CORRELATION BETWEEN CLINICAL FINDINGS AND FUNDUS FLUORESCEIN ANGIOGRAPHY FINDINGS IN PATIENTS WITH PREPROLIFERATIVE DIABETIC RETINOPATHY

Fluorescein angiography has been extremely valuable for expanding our knowledge to visualize the chorioretinal circulation and in evaluating retinal vascular disorders. The angiogram is used to determine the extent of damage, to develop treatment plan and to monitor the results of treatment. In diabetic retinopathy the angiogram is useful in identifying the extent of ischemia, the location of micro aneurysms, the presence of intraretinal microvascular abnormalities (IRMA) that can only be confirmed on angiogram; neovascularization and the extent of macular edema. Fluorescein angiography is an excellent method to display the retinal capillaries in detail to show the pathologic changes because the retinal pigment epithelium provides a good background. FFA is not only useful for diagnosis but also to gauge the progression and management of diabetic retinopathy (DR). FFA is a therapeutic guide to laser photocoagulation treatment for several retinal vascular diseases. In this study, we aimed at highlighting the problems that can occur in early diagnosis and accurate staging of diabetic retinopathy and importance of fluorescein angiography in monitoring diabetic patients.The present study was a hospital based prospective study conducted from November 2015 to April 2017 in the department of Ophthalmology SKIMS Medical College Hospital, Srinagar. Patients older than 12 years of age suffering from Diabetes Mellitus with clinical findings consistent with pre-proliferative diabetic retinopathy were included for the purpose of the study. Patients younger than 12 years of age, patients with hazy media, pregnant women, immunocompromised status patients, patients with hypersensitivity to fluorescein dye or any contraindication to fluorescein dye were excluded from the study. In our study FFA proved to be an important tool to evaluate the lesions of PPDR, which were not detectable on ophthalmoscopy and slit lamp biomicroscopy, such as areas of capillary nonperfusion. IRMA were also best picked up and differentiated from neovascularisation by means of FFA.