Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography
Purpose: To analyze the topographic distribution of neovascularization (NV) and capillary nonperfusion (CNP) using ultra-wide field fluorescein angiography (UWFFA) in patients with proliferative diabetic retinopathy (PDR). Methods: This was a prospective, single-center, observational study in which...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=8;spage=3080;epage=3084;aulast=Nidhi |
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| author | Vatsala Nidhi Saurabh Verma Nawazish Shaikh Shorya V Azad Rohan Chawla Pradeep Venkatesh Rajpal Vohra Vinod Kumar |
| author_facet | Vatsala Nidhi Saurabh Verma Nawazish Shaikh Shorya V Azad Rohan Chawla Pradeep Venkatesh Rajpal Vohra Vinod Kumar |
| author_sort | Vatsala Nidhi |
| collection | DOAJ |
| description | Purpose: To analyze the topographic distribution of neovascularization (NV) and capillary nonperfusion (CNP) using ultra-wide field fluorescein angiography (UWFFA) in patients with proliferative diabetic retinopathy (PDR). Methods: This was a prospective, single-center, observational study in which all patients who presented between March 2019 and December 2020 and satisfied the inclusion criteria were recruited. In our study, patients with treatment-naïve PDR without any fibrovascular proliferation underwent UWFFA. The images were analyzed qualitatively for the topographic distribution of NV and the CNP area was quantified. The number of lesions picked by UWFFA was compared with 7 standard field (7SF) image using overlay of 7SF. The main outcome measure was characteristics of neovascularization, such as the number, location, and area of CNP, measured using UWFFA, which was considered with 95% confidence intervals (CI). Results: Two hundred and fifty-three eyes of 187 patients with a mean age of 56.03 ± 8 years were included. Mean neovascularization elsewhere (NVE) was 2.91 ± 3.43. Maximum NVEs were seen in the superotemporal (ST; 0.9 ± 1.13) quadrant, followed by the inferotemporal (IT; 0.7 ± 1.08), inferonasal (IN; 0.66 ± 1.02) and superonasal (SN; 0.66 ± 1.01) quadrants. Maximum CNP area was seen in the SN (13.75 ± 8.83 disc diameter square [DD2]) quadrant, followed by the IN (13.48 ± 8.59 DD2), IT (11.34 ± 8.37 DD2), and ST (11.3 ± 8.34 DD2) quadrants. Mean CNP area was maximum in patients with only neovascularization of disc (NVD; 64.99 ± 41.47 DD2), followed by both NVD and NVE (61.37 ± 35.61 DD2), and was minimum in patients with only NVE (36.44 ± 22.03 DD2). Eighty-one (32%) eyes out of 253 had NVE and 189 (75%) out of 253 had CNP area outside 7SF (overlay) of Early Treatment Diabetic Retinopathy Study (ETDRS). Conclusion: Diabetic NV lesions and CNP areas are distributed asymmetrically throughout the retina and are not restricted to the posterior pole. Compared to conventional 7SF imaging, UWFFA reveals significantly more retinal vascular pathology in patients with PDR. |
| first_indexed | 2024-03-11T15:45:12Z |
| format | Article |
| id | doaj.art-7733bbc7961346e69e6712577fe03c48 |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-03-11T15:45:12Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
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| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-7733bbc7961346e69e6712577fe03c482023-10-26T06:49:07ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892023-01-017183080308410.4103/IJO.IJO_3285_22Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiographyVatsala NidhiSaurabh VermaNawazish ShaikhShorya V AzadRohan ChawlaPradeep VenkateshRajpal VohraVinod KumarPurpose: To analyze the topographic distribution of neovascularization (NV) and capillary nonperfusion (CNP) using ultra-wide field fluorescein angiography (UWFFA) in patients with proliferative diabetic retinopathy (PDR). Methods: This was a prospective, single-center, observational study in which all patients who presented between March 2019 and December 2020 and satisfied the inclusion criteria were recruited. In our study, patients with treatment-naïve PDR without any fibrovascular proliferation underwent UWFFA. The images were analyzed qualitatively for the topographic distribution of NV and the CNP area was quantified. The number of lesions picked by UWFFA was compared with 7 standard field (7SF) image using overlay of 7SF. The main outcome measure was characteristics of neovascularization, such as the number, location, and area of CNP, measured using UWFFA, which was considered with 95% confidence intervals (CI). Results: Two hundred and fifty-three eyes of 187 patients with a mean age of 56.03 ± 8 years were included. Mean neovascularization elsewhere (NVE) was 2.91 ± 3.43. Maximum NVEs were seen in the superotemporal (ST; 0.9 ± 1.13) quadrant, followed by the inferotemporal (IT; 0.7 ± 1.08), inferonasal (IN; 0.66 ± 1.02) and superonasal (SN; 0.66 ± 1.01) quadrants. Maximum CNP area was seen in the SN (13.75 ± 8.83 disc diameter square [DD2]) quadrant, followed by the IN (13.48 ± 8.59 DD2), IT (11.34 ± 8.37 DD2), and ST (11.3 ± 8.34 DD2) quadrants. Mean CNP area was maximum in patients with only neovascularization of disc (NVD; 64.99 ± 41.47 DD2), followed by both NVD and NVE (61.37 ± 35.61 DD2), and was minimum in patients with only NVE (36.44 ± 22.03 DD2). Eighty-one (32%) eyes out of 253 had NVE and 189 (75%) out of 253 had CNP area outside 7SF (overlay) of Early Treatment Diabetic Retinopathy Study (ETDRS). Conclusion: Diabetic NV lesions and CNP areas are distributed asymmetrically throughout the retina and are not restricted to the posterior pole. Compared to conventional 7SF imaging, UWFFA reveals significantly more retinal vascular pathology in patients with PDR.http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=8;spage=3080;epage=3084;aulast=Nidhicapillary nonperfusionneovascularizationneovascularization at discproliferative diabetic retinopathyultra-wide field fluorescein angiography |
| spellingShingle | Vatsala Nidhi Saurabh Verma Nawazish Shaikh Shorya V Azad Rohan Chawla Pradeep Venkatesh Rajpal Vohra Vinod Kumar Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography Indian Journal of Ophthalmology capillary nonperfusion neovascularization neovascularization at disc proliferative diabetic retinopathy ultra-wide field fluorescein angiography |
| title | Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography |
| title_full | Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography |
| title_fullStr | Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography |
| title_full_unstemmed | Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography |
| title_short | Topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra-wide field angiography |
| title_sort | topographic distribution of retinal neovascularization in proliferative diabetic retinopathy using ultra wide field angiography |
| topic | capillary nonperfusion neovascularization neovascularization at disc proliferative diabetic retinopathy ultra-wide field fluorescein angiography |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2023;volume=71;issue=8;spage=3080;epage=3084;aulast=Nidhi |
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