The Relationship between Macular Pigment and Vessel Density in Patients with Type 1 Diabetes Mellitus.

AIM: Macular pigment density and microvascular density on optical coherence tomography angiography (OCTA) were measured in a cohort of type 1 diabetes mellitus (T1DM) patients with retinopathy in the attempt to shed light on the pathophysiology of this condition. METHODS: Eighty-two consecutive eyes of 59 patients with diabetic retinopathy examined at the Eye Clinic of the University of Naples Federico II from November 2016 to April 2017 were enrolled in this prospective study. Eighty normal eyes of 40 age-matched subjects without diabetes mellitus, without a history of glaucoma or evidence of intraocular surgery, and without retinal pathologic features constituted the control group. All patients and controls underwent a complete ophthalmic examination, best corrected visual acuity evaluation according to the ETDRS visual logMAR scale, measurement of intraocular pressure, OCTA, and evaluation of macular pigment. RESULTS: There were no significant age differences between patients and controls. Both macular pigment measurements and vessel density measured by OCTA were significantly lower in patients than in controls. A moderate correlation was found between vessel density in all ETDRS sectors and macular pigment parameters. CONCLUSIONS: There was a reduction in macular pigment and in OCTA vessel density in T1DM patients with retinopathy, which may have prognostic value in determining disease progression.

Evaluation of Vascular Changes with Optical Coherence Tomography Angiography after Plaque Radiotherapy of Choroidal Melanoma.

AIM: The purpose of this paper was to evaluate whether optical coherence tomography angiography (OCT-A) can be used to quantify the vascular changes in radiation maculopathy, and changes in the tumor vasculature in eyes treated with plaque radiotherapy for choroidal melanoma. METHODS: In this prospective study, we evaluated 39 Caucasian patients with choroidal melanoma (39 eyes) treated with ruthenium-106 plaque radiotherapy. The patients underwent complete ophthalmic examination, bulbar echography, and OCT-A before and 1 year after treatment. RESULTS: At baseline, the mean best-corrected visual acuity (BCVA) in the affected eyes was 0.35 ± 0.40 logMAR, and the mean tumor thickness was 2.68 ± 0.25 mm at A-scan echography. After treatment, the mean BCVA increased to 0.41 logMAR, the mean tumor thickness decreased to 1.66 ± 0.23 mm, and the tumor basal diameter was significantly reduced (U = 108, p = 0.001). Moreover, the capillary vessel density was significantly lower in all Early Treatment of Diabetic Retinopathy Study sectors, and both the vessel and flow areas were significantly reduced (p = 0.030 and p = 0.001, respectively). CONCLUSIONS: OCT-A is a noninvasive, reliable method with which to quantify the vessel changes in radiation maculopathy and, given the association between vascularization and malignancy, this procedure may be an aid in treatment decision-making and in monitoring the efficacy of treatment.

Multimodal Imaging in Autosomal Dominant Cone-Rod Dystrophy Caused by Novel CRX Variant.

AIM: To characterize by multimodal approach the phenotype of patients from a 3 generations pedigree, affected by autosomal dominant cone-rod dystrophy (CRD), found to carry a novel pathogenic variant in the cone-rod homeobox-containing (CRX) gene. METHODS: Examination of the adult patients included the following tests: visual acuity, multicolour imaging, spectral domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF) and OCT angiography (OCT-A) recordings. In a 2.5-year-old child, cycloplegic refraction, fundoscopy, ocular motility evaluation and electrophysiological exams were performed. Next Generation Sequencing of patients' DNA has been carried out. RESULTS: A novel CRX pathogenic variant has been identified in our patients. The 2.5-year-old child in the third generation was found to have inherited the variant, with no clinical signs of the condition, but electroretinographic abnormalities in the scotopic component. In the adult patients, diffuse atrophy of the retinal pigment epithelium/photoreceptor complex in the macular region was evident at the OCT and FAF, while OCT-A showed choriocapillaris density reduction. CONCLUSIONS: Multimodal study allowed the characterization of a peculiar form of CRD. The novel pathogenic variant seems to have a different effect on the phenotype if compared with a previously described similar one, giving an insight into the pathogenic mechanism of CRX-related retinal dystrophies and offering valuable information that could lead to the development of possible future therapies.

A randomized trial of intravitreal bevacizumab vs. ranibizumab for myopic CNV.

AIMS: The aim was to compare the efficacy of intravitreal therapy with bevacizumab and ranibizumab for choroidal neovascularization (CNV) in pathologic myopia (PM). METHODS: This was a prospective multicenter randomized nonblinded trial. RESULTS: In seven centers, 78 eyes were randomized 1:1 to treatment with bevacizumab (group B, 40 eyes) or ranibizumab (group R, 38 eyes) given with an "on demand" regimen (PRN). The mean follow-up was 19 months (SD 2, range 12-24). The mean BCVA at baseline was 0.60 logMAR (20/80 Snellen equivalent, Seq) and 50 letter score (ls). Mean final BCVA was 0.51 LogMAR (20/63 Seq) and 57 ls (p = 0.0009 and p = 0.0002, respectively). In group B, mean basal BCVA was 0.52 logMAR (20/63 Seq) and 54 ls, and final BCVA was 0.51 logMar (20/63 Seq) and 57 ls. In group R, mean basal BCVA was 0.62 logMAR (20/80 Seq) and 45 ls, and the final values were 0.50 logMAR (20/63 Seq) and 58 ls. Statistical comparison of the two groups showed no significant difference (logMAR p = 0.90 and letters p = 0.78). Multivariate analysis showed no influence of age or previous photodynamic treatment (PDT) on final visual changes. The mean number of treatments in the first year was 2.7 in group B and 2.3 in group R (p = 0.09). CONCLUSION: Myopic CNV equally benefits from on-demand intravitreal injection of either bevacizumab or ranibizumab; the therapeutic effect is independent of previous PDT and age.

Microperimetry of subretinal drusenoid deposits.

PURPOSE: To investigate light sensitivity in eyes presenting with subretinal drusenoid deposits (SDD). METHODS: All consecutive patients with SDD only seen between January 2012 and July 2012 were included. A control group of consecutive age- and sex-matched control subjects presenting at least one eye with early age-related macular degeneration was considered. In all cases best-corrected visual acuity (BCVA), color fundus photography, fundus autofluorescence imaging and spectral-domain-optical coherence tomography with integrated microperimetry were performed. RESULTS: Twenty-one eyes (21 patients, 9 females, 12 males, mean age 69.2 ± 5.3 years, mean BCVA 0.18 ± 0.14 LogMAR) were included in the SDD group. Twenty eyes of 20 patients (13 females, 7 males, mean age 69.1 ± 3.9 years, mean BCVA 0.16 ± 0.15 LogMAR) were included in the control group. In eyes with SDD the choroid was thinner at the subfoveal location, and at 1,500 µm superior, inferior, temporal and nasal to the fovea (p < 0.05). In eyes with SDD, the overall mean light sensitivity in the central macula (4.21 ± 2.46 dB) was significantly reduced when compared to the control group (6.81 ± 2.12 dB, p = 0.001), while stable fixation was present in both groups. Correlation between BCVA and mean light sensitivity in the central 7 × 7 mm square was low in the SDD group (Pearson's rho = 0.4, p = 0.01), while it was good in the control group (Pearson's rho = 0.7, p = 0.001). CONCLUSIONS: Eyes with SDD showed reduced sensitivity despite preserved BCVA. Reduced choroidal thickness could be involved in reduction of light sensitivity.

Choroidal thickness in open-angle glaucoma measured by spectral-domain scanning laser ophthalmoscopy/optical coherence tomography.

AIMS: To measure macular choroidal thickness in healthy and glaucomatous eyes using spectral-domain scanning laser ophthalmoscopy/optical coherence tomography. METHODS: Choroidal thickness was measured in 21 healthy eyes and 16 glaucomatous eyes. Choroidal thickness was measured under the fovea and at 500-µm intervals from the foveal center to 4 mm in the nasal and temporal directions. Vessels were counted in a macular area of 8,000 µm(2). Only choroidal vessels with a horizontal diameter of at least 155 µm and a vertical diameter of at least 50 µm were considered. RESULTS: The mean choroidal thickness was greatest below the fovea, i.e. 343.8 µm (SD ± 29.06) in controls and 411.56 µm (SD ± 33.60; p < 0.001) in the glaucomatous group. The mean vertical diameter was significantly greater (p = 0.008) in glaucomatous eyes (112.18 ± 37.64 µm) than in healthy eyes (103.98 ± 25.67 µm), whereas the luminal area of vessels was significantly larger (p = 0.3) in glaucomatous eyes (39,157.34 ± 21,657.23 µm(2)) than in healthy eyes (43,779.84 ± 22,874.87 µm(2)). CONCLUSIONS: We show that choroidal thickness is increased in glaucomatous eyes due to an increase in both the vertical diameter and the luminal area of the vessels. This seems to implicate the choroid in the pathogenesis of open-angle glaucoma.

Retinal micropseudocysts in diabetic retinopathy: prospective functional and anatomic evaluation.

AIM: To evaluate the prevalence, progression and functional predictive value of retinal micropseudocysts (MPCs) in diabetic patients. METHODS: Prospective controlled observational study. From among all the type 2 diabetic patients evaluated during a period of 5 months between September 2009 and January 2010, we enrolled all patients with retinal MPCs at spectral-domain scanning laser ophthalmoscope/optical coherence tomography (SD-SLO/OCT) not previously treated for diabetic retinopathy. Forty diabetic patients without MPCs served as the control group. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), macular sensitivity and stability of fixation at SD-SLO/OCT microperimetry were measured monthly for 12 months. RESULTS: 22/156 patients with type 2 diabetes (14.1%, 32 eyes) met the inclusion criteria. The 95% confidence interval for the prevalence estimate of MPCs was 12.3-16.6%. Mean BCVA, CRT and central retinal sensitivity at baseline were 77.53 ± 2.2 Early Treatment Diabetic Retinopathy Study letters, 242.31 ± 31.0 µm and 15.95 ± 0.61 dB, respectively. Fixation was stable in all cases. Compared to the control group, eyes with MPCs had similar BCVA but greater CRT (p = 0.01) and reduced macular sensitivity (p = 0.001) at baseline and at each follow-up visit. Over time, CRT remained stable in eyes with MPCs, whereas macular sensitivity progressively decreased. CONCLUSION: MPCs in diabetic retinopathy are associated, temporally or causally, with a progressive reduction of macular sensitivity despite a stable BCVA, CRT and fixation.

Novel USH1G homozygous variant underlying USH2-like phenotype of Usher syndrome.

PURPOSE: Usher syndrome (USH) is an autosomal recessive disorder characterized by congenital sensorineural hearing impairment and retinitis pigmentosa. Classification distinguishes three clinical types of which type I (USH1) is the most severe, with vestibular dysfunction as an added feature. To date, 15 genes and 3 loci have been identified with the USH1G gene being an uncommon cause of USH. We describe an atypical USH1G-related phenotype caused by a novel homozygous missense variation in a patient with profound hearing impairment and relatively mild retinitis pigmentosa, but no vestibular dysfunction. METHODS: A 26-year-old female patient with profound congenital sensorineural hearing loss, nyctalopia and retinitis pigmentosa was studied. Audiometric, vestibular and ophthalmologic examination was performed. A panel of 13 genes was tested by next-generation sequencing (NGS). RESULTS: While the hearing loss was confirmed to be profound, the vestibular function resulted normal. Although typical retinitis pigmentosa was present, the age at onset was unusually late for USH1 syndrome. A novel homozygous missense variation (c.1187T>A, p.Leu396Gln) in the USH1G gene has been identified as causing the disease in our patient. CONCLUSIONS: Genetic and phenotypic heterogeneity are very common in both isolated and syndromic retinal dystrophies and sensorineural hearing loss. Our findings widen the spectrum of USH allelic disorders and strength the concept that variants in genes that are classically known as underlying one specific clinical USH subtype might result in unexpected phenotypes.

Evaluation of morning glory syndrome with spectral optical coherence tomography and echography.

PURPOSE: To evaluate eyes affected by morning glory syndrome (MGS) with spectral-domain optical coherence tomography (SD OCT) and echography. DESIGN: Prospective case series. PARTICIPANTS: Nineteen patients (22 eyes) with MGS observed at the Eye Department, University of Naples Federico II, Naples, Italy. METHODS: All patients underwent a complete ophthalmologic examination that included best-correct visual acuity, fundus photography, and echography. Nine patients underwent SD OCT and high-frequency B-scan echography (20 MHz). MAIN OUTCOME MEASURES: Spectral-domain optical coherence tomography and echographic findings in MGS. RESULTS: Spectral-domain optical coherence tomography revealed retinal detachment in the conus area of 5 eyes: 4 with noncontractile MGS (NCMGS) and 1 with contractile MGS (CMGS). There was evidence of a retinal break in only 2 cases. All 5 eyes had an abnormal communication between the subarachnoid space and the subretinal space. Spectral-domain optical coherence tomography did not reveal differences between CMGS and NCMGS. Echographic examination did not reveal any anatomic abnormalities of the optic nerve or orbit. CONCLUSIONS: Spectral-domain optical coherence tomography provides more information than echography about the posterior pole, whereas echographic examination is the only technique that can confirm the anatomic integrity of the optic nerve in the orbital wall. Retinal detachment in MGS generally is ascribed to abnormal communication between the subretinal and subarachnoid or vitreous compartments. These data suggest that myopialike retinal detachment without a retinal break may result from tissue stretching around the peripapillary conus.

Choriocapillary vascular density in central serous chorioretinopathy complicated by choroidal neovascularization.

BACKGROUND: To evaluate choriocapillary vascular density (CVD) in eyes with central serous chorioretinopathy (CSC) complicated by choroidal neovascularization (CNV), at baseline and after intravitreal injections (IVR) of Ranibizumab, using optical coherence tomography angiography (OCTA). METHODS: Twelve eyes of 12 patients were enrolled as group 1 and 12 unaffected fellow eyes formed group 2. Twelve eyes of 12 healthy controls were the control group. RESULTS: CVD in Group 1 did not differ before and after treatment. CVD of Group 1 was significantly lower compared with controls at baseline (whole, parafovea and fovea p < 0.05). CVD of controls resulted significantly higher than Group 2 at baseline (whole, parafovea and fovea p < 0.05). There were not significant differences in CVD between Groups 1 and 2 at baseline (p > 0.05). CONCLUSIONS: OCTA revealed a choriocapillary hypoperfusion that may be responsable for the beginning of this disease and the late development of CNV.

Bevacizumab in macular edema: functional and anatomic changes in a prospective case series.

OBJECTIVE: To evaluate the early rate of change of best-corrected visual acuity (BCVA), central retinal sensitivity, neuroretinal and choroidal thickness in patients with macular edema after 1.25 mg/0.05 ml intravitreal bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA). METHODS: A prospective, nonrandomized, interventional study. Thirty-seven consecutive eyes with macular edema were included in the study. For all eyes, BCVA, central retinochoroidal thickness at standardized A-scan, central retinal thickness, and central retinal sensitivity recorded with a spectral scanning laser ophthalmoscope optical coherence tomography/microperimeter device were evaluated at baseline and 7, 15, 30, 37, 45, and 60 days after initial treatment. All patients received 2 intravitreal bevacizumab injections at 1-month interval. RESULTS: A significant although not related improvement of BCVA and retinal sensitivity was seen after 1 month and 2 months of follow-up. Anatomic improvement only involved the neuroretina, although significant changes of central choroidal thickness were not detected. CONCLUSION: Intravitreal bevacizumab for macular edema determines significant early functional and anatomic improvements.

Three-dimensional visualization of vitreoretinal abnormalities in high myopia.

The authors have evaluated with three-dimensional (3D) spectral domain optical coherence tomography (SD-OCT) four highly myopic eyes (2 patients) presenting with peripapillary detachment of the pigment epithelium (PDPM), vitreoretinal tractions, and myopic retinoschisis. Three-dimensional SD-OCT analysis of PDPM revealed an optically empty space localized beneath the retinal pigment epithelium (RPE). A peripapillary separation of the retina-RPE complex from the choroid could explain the presence of this space. The 3D imaging of vitreomacular tractions could help physicians plan the appropriate surgical approach in patients with myopic posterior detachment due to macular hole.

Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab.

PURPOSE:: To describe the optical coherence tomography angiography characteristics of myopic patients with choroidal neovascularization secondary to pathologic myopia during ranibizumab therapy. METHODS:: Nineteen patients were enrolled in this prospective study (13 females, 6 males, mean age 55.25 ± 9.63 years) for a total of 20 eyes examined (14 right eyes, 6 left eyes). Images were analyzed independently by two examiners. RESULTS:: Mean follow-up was 5.75 ± 1.88 months, with a mean intravitreal injections of 1.90 ± 0.44. Mean best-corrected visual acuity at baseline was 0.39 ± 0.18 logMAR versus 0.26 ± 0.16 logMAR 6 months after treatment. The neovascular area (Z = -2.091, p = 0.037) was significantly reduced after treatment, whereas vessel density was not (Z = -1.848, p = 0.065). Moreover, the best-corrected visual acuity was increased (Z = -3.055, p = 0.002). Neovascular area was significantly correlated with best-corrected visual acuity, at both baseline and follow-up (p < 0.05). CONCLUSION:: Our data suggest that optical coherence tomography angiography is a reproducible non-invasive examination with which to monitor changes in the neovascular area in patients with pathologic myopia treated with ranibizumab.

Optical coherence tomography angiography to assess vascular remodeling of the choriocapillaris after low-fluence photodynamic therapy for chronic central serous chorioretinopathy.

BACKGROUND: To evaluate the efficacy of optical coherence tomography angiography (OCTA) in identifying changes in the choriocapillaris layer after low-fluence verteporfin photodynamic therapy (vPDT) in patients affected by chronic central serous chorioretinopathy (CSCR). METHODS: Low-fluence vPDT was performed on 28 eyes of 27 patients with CSCR. All patients underwent the following tests at baseline and 6 months after treatment: best corrected visual acuity (BCVA), fluorescein angiography, indocyanine green angiography, enhanced depth imaging OCT and OCTA. RESULTS: Subretinal fluid was completely absorbed in 18 of the 28 affected eyes (64.3%) after low-fluence vPDT ("responders"), and incompletely absorbed in 10 eyes (35.7%) ("non responders"). BCVA was significantly improved (p = 0.006) whereas central foveal thickness and choroidal foveal thickness were significantly decreased (p = 0.001 and p = 0.00 respectively) 6 months after treatment in responders. CONCLUSIONS: OCTA revealed a different pattern of vascular remodeling of the choriocapillaris between CSC patients who responded and those who did not respond to low-fluence vPDT.

En face optical coherence tomography of the posterior pole in high myopia.

PURPOSE: To evaluate a large series of patients affected by high myopia using multiplanar imaging provided by en face optical coherence tomography (OCT). DESIGN: Observational cross-sectional study. METHODS: En face OCT longitudinal cross-sectional B scans and coronal C scans were obtained in 200 eyes of 100 patients with myopia greater than -6 diopters and evidence of posterior staphyloma at fundus examination and at ultrasound B-scan evaluation. RESULTS: A macular hole was present in three eyes (1.5%). We detected posterior retinal detachment in 37 cases (18.5%). In 15 eyes (7.5%) detachment was associated with a macular hole. In the remaining 22 eyes (11%), the detachment was located in the area of the staphyloma, and was associated with vitreoretinal traction in four eyes (18.2%) of 22 eyes. There was evidence of detachment of the internal limiting membrane (ILM) in 12 eyes (6%) and retinoschisis in 27 (13.5%) of 200 eyes. Retinal vascular microfolds were detected in 40 eyes (20%), and occurred in all cases of peripapillary retinal detachment, ILM detachment, and retinoschisis. Paravascular microcysts occurred in three eyes (1.5%), and peripapillary detachment of the pigment epithelium in 10 eyes (5%). CONCLUSIONS: En face OCT provides accurate imaging of retinal abnormalities in high myopia and allows width measurement and point-to-point localization of alterations. Thus, it can represent a noninvasive way to detect minimal changes during follow-up. Posterior detachment in the absence of a macular hole seems to be related to vitreoretinal traction, staphyloma, and inward forces exerted by rigid retinal vessels and ILM. En face OCT-assisted surgery of macular holes could help to plan removal of premacular tractional structures.

Clinical evolution of neuroretinitis in Parry-Romberg syndrome.

A 16-year-old girl with Parry-Romberg syndrome presented with monolateral exudative neuroretinitis and retinal telangiectasis that had been observed for 42 months. She was treated with immunosuppressive therapy with A-cyclosporine for 1 year, followed by laser treatment of telangiectasis. Her visual acuity improved from 20/200 to 20/70 in 1 year with a reduction of neuroretinal exudation. Laser treatment resulted in a further improvement of visual acuity to 20/40. Clinical findings remained unchanged during 2 years of follow-up. The association of immunosuppressive treatment and laser therapy may improve neuroretinal disease in the presence of Parry-Romberg syndrome.

Optical coherence tomography angiography versus fluorescein angiography in the diagnosis of ischaemic diabetic maculopathy.

PURPOSE: To evaluate the efficacy of optical coherence tomography (OCT) angiography versus fluorescein angiography (FA) in terms of retinal vessel imaging in ischaemic diabetic maculopathy defined according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. METHODS: Twenty patients (31 eyes) with ischaemic diabetic maculopathy and 17 control subjects (27 eyes) were enrolled in this prospective study. Patients and control subjects underwent complete ophthalmic examination, including best-corrected visual acuity (BCVA), intraocular pressure, FA, Fourier domain optical coherence tomography (FD-OCT) and OCT angiography. Fluorescein angiograms and OCT angiography images were graded according to the foveal avascular zone (FAZ) of the ETDRS group. Ganglion cell complex (GCC) thickness was evaluated with FD-OCT. RESULTS: Optical coherence tomography (OCT) angiography images closely correlated with FA in terms of FAZ parameters. The correlation was strongest with OCT angiography deep imaging. The average GCC thickness was smaller in patients than in controls. Neither GCC parameters nor FAZ was correlated to BCVA. CONCLUSIONS: Given the correlation between FA and OCT angiography in terms of FAZ parameters, the newer method can be considered a valid, reliable and easy-to-perform method with which to evaluate ischaemic diabetic maculopathy without contrast injection, and thus to visualize and quantify non-perfusion areas without risks of anaphylactic reactions.

Study of the Radial Peripapillary Capillary Network in Congenital Optic Disc Anomalies With Optical Coherence Tomography Angiography.

PURPOSE: To evaluate the radial peripapillary capillary network with optical coherence tomography angiography (angio-OCT) in morning glory syndrome (MGS), optic disc colobomas, and optic disc pits, and to explore possible correlations between the neural vascular structure and the pathogenesis of congenital optic disc anomalies. DESIGN: Prospective observational comparative case series. METHODS: Fifteen eyes of 15 patients with congenital optic disc anomalies were enrolled in this study. All patients underwent angio-OCT. The scans were centered on optic discs. RESULTS: The mean age at presentation was 33 years (range: 19-50 years). Congenital optic disc anomalies were identified in all 15 eyes. Three eyes had the characteristic funduscopic signs of MGS, and angio-OCT scans of the peripapillary retina revealed a dense microvascular network. Optic disc colobomas were found in 5 eyes, and the characteristic funduscopic signs of optic pits were found in 7 eyes. Angio-OCT showed the absence of a radial peripapillary microvascular network in these 12 eyes. CONCLUSION: The finding that angio-OCT scans confirmed the presence of a peripapillary microvascular network only in MGS cases supports the hypothesis that a primary neuroectodermal abnormality and a secondary mesenchymal abnormality leads to MGS. Angio-OCT is a safe, rapid imaging technique that could shed light on the pathogenesis of rare diseases of the optic disc.

Evaluation of ischemic diabetic maculopathy with Fourier-domain optical coherence tomography and microperimetry.

OBJECTIVE: To evaluate the efficacy of high-speed Fourier-domain optical coherence tomography (FD-OCT) and fundus microperimetry (MP-1) in identifying the anatomic and functional features of ischemic diabetic maculopathy. DESIGN: Prospective noninterventional study. PARTICIPANTS: Forty-two consecutive eyes (23 patients) with ischemic diabetic maculopathy and 40 normal eyes (25 control subjects) were included in this study. METHODS: Best corrected visual acuity, ganglion cell complex (GCC) thickness measured with FD-OCT, and central light sensitivity recorded with MP-1 were evaluated. RESULTS: GCC thickness and light sensitivity were significantly reduced in all affected eyes versus control eyes. logMAR BVCA was significantly correlated with mean macular sensitivity (R=0.783, R(2)=0.611). CONCLUSIONS: GCC thickness and microperimetry integrated with fluorescein angiography could be a marker of retinal vascular abnormalities that is useful for the diagnosis of ischemic diabetic maculopathy.