Differential distribution of manifest lesions in diabetic retinopathy by fundus fluorescein angiography and fundus photo
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RESEARCH ARTICLE
Open Access
Differential distribution of manifest lesions in diabetic retinopathy by fundus fluorescein angiography and fundus photography Xiaoli Li1,2†, Jie Xie1†, Liang Zhang1, Ying Cui1, Guanrong Zhang3, Jun Wang1, Aiping Zhang1, Xiangting Chen1, Tian Huang1,4 and Qianli Meng1,4*
Abstract Background: To analyze the distribution of manifest lesions of diabetic retinopathy (DR) by fundus fluorescein angiography (FFA) and color fundus photography (FP). Methods: A total of 566 eyes of 324 Chinese patients diagnosed with DR were included in this retrospective study. DR severity was graded by the international grading criterion. The distributions of microaneurysms (MA), intraretinal hemorrhages/exudates (He/Ex), intraretinal microvascular abnormality (IRMA), capillary nonperfusion areas (NPA), and neovascularization (NV) were estimated by multiple logistic regression analyse based on nine-field FFA and FP images. Results: In mild nonproliferative diabetic retinopathy (NPDR), the highest frequency of MA was found in the posterior pole (67.7%), followed by the inferior nasal (59.4%), and the nasal (55.4%) fields. In moderate NPDR, MA frequently distributed in the posterior pole (98.0%), nasal (97.0%), superior (96.0%), inferior nasal (94.9%), and inferior (92.9%) fields, whereas He/Ex were most prevalent in the posterior pole (69.7%). In severe NPDR and proliferative DR, IRMA, NPA, and NV were more frequent in the nasal field, particularly in the inferior nasal field (60.3, 38.7, and 76.0%, respectively). All lesions were more observed in the combined posterior pole, nasal, and inferior nasal fields than in the posterior pole or combined two fields in the early and severe stages of DR (P < 0.05). Conclusions: The manifest lesions of DR were common in the nasal field besides the posterior pole in Chinese patients. A combined examination of the posterior pole, nasal, and inferior nasal mid-peripheral retina would help to detect different retinal lesions of DR. Trial registration: ClinicalTrial. gov, NCT03528720. Registered 18 May 2018 - Retrospectively registered. Keywords: Manifest lesions, Diabetic retinopathy, Retinal-imaging, Distribution
* Correspondence: [email protected] † Xiaoli Li and Jie Xie contributed equally to this work. 1 Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Eye Institute, 106 Zhongshan Er Road, Guangzhou 510080, People’s Republic of China 4 The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party materia
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