Quantitative Ultra-Widefield Angiography and Diabetic Retinopathy Severity

Ehlers, Justis P.; Jiang, Alice; Boss, Joseph; Hu, Ming; Figueiredo, Natália; Babiuch, Amy; Talcott, Katherine E.; Sharma, Sumit; Hach, Jenna; Le, Thuy; Rogozinski, Alison; Lunasco, Leina; Reese, Jamie; Srivastava, Sunil K.

doi:10.1016/j.ophtha.2019.05.034

Cited by 80 publications

(42 citation statements)

References 20 publications

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“…Diabetic retinopathy (DR) is a diabetes complication that affects eyes which can eventually cause blindness. It is well known that DR causes peripheral non-perfusion and late peripheral leakage, which later progresses to the central macular area, and thereby suggests an abnormal regulation of blood flow in the diabetic retina [10,11]. Nonetheless, topographic differences of perivascular mural cells in the normal and diseased retina have not yet been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Alpha-Smooth Muscle Actin-Positive Perivascular Cells in Diabetic Retina and Choroid

Kim

Choi

et al. 2020

IJMS

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Structural alterations of pericytes in microvessels are important features of diabetic retinopathy. Although capillary pericytes had been known not to have α-smooth muscle actin (αSMA), a recent study revealed that a specific fixation method enabled the visualization of αSMA along retinal capillaries. In this study, we applied snap-fixation in wild type and streptozotocin-induced diabetic mice to evaluate the differences in vascular smooth muscle cells of the retina and the choroid. Mice eyeballs were fixed in ice-cold methanol to prevent the depolymerization of filamentous actin. Snap-fixated retina showed αSMA expression in higher-order branches along the capillaries as well as the arterioles and venules, which were not detected by paraformaldehyde fixation. In contrast, most choriocapillaris, except those close to the arterioles, were not covered with αSMA-positive perivascular mural cells. Large choroidal vessels were covered with more αSMA-positive cells in the snap-fixated eyes. Diabetes induced less coverage of αSMA-positive perivascular mural cells overall, but they reached higher-order branches of the retinal capillaries, which was prominent in the aged mice. More αSMA-positive pericytes were observed in the choroid of diabetic mice, but the αSMA-positive expression reduced with aging. This study suggests the potential role of smooth muscle cells in the pathogenesis of age-related diabetic retinopathy and choroidopathy.

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Section: Introductionmentioning

confidence: 99%

Alpha-Smooth Muscle Actin-Positive Perivascular Cells in Diabetic Retina and Choroid

Kim

Choi

et al. 2020

IJMS

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“…Based on the classification, the following nomenclature was used: no, mild, moderate, and severe non-proliferative diabetic retinopathy (NPDR). UWFA images were evaluated to identify the number of MAs, ischemic index and leakage index, according to the method of a previous study from Ehlers et al [ 13 ] The region of interest (ROI) was defined as a gradable area without artifacts and eyelashes (see Fig. 2 ).…”

Section: Methodsmentioning

confidence: 99%

“…This technology can be combined with fluorescein (FA) and indocyanine green angiography depicting the same field of view [ 10 ]. Previous studies analyzed angiographic features on UWFA, like ischemic index and leakage index, and found significant correlations with DR severity [ 11 – 13 ]. The panretinal evaluation of DR including angiographic features based on FA provides a more comprehensive picture of the disease and has a potential to predict outcomes and prognosis [ 10 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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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“…Neben diesen Aspekten sollen im Folgenden außerdem auch neue diagnostische Modalitäten wie die OCT-Angiografie und Weitwinkelangiografie bei Indikationsstellung und Monitoring einer Therapie des diabetischen Makulaödems angesprochen werden [45]. Außerdem soll dieser Text die aktualisierten Kernaussagen ergänzen, indem er Daten einordnet, die für die Bewertung der verschiedenen Substanzgruppen und Präparate in der Differenzialtherapie des diabetischen Makulaödems hilfreich sein können.…”

Section: Hintergrundunclassified

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

2020

Klin Monatsbl Augenheilkd

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Quantitative Ultra-Widefield Angiography and Diabetic Retinopathy Severity

Cited by 80 publications

References 20 publications

Alpha-Smooth Muscle Actin-Positive Perivascular Cells in Diabetic Retina and Choroid

Alpha-Smooth Muscle Actin-Positive Perivascular Cells in Diabetic Retina and Choroid

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

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

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