Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 11;13(8):2219.
doi: 10.3390/jcm13082219.

The Natural History of Retinal Sensitivity Loss in Diabetic Macular Ischemia over One Year Evaluated by Microperimetry

Wei-Shan Tsai  1 , Sridevi Thottarath  1 , Sarega Gurudas  1 , Jinzhi Zhao  2 , Chui Ming Gemmy Cheung  2 , Taffeta Ching Ning Yamaguchi  3 , Andrea Giani  3 , Elizabeth Pearce  3 , Sobha Sivaprasad  1
Affiliations

The Natural History of Retinal Sensitivity Loss in Diabetic Macular Ischemia over One Year Evaluated by Microperimetry

Wei-Shan Tsai et al. J Clin Med. .

Abstract

Background/Objectives: This one-year prospective observational study, conducted at two centers, aimed to report the natural history of retinal sensitivity (RS) loss in diabetic macular ischemia (DMI). Methods: Patients with stable-treated proliferative diabetic retinopathy (PDR) were recruited if there was evidence of DMI on optical coherence tomography angiography, defined as a foveal avascular zone ≥ 0.5 mm2 or parafoveal capillary dropout ≥ 1 quadrant. The minimal visual acuity required for performing microperimetry (MP) was ≥54 Early Treatment Diabetic Retinopathy Study letters (Snellen equivalent 20/80). The overall RS (oRS) and pointwise sensitivity (PWS) within the 3 × 3 mm macula were assessed at baseline and twelve months. A value <25 decibels (dB) was defined as impaired RS, and a decrease of 2 and 7 dB was regarded as mild and severe loss, respectively. Results: A total of 88 patients (97 eyes) were included. No statistically significant MP changes were detected at one year. However, 10% of the cohort lost oRS ≥ 2 dB, and 73% lost ≥2 dB PWS in ≥5 loci, whereas 1% lost oRS ≥ 7 dB, and 4% lost ≥7 dB PWS in ≥5 loci. The foveola and temporal parafovea were the most vulnerable to severe RS loss. Compared to their counterpart, eyes with baseline oRS ≥ 25 dB had significantly more RS loss in the macula and superior parafovea (55% versus 32% and 53% versus 28%, both p = 0.01). Conclusions: Rather than oRS loss, ≥2 dB loss in PWS in ≥5 loci is a more feasible outcome measure for clinical trials in DMI.

Keywords: diabetic macular ischemia; diabetic retinopathy; microperimetry; proliferative diabetic retinopathy; retinal sensitivity.

PubMed Disclaimer

Conflict of interest statement

Dr Pearce, Dr Yamaguchi, and Dr Giani are employees of Boehringer Ingelheim. Dr Sivaprasad reported receiving financial support from AbbVie, Amgen, Apellis, Bayer, Biogen, Boehringer Ingelheim, Novartis, Eyebiotech, Eyepoint Pharmaceuticals, Janssen Pharmaceuticals, Nova Nordisk, Optos, Ocular Therapeutix, Kriya Therapeutics, OcuTerra, Roche, and Stealth Biotherapeutics. Dr Cheung is a consultant for Topcon, Novartis, Bayer, Allergan, Roche, Boehringer Ingelheim, and Samsung.

Figures

Figure 1
Figure 1
A picture of the 21 testing loci on microperimetry (left), the schematic view of these 21 pointwise retinal sensitivities (middle) and regional mean retinal sensitivity (right). Abbreviations: MS = mean sensitivity; RS = retinal sensitivity.
Figure 2
Figure 2
A topographic map showing the retinal sensitivity change from baseline to one year at different loci. There was no significant deterioration in overall, parafoveal, or pointwise retinal sensitivity. Abbreviations: dB = decibels, RS = retinal sensitivity.
Figure 3
Figure 3
A heat map of the most vulnerable loci at risk of severe and mild retinal sensitivity loss at one year. The curvilinear lines depict the location of papillomacular bundle. Abbreviations: dB = decibel; RS = retinal sensitivity.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. International Diabetes Federation IDF Diabetes Atlas. [(accessed on 22 May 2023)]. Available online: www.diabetesatlas.org.
    1. Steinmetz J.D., Bourne R.R.A., Briant P.S., Flaxman S.R., Taylor H.R.B., Jonas J.B., Abdoli A.A., Abrha W.A., Abualhasan A., Abu-Gharbieh E.G., et al. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The Right to Sight: An analysis for the Global Burden of Disease Study. Lancet Glob. Health. 2021;9:e144–e160. doi: 10.1016/S2214-109X(20)30489-7. - DOI - PMC - PubMed
    1. Sim D.A., Keane P.A., Zarranz-Ventura J., Fung S., Powner M.B., Platteau E., Bunce C.V., Fruttiger M., Patel P.J., Tufail A., et al. The Effects of Macular Ischemia on Visual Acuity in Diabetic Retinopathy. Investig. Ophthalmol. Vis. Sci. 2013;54:2353–2360. doi: 10.1167/iovs.12-11103. - DOI - PubMed
    1. Sim D.A., Keane P.A., Zarranz-Ventura J., Bunce C.V., Fruttiger M., Patel P.J., Tufail A., Egan C.A. Predictive Factors for the Progression of Diabetic Macular Ischemia. Am. J. Ophthalmol. 2013;156:684–692. doi: 10.1016/j.ajo.2013.05.033. - DOI - PubMed
    1. Manousaridis K., Talks J. Macular ischaemia: A contraindication for anti-VEGF treatment in retinal vascular disease? Br. J. Ophthalmol. 2012;96:179–184. doi: 10.1136/bjophthalmol-2011-301087. - DOI - PubMed

LinkOut - more resources