TOPOGRAPHIC PATTERNS OF PERIPHERAL DIABETIC NEOVASCULARIZATION ON ULTRA-WIDEFIELD FLUORESCEIN ANGIOGRAPHY

Area of Science:

• Ophthalmology
• Diabetic Retinopathy Research
• Medical Imaging

Background:

• Proliferative diabetic retinopathy (PDR) is a leading cause of vision loss.
• Standard imaging may miss peripheral retinal neovascularization (PNV).
• Ultra-widefield fluorescein angiography (UWFFA) offers a wider view of the retina.

Purpose of the Study:

• To determine the prevalence and distribution of PNV in treatment-naïve PDR patients using UWFFA.
• To analyze the association of PNV with other neovascular lesions.
• To assess the clinical relevance of PNV in PDR management.

Main Methods:

• Retrospective observational study of 97 eyes from 61 treatment-naïve PDR patients.
• Application of a grid overlay on UWFFA images to delineate ETDRS and peripheral fields.
• Classification of neovascularization as NVD, NVE, and PNV based on location.

Main Results:

• PNV was present in 57.7% of eyes, rarely occurring in isolation (3.1%).
• PNV frequently coexisted with neovascularization of the disc (NVD) and/or neovascularization elsewhere (NVE) (74.7%).
• PNV showed highest prevalence in Extended Field 6 (43.3%) and was associated with younger patients (≤50 years).

Conclusions:

• Retinal neovascularization extends beyond the ETDRS 7-field area in PDR patients.
• PNV is common and often coexists with posterior neovascularization, supporting the continued use of ETDRS imaging.
• Vigilant monitoring and tailored management are crucial, especially for younger PDR patients with PNV.