Journal article
Reassessment of arterial versus venous perfusion of diabetic retinal neovascularization using ultrawide-field fluorescein angiography
Graefe's archive for clinical and experimental ophthalmology, Vol.263(2), pp.361-368
02/2025
DOI: 10.1007/s00417-024-06650-3
PMID: 39377805
Abstract
The purpose of this study was to assess whether diabetic NV is perfused by the arterial or the venous circulation.
This is a retrospective, consecutive case series evaluating patients with proliferative diabetic retinopathy (PDR) imaged with ultrawide-field (UWF) fluorescein angiography (FA). Areas of neovascularization elsewhere (NVE) and neovascularization of the disc (NVD) were assessed. Perfusion was defined as arterial, arteriovenous, or venous if the area of diabetic neovascularization (NV) began to hyperfluoresce either prior, during, or after laminar venous flow, respectively.
A total of 180 eyes from 176 patients with 928 NV were identified (830 NVE, 98 NVD). Of those, 5.1% of NVE were classified as arterial and 58.2% of NVD were classified as arterial. The remaining NV were classified as arteriovenous except for a small subset (6.1%) which were indeterminate. None of the NV were classified as venous. Noteworthy examples demonstrated NV that nearly fully perfused prior to any detectable fluorescence within nearby veins as well as clear shunting of blood from a feeding artery to a draining vein.
UWF FA images suggest that some NV is perfused by retinal arteries. This may be useful in devising strategies for early detection and treatment of NV precursors.
What is known • Diabetic retinal neovascularization has long been thought to be perfused by the retinal venous circulation. • Vascular endothelial growth factor has been shown to play key roles in both angiogenesis and arteriogenesis. What is new • Ultrawide-field fluorescein angiography demonstrates that at least some diabetic neovascularization is perfused by the retinal arterial circulation. • This supports the hypothesis that diabetic neovascularization may arise from arterially-perfused intraretinal microvascular abnormalities in the capillary bed.
Details
- Title: Subtitle
- Reassessment of arterial versus venous perfusion of diabetic retinal neovascularization using ultrawide-field fluorescein angiography
- Creators
- Benjamin R Lin - Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USAPiero Carletti - Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USAJonathan Yi - Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USAPhilip J Rosenfeld - Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida, USAJonathan F Russell - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Graefe's archive for clinical and experimental ophthalmology, Vol.263(2), pp.361-368
- DOI
- 10.1007/s00417-024-06650-3
- PMID
- 39377805
- NLM abbreviation
- Graefes Arch Clin Exp Ophthalmol
- ISSN
- 0721-832X
- eISSN
- 1435-702X
- Publisher
- SPRINGER
- Grant note
- National Eye Institute Center Core Grant: P30EY014801
Research supported by grants from Carl Zeiss Meditech, Inc., an unrestricted grant from the Research to Prevent Blindness, Inc. (New York, NY), and the National Eye Institute Center Core Grant (P30EY014801) to the Department of Ophthalmology, University of Miami Miller School of Medicine. The funding organizations had no role in the design or conduct of the present research.
- Language
- English
- Electronic publication date
- 10/08/2024
- Date published
- 02/2025
- Academic Unit
- Ophthalmology and Visual Sciences
- Record Identifier
- 9984723056802771
Metrics
1 Record Views