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Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging

BACKGROUND: The aim of our study was to investigate a possible association between macular perfusion status and retinal ischemia and leakage up to far peripheral retinal areas in eyes with early to advanced stages of diabetic retinopathy (DR). METHODS: In a retrospective, cross sectional analysis ul...

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Autores principales: Hajdu, Dorottya, Sedova, Aleksandra, Datlinger, Felix, Hafner, Julia, Steiner, Irene, Kriechbaum, Katharina, Scholda, Christoph, Sacu, Stefan, Schmidt-Erfurth, Ursula, Pollreisz, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640640/
https://www.ncbi.nlm.nih.gov/pubmed/33292856
http://dx.doi.org/10.1186/s40942-020-00253-w
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author Hajdu, Dorottya
Sedova, Aleksandra
Datlinger, Felix
Hafner, Julia
Steiner, Irene
Kriechbaum, Katharina
Scholda, Christoph
Sacu, Stefan
Schmidt-Erfurth, Ursula
Pollreisz, Andreas
author_facet Hajdu, Dorottya
Sedova, Aleksandra
Datlinger, Felix
Hafner, Julia
Steiner, Irene
Kriechbaum, Katharina
Scholda, Christoph
Sacu, Stefan
Schmidt-Erfurth, Ursula
Pollreisz, Andreas
author_sort Hajdu, Dorottya
collection PubMed
description BACKGROUND: The aim of our study was to investigate a possible association between macular perfusion status and retinal ischemia and leakage up to far peripheral retinal areas in eyes with early to advanced stages of diabetic retinopathy (DR). METHODS: In a retrospective, cross sectional analysis ultrawide field (UWF) color fundus photos (Optos, Optomap California) were graded for DR severity. Foveal avascular zone (FAZ) and vessel density from the superficial (SCP) and deep capillary plexus (DCP) were assessed on optical coherence tomography angiography (OCTA) scans (Topcon, DRI-OCT Triton). UWF angiography images were used to quantify leakage/ischemic index and number of microaneurysms (MA). Age, gender, disease duration, type of diabetes, HbA1C, hypertension, complications of diabetes and ocular history were recorded. Univariate mixed models and Spearman correlation analysis were used for statistical testing. RESULTS: 24 eyes of 17 laser-naive diabetic patients with different stages of DR were analyzed. The mean age was 59.56 ± 8.46 years and the mean disease duration 19.65 ± 12.25 years. No statistically significant associations between FAZ size, macular vessel density of SCP/DCP and peripheral retinal ischemia, leakage and MA number were demonstrated. Higher stages of DR were associated with ischemic index (estimate [95% CI]: 13.04 [1.5; 24.5], p = 0.033) and MA count (estimate [95% CI]: 43.7 [15.6; 71.8], p = 0.01), but no association with leakage index was observed. Only weak correlations between DR severity and anamnestic data were found. CONCLUSION: Retinal ischemic index and the amount of MAs assessed on UWFA up to peripheral areas are indicators of DR severity but not related to microvascular perfusion status in the macular region. Significance and timely sequence of macular vessel density in DR progression may need to be re-evaluated in future studies.
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spelling pubmed-76406402020-11-04 Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging Hajdu, Dorottya Sedova, Aleksandra Datlinger, Felix Hafner, Julia Steiner, Irene Kriechbaum, Katharina Scholda, Christoph Sacu, Stefan Schmidt-Erfurth, Ursula Pollreisz, Andreas Int J Retina Vitreous Original Article BACKGROUND: The aim of our study was to investigate a possible association between macular perfusion status and retinal ischemia and leakage up to far peripheral retinal areas in eyes with early to advanced stages of diabetic retinopathy (DR). METHODS: In a retrospective, cross sectional analysis ultrawide field (UWF) color fundus photos (Optos, Optomap California) were graded for DR severity. Foveal avascular zone (FAZ) and vessel density from the superficial (SCP) and deep capillary plexus (DCP) were assessed on optical coherence tomography angiography (OCTA) scans (Topcon, DRI-OCT Triton). UWF angiography images were used to quantify leakage/ischemic index and number of microaneurysms (MA). Age, gender, disease duration, type of diabetes, HbA1C, hypertension, complications of diabetes and ocular history were recorded. Univariate mixed models and Spearman correlation analysis were used for statistical testing. RESULTS: 24 eyes of 17 laser-naive diabetic patients with different stages of DR were analyzed. The mean age was 59.56 ± 8.46 years and the mean disease duration 19.65 ± 12.25 years. No statistically significant associations between FAZ size, macular vessel density of SCP/DCP and peripheral retinal ischemia, leakage and MA number were demonstrated. Higher stages of DR were associated with ischemic index (estimate [95% CI]: 13.04 [1.5; 24.5], p = 0.033) and MA count (estimate [95% CI]: 43.7 [15.6; 71.8], p = 0.01), but no association with leakage index was observed. Only weak correlations between DR severity and anamnestic data were found. CONCLUSION: Retinal ischemic index and the amount of MAs assessed on UWFA up to peripheral areas are indicators of DR severity but not related to microvascular perfusion status in the macular region. Significance and timely sequence of macular vessel density in DR progression may need to be re-evaluated in future studies. BioMed Central 2020-11-04 /pmc/articles/PMC7640640/ /pubmed/33292856 http://dx.doi.org/10.1186/s40942-020-00253-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Article
Hajdu, Dorottya
Sedova, Aleksandra
Datlinger, Felix
Hafner, Julia
Steiner, Irene
Kriechbaum, Katharina
Scholda, Christoph
Sacu, Stefan
Schmidt-Erfurth, Ursula
Pollreisz, Andreas
Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging
title Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging
title_full Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging
title_fullStr Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging
title_full_unstemmed Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging
title_short Association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging
title_sort association of macular perfusion status with microvascular parameters up to the far periphery in diabetic retinopathy using multimodal imaging
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640640/
https://www.ncbi.nlm.nih.gov/pubmed/33292856
http://dx.doi.org/10.1186/s40942-020-00253-w
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