Abstract
Purpose
To determine the relationship between baseline retinal non-perfusion area (NPA) and retinal vascular bed area (RVBA) on ultra-wide field fluorescein angiography (UWF FA) and long-term response to intravitreal ranibizumab therapy in diabetic macular oedema (DMO).
Methods
A post-hoc, 2-year observational case series. Baseline UWF FA images (Optos 200Tx) of 40 eyes from 29 patients with diabetes mellitus and treatment naïve DMO in the DAVE (NCT01552408) study were montaged and stereographically projected at the Doheny Image Reading Center to adjust for peripheral distortion. The retinal vasculature was automatically extracted to calculate RVBA. NPA was manually delineated by two masked certified graders. RVBA and NPA were computed in mm2 automatically by adjusting for peripheral distortion and then correlated with the severity of DMO.
Results
While global NPA at baseline was not correlated to retinal thickness measurements, baseline NPA in the superior retina was associated with the macular volume (MV) improvement (P = 0.022). Multivariate analysis revealed a smaller RVBA at baseline was correlated with a better MV outcome at two-year follow-up after adjusting for confounding factors (P = 0.049).
Conclusion
Eyes with smaller baseline RVBA appear to have a better long-term anatomic outcome of DMO.
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Funding
MI reported receiving grants, personal fees, or nonfinancial support from Thrombogenics, Omeros, Boehringer Ingelheim, and Genentech. SRS reported receiving grants, personal fees, or nonfinancial support from Carl Zeiss Meditec, Optos, Allergan, Genentech, Alcon, Novartis, Roche, Regeneron, Bayer, Thrombogenics, StemCells Inc, and Avalanche. The research presented by WF received support from the National Natural Science Foundation of China (Grant No. 81900863).
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WF and MI had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: WF and MI. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: WF. Critical revision of the manuscript for important intellectual content: WF and MI. Statistical analysis: WF. Administrative, technical, or material support: CCW, DMB and SRS. Study supervision: WF and MI.
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Fan, W., Uji, A., Wykoff, C.C. et al. Baseline retinal vascular bed area on ultra-wide field fluorescein angiography correlates with the anatomical outcome of diabetic macular oedema to ranibizumab therapy: two-year analysis of the DAVE Study. Eye 37, 678–683 (2023). https://doi.org/10.1038/s41433-021-01777-7
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DOI: https://doi.org/10.1038/s41433-021-01777-7
