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Diabetic macular ischemia

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Abstract

Aim

Since its relevance on diagnosis and prognosis of diabetic retinopathy (DR), this review will examine a multimodal imaging approach to detect diabetic macular ischemia (DMI).

Methods

A PubMed engine search was carried out using the term “macular ischemia” paired with “diabetes,” and “diabetic macular ischemia” paired to “fluorescein angiography,” “ultra-wide field fluorescein angiography,” “optical coherence tomography angiography,” “octa,” “2D octa,” “ultra-wide field octa,” “3D octa,” “visual acuity.” All studies published in English up to October 2021 irrespective of their publication status were reviewed, and relevant publications were included in this review.

Results

Recently, new technologies have been proposed as an alternative to fluorescein angiography (FA), which is an actual diagnostic gold standard technique. Nowadays, optical coherence tomography angiography (OCTA) has emerged as the most promising and reliable procedure able to provide a qualitative and quantitative description of DMI. Newer three-dimensional (3D) OCTA approach will be discussed too. Moreover, we will discuss how OCTA might identify preclinical alterations before the onset of DR and allow prediction about the progression of disease.

Conclusion

OCTA has significantly expanded our knowledge on diabetic macular ischemia.

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All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

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Authors and Affiliations

  1. School of Medicine, Vita-Salute San Raffaele University, Milan, Italy

    Beatrice Tombolini, Enrico Borrelli, Riccardo Sacconi, Francesco Bandello & Giuseppe Querques

  2. Ophthalmology Unit, Division of Head and Neck, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Beatrice Tombolini, Enrico Borrelli, Riccardo Sacconi, Francesco Bandello & Giuseppe Querques

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The authors declare that there are no conflicts of interest regarding the publication of this article. Beatrice Tombolini: none. Enrico Borrelli: consultant for Zeiss (Dublin, USA), CenterVue (Padua, Italy). Riccardo Sacconi: consultant for Bayer Shering-Pharma (Berlin, Germany), Novartis (Basel, Switzerland), Zeiss (Dublin, USA). Francesco Bandello consultant for: Alcon (Fort Worth,Texas, USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch And Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La-Roche (Basel, Switzerland), NovagaliPharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee,Belgium), Zeiss (Dublin, USA). Giuseppe Querques consultant for: Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Bayer Shering-Pharma (Berlin, Germany), Heidelberg (Germany), Novartis (Basel, Switzerland), Sandoz (Berlin, Germany), Zeiss (Dublin, USA).

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Tombolini, B., Borrelli, E., Sacconi, R. et al. Diabetic macular ischemia. Acta Diabetol 59, 751–759 (2022). https://doi.org/10.1007/s00592-021-01844-1

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