Contribution of wide field angiography to diabetic macular edema

PurposeTo evaluate diabetic macular edema in non proliferative diabetic retinopathy (NPDR) using a wide field fluorescein angiography.MethodsIn a retrospective study, consecutive wide‐field angiographs using the Heidelberg Retina Angiograph 2 with a contact lens system Staurenghi and SD‐OCT were performed in diabetic patients with non proliferative diabetic retinopathy.ResultsA total of 71 eyes in 39 diabetic, average age was 58 years (SD 12). Most of the patients had type 2 diabetes mellitus (92%) and average duration since diabetes diagnosis was 10 years. Mean HA1c was 7.4%. Distribution of NPDR severity was: mild NPDR in 6% of eyes, moderate NPDR in 21% and severe NPDR in 73%. Macular edema was found in 53%. A thicker retina was observed in eyes with peripheral non perfusion (353 vs. 254 μm p = 0.006). Retinal non perfusion was associated with macular edema (97 vs. 76%, p = 0.01) and poor visual acuity (p < 0.001).ConclusionsDiabetic macular edema seems to be strongly associated with peripheral retinal non perfusion. So treatment and management of diabetic macular edema may be reconsidered using either a targeted laser treatment in the area of retinal non perfusion or anti‐VEGF intravitreal injection.