Comparison of Diabetic Retinopathy Lesions Identified Using Ultrawide Field Imaging and Optical Coherence Tomography Angiography.

IF 2 4区医学 Q2 OPHTHALMOLOGY Ophthalmic Research Pub Date : 2023-01-01 Epub Date: 2023-06-28 DOI:10.1159/000531723

Recivall P Salongcay, Lizzie Anne C Aquino, Claude Michael G Salva, Tunde Peto, Paolo S Silva

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Abstract

Introduction: Optical coherence tomography (OCT) angiography (OCTA) has the potential to influence the diagnosis and management of diabetic eye disease. This study aims to determine the correlation between diabetic retinopathy (DR) findings on ultrawide field (UWF) color photography (UWF-CP), UWF fluorescein angiography (UWF-FA), and OCTA.

Methods: This is a cross-sectional, prospective study. One hundred and fourteen eyes from 57 patients with diabetes underwent mydriatic UWF-CP, UWF-FA, and OCTA. DR severity was assessed. Ischemic areas were identified on UWF-FA using ImageJ and the nonperfusion index (NPI) was calculated. Diabetic macular edema (DME) was assessed using OCT. Superficial capillary plexus vessel density (VD), vessel perfusion (VP), and foveal avascular zone (FAZ) area were automatically measured on OCTA. Pearson correlation coefficient between the imaging modalities was determined.

Results: Forty-five eyes were excluded due to non-DR findings or prior laser photocoagulation; 69 eyes were analyzed. DR severity was associated with larger NPI (r = 0.55944, p < 0.0001) even after distinguishing between cones (Cone Nonperfusion Index [CPI]: r = 0.55617, p < 0.0001) and rods (Rod Nonperfusion Index [RPI]: r = 0.55285, p < 0.0001). In eyes with nonproliferative DR (NPDR), NPI is correlated with DME (r = 0.51156, p = 0.0017) and central subfield thickness (CST) (r = 0.67496, p < 0.0001). UWF-FA macular nonperfusion correlated with NPI (r = 0.42899, p = 0.0101), CPI (r = 0.50028, p = 0.0022), and RPI (r = 0.49027, p = 0.0028). Central VD and VP correlated with the DME presence (r = 0.52456, p < 0.0001; r = 0.51952, p < 0.0001) and CST (r = 0.50133, p < 0.0001; r = 0.48731, p < 0.0001). Central VD and VP were correlated with macular nonperfusion (r = 0.44503, p = 0.0065; r = 0.44239, p = 0.0069) in eyes with NPDR. Larger FAZ was correlated with decreased central VD (r = -0.60089, p = 0.0001) and decreased central VP (r = -0.59224, p = 0.0001).

Conclusion: UWF-CP, UWF-FA, and OCTA findings provide relevant clinical information on diabetic eyes. Nonperfusion on UWF-FA is correlated with DR severity and DME. OCTA metrics of the superficial capillary plexus correlate with the incidence of DME and macular ischemia.

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超宽视野成像和光学相干断层扫描血管造影识别糖尿病视网膜病变的比较。

引言：光学相干断层扫描（OCT）血管造影术（OCTA）有可能影响糖尿病眼病的诊断和治疗。本研究旨在确定糖尿病视网膜病变（DR）在超宽视野（UWF）彩色摄影（UWF-CP）、UWF荧光素血管造影术（UWF-FA）和OCTA上的表现之间的相关性。方法：这是一项横断面前瞻性研究。来自57名糖尿病患者的114只眼睛接受了散瞳UWF-CP、UWF-FA和OCTA。评估DR的严重程度。使用ImageJ在UWF-FA上识别缺血区域，并计算非融合指数（NPI）。使用OCTA评估糖尿病黄斑水肿（DME）。OCTA自动测量浅表毛细血管丛血管密度（VD）、血管灌注（VP）和中央凹无血管区（FAZ）面积。确定了成像模式之间的Pearson相关系数。结果：45眼因非DR表现或既往激光光凝而被排除在外；分析69眼。DR严重程度与较大的NPI相关（r=0.55944，p<；0.0001），即使在区分锥体（锥体非灌注指数[CPI]:r=0.55617，p<；0.0001，NPI与DME（r=0.51156，p=0.0017）和中心亚视野厚度（CST）（r=0.67496，p<；0.0001）相关。UWF-FA黄斑不融合与NPI（r=0.42899，p=0.0101）、CPI（r=0.50028，p=0.0022）相关，和RPI（r=0.49027，p=0.0028）。中心性VD和VP与DME的存在相关（r=0.52456，p<；0.0001；r=0.51952，p>；0.0001）和CST（r=0.50133，p&；0.0001，r=0.48731，p&<；0.0001。较大的FAZ与中心VD降低（r=-0.60089，p=0.0001）和中心VP降低（r=-0.59224，p=0.0001）相关。结论：UWF-CP、UWF-FA和OCTA的发现为糖尿病眼提供了相关的临床信息。UWF-FA未灌注与DR严重程度和DME相关。浅表毛细血管丛的OCTA指标与DME和黄斑缺血的发生率相关。

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来源期刊

Ophthalmic Research 医学-眼科学

CiteScore

3.80

自引率

4.80%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.