Association of Diabetic Lesions and Retinal Nonperfusion Using Widefield Multimodal Imaging.
| Autor: | Stino H; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Huber KL; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Niederleithner M; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Mahnert N; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Sedova A; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Schlegl T; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Steiner I; Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria., Sacu S; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Drexler W; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Schmoll T; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; Carl Zeiss Meditec, Inc., Dublin, California., Leitgeb R; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria., Schmidt-Erfurth U; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria., Pollreisz A; Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Electronic address: andreas.pollreisz@meduniwien.ac.at. |
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| Jazyk: | angličtina |
| Zdroj: | Ophthalmology. Retina [Ophthalmol Retina] 2023 Dec; Vol. 7 (12), pp. 1042-1050. Date of Electronic Publication: 2023 Jul 28. |
| DOI: | 10.1016/j.oret.2023.07.020 |
| Abstrakt: | Purpose: To evaluate the association of microvascular lesions on ultrawidefield (UWF) color fundus (CF) images with retinal nonperfusion (RNP) up to the midperiphery on single-capture widefield (WF) OCT angiography (OCTA) in patients with diabetic retinopathy (DR). Design: Cross-sectional study. Subjects: Seventy-five eyes of 50 patients with mild to severe nonproliferative DR (NPDR) and proliferative DR (PDR) were included in this analysis. Methods: ETDRS level and presence of predominantly peripheral lesions (PPLs) were assessed on UWF-CF images acquired with a Zeiss Clarus 700. Single-capture 65°-WF-OCTA was performed using a PlexElite prototype (Carl Zeiss Meditec, Inc.). A custom grid consisting of a central ETDRS grid extended by 2 rings reaching up to the midperiphery was overlaid to subdivide retinal areas visible on WF-OCTA en face images. Retinal nonperfusion was measured in each area and in total. Nonperfusion index (NPI) was calculated from total RNP. On UWF-CF images, the number of microaneurysms, hemorrhages, neovascularizations, and areas with intraretinal microvascular abnormalities (IRMAs) were evaluated using the same grid. Main Outcome Measures: Association of diabetic lesions with RNP was calculated using Spearman correlations (r Results: Median RNP on WF-OCTA was 0 mm 2 (0-0.9), 4.9 mm 2 (1.9-5.4), 23.4 mm 2 (17.8-37), and 68.4 mm 2 (40.8-91.7) in mild, moderate, and severe NPDR and PDR, respectively. We found a statistically significant correlation (P < 0.01) of overall RNP (r Conclusion: The combination of UWF-CF imaging and single-capture WF-OCTA allows precise and noninvasive analysis of the retinal vasculature up to the midperiphery in patients with DR. The presence and extent of IRMAs on CF images may serve as an indicator for underlying RNP, which is more pronounced in eyes with PPLs. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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