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Ocena stref niedokrwiennych siatkówki obwodowej za pomocą szerokokątnej angiografii fluoresceinowej u chorych na retinopatię cukrzycową
Peripheral Retinal Ischemic Zones Assessment Using Ultra-widefield Fluorescein Angiography in Patients with Diabetic Retinopathy
Bogumiła Sędziak-Marcinek, Sławomir Teper, Magdalena Hunt, Edward Wylęgała
Katedra i Oddział Kliniczny Okulistyki Szpitala Kolejowego w Katowicach, Wydział Lekarsko-Dentystyczny w Zabrzu,
Śląski Uniwersytet Medyczny w Katowicach
Kierownik: prof. dr hab. n. med. Edward Wylęgała
Summary: Purpose: The aim of the study is to present the use of ultra-wide-field fluorescein angiography in detection of peripheral retinal ischemic zones in patients with diabetic retinopathy.
Material and Methods: 43 patients from the Ophthalmic Clinic of the District Railway Hospital in Katowice who came with a diagnosis of diabetic retinopathy and diabetic macular edema were enrolled to the study. The patients underwent assessment of the fundus in the slit lamp, best corrected visual acuity, OCT Optical Coherence Tomography scan (Triton, Topcon) and ultra-widefield fluorescein angiography using the widefield ophthalmoscope, California Optos. The obtained angiographic images were then analyzed with the evaluation of peripheral retinal ischemic zones (ISI – Ischaemic Index, NPA – Nonperfusion Area). Patients were qualified for further treatment depending on the severity of diabetic retinopathy and peripheral ischemic zones.
Results: 86 photos of the UWA-FA ultra-wide-field fluorescein angiography of 86 eyes were enrolled to the analysis of the ischemic areas of the retina. In 66 eyes, ischemic areas were found, in 20 eyes no ischemic areas were found. The average age of patients was 64.4 years (58–84 years), including 20 women and 23 men, 3 patients with type 1 diabetes and 40 patients with type 2 diabetes. The average best corrected visual acuity value was 0.52 ± 0.23, the average central retinal thickness was 425 ± 62 µm. The average ischaemic index value was 13.2% ± 10%, the average nonperfusion area value was 153 ± 121 mm2.
Conclusions: Ultra wide-field fluorescein angiography is an effective tool for assessing retinal ischemic areas in diabetic retinopathy. Ultra-wide imaging allows to evaluate the retinal far-periphery areas which provide a number of important information about diabetic retinopathy and prognosis in diabetic macular edema.
Słowa kluczowe: retinopatia cukrzycowa, cukrzyca, szerokokątna angiografia fluoresceinowa, cukrzycowy obrzęk plamki, niedokrwienie siatkówki obwodowej.
Keywords: diabetic retinopathy, diabetes, wide-field fluorescein angiography, diabetic macular edema, peripheral retinal ischemia.