Invest Ophthalmol Vis SciMarch 201545 citations

Disorganized retinal lamellar structures in nonperfused areas of diabetic retinopathy.

Dodo Yoko, Murakami Tomoaki, Uji Akihito, Yoshitake Shin, Yoshimura Nagahisa

View on PubMed DOI: 10.1167/iovs.14-15924

AI Summary

This study found that nonperfused areas in diabetic retinopathy consistently show a blurred boundary between retinal layers on OCT, indicating structural damage linked to vision loss.

Abstract

Purpose

To investigate morphologic changes on spectral-domain optical coherence tomography (SD-OCT) images in nonperfused areas (NPAs) in diabetic retinopathy (DR).

Methods

One hundred eight consecutive eyes of 80 patients with diabetic ischemic maculopathy were retrospectively reviewed. The boundary between the nerve fiber layer (NFL) and the ganglion cell layer (GCL)/inner plexiform layer (IPL) and the status of Henle's layer were characterized on the vertical sectional images of SD-OCT. These findings were compared with the NPAs on the FA images and the logMAR visual acuity (VA).

Results

The SD-OCT images showed that most areas of capillary nonperfusion had an indistinct boundary between the NFL and GCL/IPL in DR, regardless of high or moderate OCT reflectivity. The total transverse length of the NPAs was correlated positively with that of the areas with no boundary between these layers in all 108 eyes (R = 0.860, P < 0.001). Sixty-four eyes that had center-involved diabetic macular edema (DME) also had a significant association between them (R = 0.764, P < 0.001), and the most significant correlation was seen in eyes without DME (R = 0.955, P < 0.001). The macular transverse length of the areas with no boundary between the NFL and GCL/IPL was associated modestly with the logMAR VA (R = 0.334, P < 0.001). The indistinct Henle's layer on SD-OCT images often was delineated specifically in the NPAs rather than in the perfused areas.

Conclusions

Nonperfused areas were associated significantly with the absence of a boundary between the NFL and GCL/IPL on SD-OCT images in DR.

MeSH Terms

AdultAgedAged, 80 and overDiabetic RetinopathyFemaleFluorescein AngiographyHumansIschemiaMaleMiddle AgedNerve FibersRetinal Ganglion CellsRetrospective StudiesTomography, Optical CoherenceVisual Acuity

Shields Classification

Ch. 4Optic Nerve, Retina, and Choroid

Ch. 19Glaucomas Associated with Disorders of the Retina, Vitreous, and Choroid

Key Concepts6

Most areas of capillary nonperfusion in diabetic retinopathy (DR) showed an indistinct boundary between the nerve fiber layer (NFL) and ganglion cell layer (GCL)/inner plexiform layer (IPL) on spectral-domain optical coherence tomography (SD-OCT) images, regardless of high or moderate OCT reflectivity.

DiagnosisCohortRetrospective Cohort Studyn=108 eyes of 80 patients with diabetic…Ch5

The total transverse length of nonperfused areas (NPAs) correlated positively with the total transverse length of areas with no boundary between the nerve fiber layer (NFL) and ganglion cell layer (GCL)/inner plexiform layer (IPL) in 108 eyes with diabetic ischemic maculopathy (R = 0.860, P < 0.001).

PrognosisCohortRetrospective Cohort Studyn=108 eyes of 80 patients with diabetic…Ch5

In 64 eyes with center-involved diabetic macular edema (DME), there was a significant association between the total transverse length of nonperfused areas (NPAs) and the total transverse length of areas with no boundary between the nerve fiber layer (NFL) and ganglion cell layer (GCL)/inner plexiform layer (IPL) (R = 0.764, P < 0.001).

PrognosisCohortRetrospective Cohort Studyn=64 eyes with center-involved diabetic…Ch5

The most significant correlation between the total transverse length of nonperfused areas (NPAs) and the total transverse length of areas with no boundary between the nerve fiber layer (NFL) and ganglion cell layer (GCL)/inner plexiform layer (IPL) was observed in eyes without diabetic macular edema (DME) (R = 0.955, P < 0.001).

PrognosisCohortRetrospective Cohort Studyn=Subset of 108 eyes without diabetic m…Ch5

The macular transverse length of areas with no boundary between the nerve fiber layer (NFL) and ganglion cell layer (GCL)/inner plexiform layer (IPL) was modestly associated with the logMAR visual acuity (VA) in 108 eyes with diabetic ischemic maculopathy (R = 0.334, P < 0.001).

PrognosisCohortRetrospective Cohort Studyn=108 eyes of 80 patients with diabetic…Ch5Ch7

Indistinct Henle's layer on spectral-domain optical coherence tomography (SD-OCT) images was often delineated specifically in nonperfused areas (NPAs) rather than in perfused areas in diabetic retinopathy (DR).