Symmetry of Peripheral Retinal Nonperfusion by Ischemic Index

Title Symmetry of Peripheral Retinal Nonperfusion by Ischemic Index
Author, Co-Author Ashley Speilburg, Bruce Teitelbaum, Yi Pang, Shaun Ittiara
Topic Treatment and Management of Posterior Sgmt Disease
Year
2016
Day
Thursday
Program Number
165153
Room
Ballroom A-B
Affiliation
Illinois College of Optometry
Abstract Purpose: Diabetic retinopathy is a bilateral disease, yet there is very little in the literature evaluating the symmetry of diabetic retinopathy (DR). Recently there has been increasing interest in peripheral retinal involvement in DR. Predominantly peripheral lesions have been associated with an increased risk of progression of DR and are hypothesized to come from underlying capillary nonperfusion. Ultra-widefield fluorescein angiography (UWFA) allows for improved evaluation of peripheral capillary function. The purpose of this study was to evaluate the symmetry of peripheral retinal ischemia in patients with diabetic retinopathy.  

Methods: In this cross-sectional, prospective study, 58 subjects (age: 26 – 87 years) with DR were enrolled. No patients had prior panretinal photocoagulation. UWFA images were obtained on both eyes using Optos C200 scanning laser ophthalmoscope. An ischemic index (ISI) was calculated using the area measurement function in the V2 Vantage Review Software (Optos, PLC). Spearman correlation was performed to measure the correlation in ISI between right and left eyes. Mann-Whitney test was used to test the difference in ISI between the two eyes.
 
Results: Mean (+ standard deviation) ISI in the right eye was 11.27 ± 10.19 and in the left eye was 11.64 ± 11.74. Median ISI in the right eye was 6.73 and 6.94 in the left.  The mean difference in ISI between the right and left eye was 4.46 ± 6.09 and the median difference was 6.09.  In addition, 92.6% of subjects had a difference of 10% or less and 72.2% had a difference of 5% or less between the two eyes.  A statistically significant correlation was found in the ISI between right and left eyes (rs = 0.80, p = < 0.0001). There was no statistically significant difference in ISI between the right and left eyes (p = 0.85).

Conclusion: We found that peripheral retinal ischemia measured by the ISI was symmetrical between right and left eyes in patients with DR.
Affiliation of Co-Authors Illinois College of Optometry, Illinois College of Optometry, Retinal Vitreal Consultants, Ltd.
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