title: Cilioretinal arteries in diabetic eyes are associated with increased retinal blood flow velocity and occurrence of diabetic macular edema.
abstract: OBJECTIVE
  The main purpose was to investigate the relationship between occurrence of cilioretinal arteries and macular edema in diabetic eyes in terms of retinal blood flow characteristics revealed by the Retinal Function Imager (RFI). Other standard imaging techniques such as fundus photography, fluorescein angiography, and spectral-domain optical coherence tomography/scanning laser ophthalmoscopy were also used along with the RFI. The additional purpose was to look for the evidence of cilioretinal-retinal collaterals using the RFI.
  
  
  METHODS
  Patients with a diagnosis of diabetic retinopathy were included. All patients underwent fundus photography, fluorescein angiography, spectral-domain optical coherence tomography, and imaging using RFI. The presence of cilioretinal artery (CilRA) was recognized using color/red-free fundus photographs, fluorescein angiography, and RFI. There were two groups according to the presence (CilRA group) or absence (NoCilRA group) of cilioretinal artery or arteries in the study eye.
  
  
  RESULTS
  Thirty-nine eyes with diabetic retinopathy were included. Cilioretinal artery was identified in 15 eyes (38%). In the CilRA group, spectral-domain optical coherence tomography evidence of macular edema was observed in 13 of 15 eyes (87%), whereas in the NoCilRA group, macular edema was observed on spectral-domain optical coherence tomography in 7 of 24 eyes (29%). Mean blood flow velocities in retinal arteries and veins were significantly higher in diabetic eyes with cilioretinal artery (P = 0.04 and P = 0.005, respectively). Mean blood velocity in cilioretinal arteries was significantly higher in comparison with the mean arterial blood velocity (P = 0.03). In the CilRA group, cilioretinal-retinal collaterals, assessed by RFI, were detected in 4 of 15 eyes (27%) with cilioretinal arteries. In the NoCilRA group, mean blood velocity in retinal veins was significantly higher in eyes with macular edema in comparison with those without macular edema (P = 0.03).
  
  
  CONCLUSIONS
  Using the RFI in conjunction with standard fundus imaging techniques, the presence of cilioretinal artery in diabetic eyes was found to be associated with increased retinal blood flow velocity and increased occurrence of diabetic macular edema. The occurrence of cilioretinal-retinal collaterals was also noted; however, the pathophysiologic significance of this finding requires further investigation.
authors.affiliation: Retina Center, Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, New York 10003, USA. rrosen@nyee.edu
authors.forename: Gennady
authors.initials: G
authors.lastname: Landa
authors.forename: Wendewessen
authors.initials: W
authors.lastname: Amde
authors.forename: Yodit
authors.initials: Y
authors.lastname: Haileselassie
authors.forename: Richard B
authors.initials: RB
authors.lastname: Rosen
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D019842:Ciliary Arteries / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000503:physiopathology*; D004912:Erythrocytes / Q000502:physiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010781:Photography; D012039:Regional Blood Flow; D012161:Retinal Artery / Q000502:physiology*; D041623:Tomography, Optical Coherence