Researchers recently found they could quantify nonperfusion and neovascularization using ultra-widefield fluorescein angiography (FA), which could help to predict diabetic retinopathy (DR) progression.

This retrospective case series evaluated ultra-widefield FA images of 651 eyes of 363 participants diagnosed with diabetes who ranged from having no DR to proliferative DR (PDR). The team identified demographic risk factors and advanced DR markers associated with increased areas of nonperfusion and neovascularization.

The investigators discovered that 76 eyes had no DR, 92 had mild non-proliferative DR (NPDR), 144 had moderate NPDR, 101 had severe NPDR, 220 had PDR and 18 had DR of unknown severity. They observed positive associations between male sex and total nonperfusion, black race and total neovascularization and vitreous hemorrhage and total nonperfusion. They identified a threshold total nonperfusion area of 77.48mm2, above which patients may have an increased risk of developing PDR.

While the research suggests these biomarkers, when interpreted with demographic risk factors, could help predict progression, “conclusions are limited by ascertainment and information biases because the results are from retrospective data,” the study authors added in their paper.

Yu G, Aaberg MT, Patel TP, et al. Quantification of retinal nonperfusion and neovascularization with ultrawidefield fluorescein angiography in patients with diabetes and associated characteristics of advanced disease. JAMA Ophthalmol. April 30, 2020. [Epub ahead of print].