Quantitative Analysis of Ultra-widefield Fluorescein Angiography in Diabetic Retinopathy and its Association with Diabetic Macular Edema
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0412
- VernacularTitle:糖尿病视网膜病变UWFA量化分析及其与糖尿病黄斑水肿的关联研究
- Author:
Huilin LIANG
1
;
Zhicong XU
1
;
Liang ZHANG
1
;
Dan CAO
1
Author Information
1. 广东省心血管病研究所//广东省人民医院//广东省医学科学院,广东 广州 510080
- Publication Type:Journal Article
- Keywords:
diabetic retinopathy;
center-involved diabetic macular edema;
ultra-widefield fluorescein angiography;
quantitative analysis;
microaneurysm count;
ischemic index;
leakage index
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(4):660-666
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To quantify lesion parameters in different retinal regions on ultra-widefield fluorescein angiography(UWFA)images of patients with diabetic retinopathy(DR)and to explore their association with center-involved diabetic macular edema(CI-DME).[Methods]We retrospectively analyzed UWFA and optical coherence tomography(OCT)images from 76 DR patients(101 eyes)initially diagnosed at Guangdong Provincial People's Hospital between June 2022 and June 2024.All images were captured on the same day.Eyes were classified into CI-DME and non-CI-DME groups based on central subfield thickness(CST)measured by OCT.Manual annotations of microaneurysms,non-perfusion areas,leakage areas,optic discs,and foveae were performed on UWFA images.Lesion parameters,including microaneurysm count,ischemic index,and leakage index,were quantified in the macular area,posterior area,mid-periphery,peripheral retina,and entire UWFA field.Differences in parameters between groups were compared,and their associations with CI-DME and diagnostic performance were assessed.[Results]The CI-DME group exhibited significantly higher microaneurysm count,ischemic index and leakage index in the macular area than those in the non-CI-DME eyes(all P<0.05).No significant differences were observed in these parameters in the peripheral retina between the two groups(all P＞0.05).ROC curve analysis showed that the leakage index could distinguish CI-DME better than the microaneurysm count and ischemia index.The macular leakage index had the highest discriminative ability,with an AUC of 0.80(95%CI:0.71,0.89).[Conclusion]This study found no significant association between peripheral lesion parameters on UWFA and CI-DME.However,macular lesion parameters,particularly the leakage index,were closely linked to CI-DME pathology.These findings highlight the importance of monitoring macular vascular stability to optimize clinical management for DME patients.
