Abstract
Purpose :
To examine the relationship between macular leakage on fluorescein angiography (FA) and capillary pericyte density using Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) in eyes with diabetic retinopathy (DR).
Methods :
We evaluated 12 eyes from 12 patients, 2 with no clinical signs of DR, 2 mild nonproliferative DR (NPDR), 4 moderate NPDR, 2 severe NPDR, and 2 quiescent proliferative DR (PDR). Each eye had ultrawide-field FA imaging and AOSLO images obtained within 0-6 months to evaluate leakage and quantify capillary pericytes, respectively. Macular leakage percentage was automatically quantified on late phase FA using a software approach that we validated against manual graders (details in Moonjely et al.; submitted to ARVO 2024). On the AOSLO images, pericytes were quantified along a capillary region of each eye. Pericyte counts were scaled to density per 100 µm of capillary length for statistical analysis.
Results :
Of the 12 study eyes, 9 showed leakage below 1% (low leakage: 0.08 ± 0.13) and the other 3 eyes above 1% (high leakage: 6.77 ± 4.41). Mann-Whitney U test showed that eyes with low leakage had significantly higher capillary pericyte density compared to eyes with high leakage [18.61 ± 4.78 vs 9.37 ± 0.99; p=0.013]. Considering all 12 eyes, we observed a strong, negative correlation between capillary pericyte density and macular leakage using spearman’s correlation (r=-0.661, p=0.019). Additionally, macular leakage strongly correlated to DR severity (r=0.731, p=0.007).
Conclusions :
The relationship between macular leakage and capillary pericyte density suggests that pericyte loss is associated with abnormal permeability of the retinal microvasculature, offering mechanistic insight into the pericytes' role in the pathophysiology of DR.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.