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Observational Study
. 2020 Dec 1;20(1):471.
doi: 10.1186/s12886-020-01740-2.

Differential distribution of manifest lesions in diabetic retinopathy by fundus fluorescein angiography and fundus photography

Xiaoli Li  1   2 , Jie Xie  1 , Liang Zhang  1 , Ying Cui  1 , Guanrong Zhang  3 , Jun Wang  1 , Aiping Zhang  1 , Xiangting Chen  1 , Tian Huang  1   4 , Qianli Meng  5   6
Affiliations
Observational Study

Differential distribution of manifest lesions in diabetic retinopathy by fundus fluorescein angiography and fundus photography

Xiaoli Li et al. BMC Ophthalmol. .

Abstract

Background: To analyze the distribution of manifest lesions of diabetic retinopathy (DR) by fundus fluorescein angiography (FFA) and color fundus photography (FP).

Methods: A total of 566 eyes of 324 Chinese patients diagnosed with DR were included in this retrospective study. DR severity was graded by the international grading criterion. The distributions of microaneurysms (MA), intraretinal hemorrhages/exudates (He/Ex), intraretinal microvascular abnormality (IRMA), capillary nonperfusion areas (NPA), and neovascularization (NV) were estimated by multiple logistic regression analyse based on nine-field FFA and FP images.

Results: In mild nonproliferative diabetic retinopathy (NPDR), the highest frequency of MA was found in the posterior pole (67.7%), followed by the inferior nasal (59.4%), and the nasal (55.4%) fields. In moderate NPDR, MA frequently distributed in the posterior pole (98.0%), nasal (97.0%), superior (96.0%), inferior nasal (94.9%), and inferior (92.9%) fields, whereas He/Ex were most prevalent in the posterior pole (69.7%). In severe NPDR and proliferative DR, IRMA, NPA, and NV were more frequent in the nasal field, particularly in the inferior nasal field (60.3, 38.7, and 76.0%, respectively). All lesions were more observed in the combined posterior pole, nasal, and inferior nasal fields than in the posterior pole or combined two fields in the early and severe stages of DR (P < 0.05).

Conclusions: The manifest lesions of DR were common in the nasal field besides the posterior pole in Chinese patients. A combined examination of the posterior pole, nasal, and inferior nasal mid-peripheral retina would help to detect different retinal lesions of DR.

Trial registration: ClinicalTrial. gov, NCT03528720 . Registered 18 May 2018 - Retrospectively registered.

Keywords: Diabetic retinopathy; Distribution; Manifest lesions; Retinal-imaging.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The FFA, Spectralis HRA image. The field of view is 55-degrees and captures the image in nine black circles, respectively [17]
Fig. 2
Fig. 2
The typical FFA images of different diabetic retinopathy stages. a mild NPDR; b moderate NPDR; c severe NPDR; d PDR. NPDR: nonproliferative diabetic retinopathy; PDR: proliferative diabetic retinopathy
Fig. 3
Fig. 3
The frequencies of clinical signs of diabetic retinopathy in the posterior pole, the combined two and three fields. MA: microaneurysms; He/Ex: intraretinal hemorrhages and exudates; IRMA: intraretinal microvascular abnormality; NPA: capillary nonperfusion area; NV: neovascularization; NPDR: nonproliferative diabetic retinopathy; PDR: proliferative diabetic retinopathy. *Compared to the posterior pole, P < 0.05. #Compared to two combined fields respectively, P < 0.05. §Compared to combined field with the posterior pole and the nasal retina, P < 0.05
See this image and copyright information in PMC

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