srivastava Bausch and Lomb, Adverum, Novartis, Regeneron, Code C (Consultant/Contractor), Regeneron, Allergan, Gilead, Code F (Financial Support), Leica, Code P (Patent); Jamie Reese None; Justis Ehlers Aerpio, Alcon, Allegro, Allergan, Genentech/Roche, Novartis, Thrombogenics/Oxurion, Leica, Ziess, Regeneron, Santen, Stealth, Adverum, IvericBio, Apellis, Boehringer-Ingelheim, Regenxbio, Code C (Consultant/Contractor), Aerpio, Alcon, Thrombogenics/Oxurion, Regeneron, Genentech, Novartis, Allergan, Boehringer-Ingelheim, IvericBio, Adverum, Code F (Financial Support), Leica, Code P (Patent)
  • Footnotes
    Support  NIH-NEI P30 Core Grant (IP30EY025585) (Cole Eye), Unrestricted Grants from The Research to Prevent Blindness, Inc (Cole Eye), Cleveland Eye Bank Foundation awarded to the Cole Eye Institute (Cole Eye), K23-EY022947-01A1 (JPE), Grant from Regeneron
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2172 – F0235. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Christopher J. Mugnaini, Gagan Kalra, Charles Clifton Wykoff, Katherine Talcott, Sunil K Srivastava, Jamie Reese, Justis P Ehlers; Evaluation of Baseline Quantitative Ultra-widefield Leakage Patterns with Angiographic Features, Diabetic Retinopathy Severity and Treatment Response in the PRIME Study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2172 – F0235.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : To examine the relationship between leakage patterns, quantitative ultra-wide field fluorescein angiography (qUWFA) parameters, diabetic retinopathy severity score (DRSS) and measures of treatment response using baseline images in the PRIME study.

Methods : The PRIME study is a prospective randomized trial. Baseline angiograms were analyzed using an automated machine learning platform to acquire qUWFA parameters including perivascular leakage index (PLI), general leakage index (GLI), microaneurysm (MA) count, and ischemic index for both panretinal and macular regions. Perivascular leakage was identified as leakage within 5 pixels of the segmented blood vessel wall. General leakage was classified exclusively as leakage which exceeded the 5 pixel distance from the segmented blood vessel wall. PLI and GLI were correlated with other qUWFA metrics and measures of treatment response including the time required for 2-step DRSS improvement. The baseline DRSS score was used to sort eyes into severe non-proliferative (NPDR) and proliferative (PDR) DR groups. Time until 2-step improvement was used to sort eyes into ≤16 weeks and >16 weeks groups. Mean LIs were compared between NPDR, PDR, ≤16 weeks and >16 weeks groups using Student’s t-test.

Results : Thirty-eight eyes were included for this analysis. Panretinal PLI correlated positively with total MA count (r=0.32, p=0.04) and panretinal ischemic index (r=0.39, p=.01). Panretinal GLI positively correlated with macular MA count (r=0.40, p=0.009) and panretinal ischemic index (r=0.39, 0.01). Severe NPDR eyes had a greater macular PLI compared to PDR eyes (4.5% vs 2.8%, p=0.035), however there was no significant difference between groups for other leakage parameters. Eyes requiring >16 weeks of monthly therapy for achieving 2 step DRSS improvement had a greater baseline panretinal GLI than eyes in ≤16 weeks group (2.8% vs 1.9%, p=0.026).

Conclusions : Perivascular and general leakage patterns appeared to be uniquely linked to different angiographic and DR-related variables. The ability to quantify and discriminate between these leakage types may provide important information regarding additional DR features and should be further explored for prognostic significance.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

×
×

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.

×