Central and Peripheral Involvement of the Retina in the Initial Stages of Diabetic Retinopathy

Abstract

Purpose: To determine the degree of central microvascular closure using optical coherence tomography angiography (OCTA) in eyes of type 2 diabetes patients with visible lesions only in the central retina or only in the periphery. Methods: Cross-sectional study. All 127 eyes underwent Ultra-Widefield Fundus Photography (UWF-FP) 200° examinations with OPTOS California (Optos, Dunfermline, UK) and Cirrus Angioplex OCT-Angiography 3x3mm acquisitions (ZEISS, Dublin, CA, USA). Results: Twenty-five eyes showed visible lesions only in the central retina (inside the 7-ETDRS fields area), 57 only in the peripheral retina (outside the 7-ETDRS fields) and 45 presented visible lesions in entire retina (both locations). The group with visible lesions only in the periphery showed definite closure in the superficial capillary plexus (SCP) in 49% of the eyes, whereas the group with visible lesions only in the central 7-ETDRS fields area showed a definite closure in 64%. Conclusions: Central capillary closure is already present in the initial stages of diabetic retinopathy even when lesions are only visible in the peripheral retina. Capillary closure in the SCP is three times more frequent than in the DCP, demonstrating earlier closure of the SCP. Eyes with visible lesions only in the periphery show a milder form of retinopathy.