Characterization of the Disorganization of the Inner Retinal Layers in Diabetics Using Increased Axial Resolution Optical Coherence Tomography.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY Translational Vision Science & Technology Pub Date : 2025-01-02 DOI:10.1167/tvst.14.1.12

Katharina Wall, Lilith P Arend, Leon von der Emde, Marlene Saßmannshausen, Frank G Holz, Thomas Ach

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Abstract

Purpose: To compare a novel high-resolution optical coherence tomography (OCT) with improved axial resolution (High-Res OCT) with conventional spectral-domain OCT (SD-OCT) with regard to their capacity to characterize the disorganization of the retinal inner layers (DRIL) in diabetic maculopathy.

Methods: Diabetic patients underwent multimodal retinal imaging (SD-OCT, High-Res OCT, and color fundus photography). Best-corrected visual acuity and diabetes characteristics were recorded. DR was graded using the international clinical diabetic retinopathy severity scale (DRSS). In each OCT B-scan, retinal layers were segmented and the loss of discernibility was annotated. DRIL areas were analyzed in en face projection using FIJI plugins. The Wilcoxon test and regression models were used for statistical analysis.

Results: In 93 eyes of 93 patients (mean age, 61.8 ± 12.9 years) DRIL was identified in 48 eyes. DRIL was most frequent in the central subfield (27%). In DRIL eyes, DRSS was significantly higher (4.43 ± 1.01 vs. 2.12 ± 1.66; P < 0.001), BCVA was significantly worse (0.34 ± 0.38 vs. 0.13 ± 0.22; P < 0.001), and the loss of discernibility of the individual inner retinal layers was significantly smaller in High-Res OCT compared with SD-OCT (0.21 ± 0.29 vs. 1.21 ± 1.21 mm2; P < 0.001). The discernibility loss was greatest in the retinal nerve fiber layer and ganglion cell layer.

Conclusions: DRIL occurs in eyes with advanced diabetic retinopathy, with a characteristic spread: from the inner toward the outer retina. High-Res OCT shows significantly smaller DRIL areas compared with SD-OCT, because of a more precise delineation of the inner retinal layers.

Translational relevance: Using OCT with increased axial resolution could enhance our understanding of DRIL development and progression, providing deeper insights into pathophysiological aspects, including malperfusion in the inner capillary plexus.

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利用增加轴向分辨率光学相干断层扫描表征糖尿病患者视网膜内层紊乱。

目的：比较具有改进轴向分辨率的新型高分辨率光学相干断层扫描（OCT）与传统的光谱域OCT （SD-OCT）表征糖尿病黄斑病变视网膜内层（DRIL）紊乱的能力。方法：对糖尿病患者行多模态视网膜成像（SD-OCT、高分辨率OCT和彩色眼底摄影）。记录最佳矫正视力和糖尿病特征。采用国际临床糖尿病视网膜病变严重程度量表（DRSS）对DR进行分级。在每次OCT b扫描中，视网膜层被分割，并注释了可识别性的丧失。利用斐济插件对钻孔区域进行正面投影分析。采用Wilcoxon检验和回归模型进行统计分析。结果：93例患者93只眼（平均年龄61.8±12.9岁）中，48只眼出现DRIL。DRIL在中心子区最常见（27%）。DRIL组的DRSS显著高于前者(4.43±1.01∶2.12±1.66；P < 0.001)， BCVA明显更差(0.34±0.38∶0.13±0.22；P < 0.001)，与SD-OCT相比，高分辨率OCT对单个视网膜内层的识别损失明显更小(0.21±0.29 vs. 1.21±1.21 mm2；P < 0.001)。视网膜神经纤维层和神经节细胞层的识别能力下降最大。结论：DRIL发生在晚期糖尿病视网膜病变的眼睛中，具有特征性的扩散：从视网膜内部向外层扩散。与SD-OCT相比，高分辨率OCT显示的DRIL区域明显更小，因为它能更精确地描绘视网膜内层。翻译相关性：使用轴向分辨率提高的OCT可以增强我们对DRIL发生和进展的理解，提供更深入的病理生理方面的见解，包括内毛细血管丛的灌注不良。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.