Aims: To compare the macular capillary blood flow of patients with clinically significant diabetic macular oedema (DMO)-with that of non-diabetic subjects and to determine the relation between blood flow and capillary...Aims: To compare the macular capillary blood flow of patients with clinically significant diabetic macular oedema (DMO)-with that of non-diabetic subjects and to determine the relation between blood flow and capillary leakage in patients with DMO. Methods: The sample comprised 45 non-diabetic subjects (mean age 59 years) and 18 type 2 patients with clinically significant DMO (mean age 60 years). Macular capillary blood flow measurements were acquired using the Heidelberg retina flowmeter (HRF) and a 10° × 2.5° scan field centred on the fovea. Fluorescein angiographywas undertaken on each of the diabetic patients after the completion of HRF measurements. Results: Temporal macular capillary blood flow was significantly lower for the patients with clinically significant DMO compared with age matched non-diabetic subjects (ANCOVA, P=0.0011)-while relative nasal-temporal asymmetry of macular capillary blood flow was significantly higher (P=0.0125). Nasal-temporal asymmetry ofmacular capillary blood flowwas significantly higher for the patients with DMO and capillary leakage within the scan area (two tailed t test, P=0.0071). Macular capillary blood flow was always lower in areas of DMO and capillary leakage. Conclusion: Capillary blood flow was reduced in areas of DMO and capillary leakage, suggesting the presence of a localised perturbation of capillary blood flow regulation.展开更多
Objectives:To estimate the agreement between the macular edema maps(MEMs)of the Retina Module of the Heidelberg Retina Tomograph II(Heidelberg Engineering,Heidelberg,Germany)and contact lens fundus biomicroscopy(FB)an...Objectives:To estimate the agreement between the macular edema maps(MEMs)of the Retina Module of the Heidelberg Retina Tomograph II(Heidelberg Engineering,Heidelberg,Germany)and contact lens fundus biomicroscopy(FB)and to assess the influence of combining MEM data with the results of short-wavelength automated perimetry(SWAP)and fluorescein angiography(FA)on diagnostic test performance.Design:Prospective,observational case series.Methods:Twenty patients(20 eyes)with diabetic retinopathy with or without clinically manifest macular edema(11 and 9 eyes,respectively)were enrolled.All patients underwent full ophthalmologic examination and also MEM assessment,SWAP,and FA.Results:Using FB as the “ gold standard,” the agreement between the MEMs and FB was very good(Kendall coefficient of concordance,0.80).Macular edema maps showed good agreement with FA and SWAP(Kendall coefficient,0.64 and 0.65).Virtually all of the edematous areas detected with MEM but not seen clinically had decreased sensitivity on SWAP and/or fluorescein leakage.Conclusions:Macular edema maps demonstrated very good agreement with FB.Combining the results of FA and SWAP with those of the MEMs provided supporting evidence of concomitant blood-retinal barrier leakage and visual dysfunction,respectively,in areas of early retinal thickening.Prospective studies are ongoing to fully assess the diagnostic test performance of MEMs in the detection of early and progressive diabetic macular edema.展开更多
文摘Aims: To compare the macular capillary blood flow of patients with clinically significant diabetic macular oedema (DMO)-with that of non-diabetic subjects and to determine the relation between blood flow and capillary leakage in patients with DMO. Methods: The sample comprised 45 non-diabetic subjects (mean age 59 years) and 18 type 2 patients with clinically significant DMO (mean age 60 years). Macular capillary blood flow measurements were acquired using the Heidelberg retina flowmeter (HRF) and a 10° × 2.5° scan field centred on the fovea. Fluorescein angiographywas undertaken on each of the diabetic patients after the completion of HRF measurements. Results: Temporal macular capillary blood flow was significantly lower for the patients with clinically significant DMO compared with age matched non-diabetic subjects (ANCOVA, P=0.0011)-while relative nasal-temporal asymmetry of macular capillary blood flow was significantly higher (P=0.0125). Nasal-temporal asymmetry ofmacular capillary blood flowwas significantly higher for the patients with DMO and capillary leakage within the scan area (two tailed t test, P=0.0071). Macular capillary blood flow was always lower in areas of DMO and capillary leakage. Conclusion: Capillary blood flow was reduced in areas of DMO and capillary leakage, suggesting the presence of a localised perturbation of capillary blood flow regulation.
文摘Objectives:To estimate the agreement between the macular edema maps(MEMs)of the Retina Module of the Heidelberg Retina Tomograph II(Heidelberg Engineering,Heidelberg,Germany)and contact lens fundus biomicroscopy(FB)and to assess the influence of combining MEM data with the results of short-wavelength automated perimetry(SWAP)and fluorescein angiography(FA)on diagnostic test performance.Design:Prospective,observational case series.Methods:Twenty patients(20 eyes)with diabetic retinopathy with or without clinically manifest macular edema(11 and 9 eyes,respectively)were enrolled.All patients underwent full ophthalmologic examination and also MEM assessment,SWAP,and FA.Results:Using FB as the “ gold standard,” the agreement between the MEMs and FB was very good(Kendall coefficient of concordance,0.80).Macular edema maps showed good agreement with FA and SWAP(Kendall coefficient,0.64 and 0.65).Virtually all of the edematous areas detected with MEM but not seen clinically had decreased sensitivity on SWAP and/or fluorescein leakage.Conclusions:Macular edema maps demonstrated very good agreement with FB.Combining the results of FA and SWAP with those of the MEMs provided supporting evidence of concomitant blood-retinal barrier leakage and visual dysfunction,respectively,in areas of early retinal thickening.Prospective studies are ongoing to fully assess the diagnostic test performance of MEMs in the detection of early and progressive diabetic macular edema.
