Assessment of Fluorescein Angiography Nonperfusion in Eyes with Diabetic Retinopathy using Ultrawide Field Retinal Imaging

PURPOSE: Evaluate association of retinal nonperfusion (NP) on ultrawide field (UWF) fluorescein angiography (FA) with diabetic retinopathy (DR) severity and predominantly peripheral lesions (PPL). METHODS: Multicenter observational study; 652 eyes (361 participants) having non-proliferative DR (NPDR) without center-involved diabetic macular edema in at least 1 eye. Baseline 200° UWF-color and UWF-FA images were graded by a central reading center for color-PPL and FA-PPL, respectively. UWF-FA were graded for NP index (NPI) within concentric zones: posterior pole (15mm). RESULTS: Baseline Early Treatment Diabetic Retinopathy Study DR severity was 31.7% no DR/mild NPDR, 24.1% moderate NPDR, 14.0% moderately severe NPDR, 25.6% severe/very severe NPDR, and 4.6% proliferative DR. Worse DR severity was associated with increased NPI overall (P=0.002), in the posterior pole (P