Objectives To explore the possible role of peripheral lesions (PLs) detected by ultrawide field (UWF) imaging system on central neurovascular structure and retinal function.
Methods Ninety-seven diabetic patients were included in this cross-sectional study using UWF pseudocolour colour imaging with Optos Daytona (Optos, PLC). UWF images were graded as with predominantly peripheral lesions (PPLs) and without PPL. Macular neurovascular alterations and retinal function were measured by optical coherence tomography angiography (OCTA) and RETeval device, respectively. Central microcirculation and retinal function were compared between eyes with and without PPL.
Results The study evaluated 186 eyes (97 patients; 43 females (44.3%)), including 92 eyes without PPL and 94 eyes with PPL. Central retinal vessel density was comparable between eyes with and without PPL. Delayed implicit time and decreased pupil area ratio were found in the PPL group compared with eyes without PPL, and this difference remained unchanged after adjusting for systemic factors (all p＜0.01).
Conclusions Our study suggests that retinal function is worse in diabetic eyes with PPL. These findings challenged the conventional ETDRS protocols which ignored peripheral retina in determining DR severity. Furthermore, combining UWF imaging with RETeval system to detect more retinal abnormalities may be helpful in DR management.
Data availability statement
Data are available on reasonable request.
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XZ and RC are joint first authors.
XZ and RC contributed equally.
LZ and DC contributed equally.
Contributors LZ, DC, XZ and RC contributed to the conception and design of the study. AL, JY, ZW, YC, KZ and PL contributed to data collection, analysis and/or interpretation. XZ and RC wrote the article. DC and LZ revised the manuscript. DC is the guarantor.
Funding This study was supported by Guangzhou Science and Technology Program (Grant Number 201904010092) and Bethune Merck Diabetes Research Foundation (Grant Number 2018-133).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.