Association of the Pattern of Retinal Capillary Non-Perfusion and Vascular Leakage with Retinal Neovascularization in Proliferative Diabetic Retinopathy

Eric E Jung; Michelle Lin; Christine Ryu; Stavros N Moysidis; Bruce Burkemper; Rajan Murgai; Amirmohsen Arbabi; Hossein Ameri

doi:10.4103/JOCO.JOCO_234_20

Association of the Pattern of Retinal Capillary Non-Perfusion and Vascular Leakage with Retinal Neovascularization in Proliferative Diabetic Retinopathy

J Curr Ophthalmol. 2021 Mar 26;33(1):56-61. doi: 10.4103/JOCO.JOCO_234_20. eCollection 2021 Jan-Mar.

Authors

Eric E Jung¹, Michelle Lin¹, Christine Ryu¹, Stavros N Moysidis¹, Bruce Burkemper¹, Rajan Murgai¹, Amirmohsen Arbabi¹, Hossein Ameri¹

Affiliation

¹ Department of Ophthalmology, USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Abstract

Purpose: To explore the correlation between retinal capillary non-perfusion and the distribution of retinal neovascularization and vascular leakage (VL) in patients with proliferative diabetic retinopathy (PDR).

Methods: Ultra-widefield angiograms of 96 eyes of 69 patients with PDR were reviewed for the proportion of non-perfused area to total gradable area, and for the presence of neovascularization and VL.

Results: Retinal neovascularization was distributed as such: neovascularization elsewhere (NVE), 57.3%; neovascularization of the disc (NVD), 11.5%; both neovascularization of the disc and elsewhere (NVED), 31.3%. The proportion of non-perfused retina, so-called ischemic index, was greater in eyes with NVED compared to eyes with NVE only, but not when compared to NVD only. Overall, 83% of eyes had VL. The presence and the extent of VL correlated with the proportion of the ischemic index. While VL and ischemic index were more severe in the mid-periphery and far-periphery, the majority of NVE was located in the posterior pole.

Conclusions: The presence of both NVD and NVE is associated with a greater ischemic index than NVE alone. Although both VL and ischemic index is significantly higher in peripheral zones, the majority of neovascularization occurs at the posterior pole.

Keywords: Diabetic retinopathy; Neovascularization; Retinal ischemia; Retinal vasculitis; Ultra-widefield fluorescein angiography; Ultra-widefield imaging; Vascular leakage.