Diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) are the 2 advanced stages of diabetic retinopathy (DR) that are the main causes for visual loss in patients with diabetes. Both DME and PDR can be readily diagnosed with clinical examination and, increasingly, by the noninvasive use of optical coherence tomography. However, another, less commonly recognized cause of visual loss in patients with diabetes is diabetic macular ischemia (DMI) in the absence of DME.1 The understanding of the natural history, risk factors, and functional outcomes of DMI remains limited. This is partly because of the long-standing need for invasive fluorescein angiography to diagnose DMI, which is characterized by enlargement of foveal avascular zone (FAZ) and retinal capillary loss.1
Cheung CMG, Wong TY. Clinical Use of Optical Coherence Tomography Angiography in Diabetic Retinopathy Treatment: Ready for Showtime? JAMA Ophthalmol. 2018;136(7):729–730. doi:10.1001/jamaophthalmol.2018.1538
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