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Semin Ophthalmol. 2010 Jan-Mar;25(1-2):27-33. doi: 10.3109/08820538.2010.481239.

Peripheral vessel leakage (PVL): a new angiographic finding in diabetic retinopathy identified with ultra wide-field fluorescein angiography.

Author information

1
The Retina Division, Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, California, USA.

Abstract

PURPOSE:

To characterize the relationship between peripheral vessel leakage and other angiographic features of diabetic retinopathy.

DESIGN:

Retrospective, consecutive case series.

METHODS:

Consecutive ultra wide-field angiographs obtained at a single institution for diabetic retinopathy were graded for angiographic characteristics including macular edema, retinal neovascularization, retinal vascular perfusion abnormalities, and retinal vascular staining and leakage.

RESULTS:

Angiographic characteristics of 264 eyes of 143 patients were evaluated. Findings included focal and diffuse angiographic macular edema (150/264, 57%), neovascularization (107/264, 41%), late peripheral vascular leakage (PVL) (107/264, 41%), and peripheral non-perfusion (142/264, 54%). Amongst all subjects untreated peripheral non-perfusion was associated with anterior neovascularization (78% vs. 48%, p = 0.0001, Fisher exact test) and posterior neovascularization (78% vs. 43%, p < 0.0001), but not with macular edema (p = 0.71). PVL was associated with peripheral non-perfusion (78% vs. 38%, p < 0.0001) and posterior neovascularization (53% vs. 35%, p = 0.01), but not with macular edema (p = 0.449). However, focal macular edema was strongly associated with PVL (33% vs. 13%, p = 0.008) in eyes without peripheral non-perfusion. Amongst untreated eyes with non-proliferative retinopathy and macular edema, there was a trend for association between macular edema and peripheral non-perfusion (p = 0.065).

CONCLUSION:

Untreated peripheral non-perfusion and late peripheral vascular leakage detected using ultra wide-field FA are associated with neovascularization in diabetic retinopathy. PVL may be associated with focal diabetic macular leakage in this cohort.

PMID:
20507194
DOI:
10.3109/08820538.2010.481239
[Indexed for MEDLINE]

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