Journal article
Region‐specific ischemia, neovascularization and macular oedema in treatment‐naïve proliferative diabetic retinopathy
Clinical & experimental ophthalmology, v 46(7), pp 757-766
Sep 2018
PMID: 29412501
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Importance
Region‐specific pathology in proliferative diabetic retinopathy enhances our understanding and management of this disease.
Background
To investigate non‐perfusion, neovascularization and macular oedema.
Design
A cross‐sectional, observational, non‐randomized study.
Participants
Consecutive 43 eyes of 27 treatment‐naïve patients.
Methods
Ultra‐widefield fluorescein angiography for studying specific zones, that is, far‐peripheral zone, mid‐peripheral zone and central retina (cr), and spectral‐domain optical coherence tomography for analysing thickness of macular layers.
Main Outcome Measures
Non‐perfusion index (NPI) and neovascularization index (NVI) in different zones, thickness of cr, retinal nerve fibre layer, ganglion cell layer (GCL), inner nuclear layer (INL) and outer plexiform layer in parafoveal regions.
Results
The NPI of far‐periphery and NVI of mid‐periphery were the highest by one‐way analysis of variance testing. Ischemic retina defined as high NPI in far‐periphery was significantly related to macular oedema via a binary classification approach (P < 0.05). The ischemic retina was correlated with a decreased thickness of both retinal nerve fibre and GCL (P < 0.05); macular oedema was correlated with increased INL thickness (P < 0.0001).
Conclusions and Relevance
The region‐specific correlation of NPI of far‐periphery and NVI of mid‐periphery, but not with central retinal thickness, suggests different pathogeneses of neovascularization and macular oedema. Retinal nerve fibre layer and GCL, both biomarkers of diabetic retinal neuronopathy, are associated with retinal ischemia, but not with macular oedema, suggesting that diabetic microangiopathy and neuronopathy possess distinct pathogenic pathways. The strong correlation between macular oedema and INL indicates that intracellular oedema is a determining factor of diabetic macular oedema.
Metrics
Details
- Title
- Region‐specific ischemia, neovascularization and macular oedema in treatment‐naïve proliferative diabetic retinopathy
- Creators
- Jason Lange - Drexel UniversityMajda Hadziahmetovic - Duke UniversityJingfa Zhang - Renji HospitalWeiye Li - Drexel University
- Publication Details
- Clinical & experimental ophthalmology, v 46(7), pp 757-766
- Publisher
- John Wiley & Sons Australia, Ltd
- Number of pages
- 10
- Grant note
- Shanghai Pujiang Program (15PJ1408700) National Natural Science Foundation of China (81570852) Research Fund from the Clear Vision Foundation, Media, Pennsylvania
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Ophthalmology [Historical]
- Web of Science ID
- WOS:000446430300006
- Scopus ID
- 2-s2.0-85043323920
- Other Identifier
- 991019167588304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Ophthalmology