Peripheral and central capillary non-perfusion in diabetic retinopathy: An updated overview

Alessio Antropoli; Alessandro Arrigo; Lamberto La Franca; Lorenzo Bianco; Eugenio Barlocci; Emanuele Fusi; Francesco Bandello; Maurizio Battaglia Parodi

doi:10.3389/fmed.2023.1125062

Peripheral and central capillary non-perfusion in diabetic retinopathy: An updated overview

Front Med (Lausanne). 2023 Mar 23:10:1125062. doi: 10.3389/fmed.2023.1125062. eCollection 2023.

Authors

Alessio Antropoli¹, Alessandro Arrigo¹, Lamberto La Franca¹, Lorenzo Bianco¹, Eugenio Barlocci¹, Emanuele Fusi¹, Francesco Bandello¹, Maurizio Battaglia Parodi¹

Affiliation

¹ Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Abstract

Capillary non-perfusion (CNP) is one of the key hallmarks of diabetic retinopathy (DR), which may develop both in the periphery and at the posterior pole. Our perspectives on CNP have extended with the introduction of optical coherence tomography angiography (OCTA) and ultra-widefield imaging, and the clinical consequences of peripheral and macular CNP have been well characterized. Fluorescein angiography (FA) continues to be the gold standard for detecting and measuring CNP, particularly when ultra-widefield imaging is available. OCTA, on the other hand, is a quicker, non-invasive approach that allows for a three-dimensional examination of CNP and may soon be regarded as an useful alternative to FA. In this review, we provide an updated scenario regarding the characteristics, clinical impact, and management of central and peripheral CNP in DR.

Keywords: diabetic macular ischemia; diabetic retinopathy; fluorescein angiography (FA); optical coherence tomography angiography (OCTA); peripheral capillary non-perfusion.

Publication types

Review