宽视场光学相干断层扫描血管造影术在评估糖尿病视网膜病变严重程度中的作用。

IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Ophthalmology and Therapy Pub Date : 2024-09-01 Epub Date: 2024-07-12 DOI:10.1007/s40123-024-00995-y
Deepika C Parameswarappa, Amelia Janis Langstang, Sanagavarapu Kavya, Ashik Mohamed, Michael W Stewart, Padmaja Kumari Rani
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摘要

导言:医生需要准确了解糖尿病视网膜病变(DR)的严重程度,以便对患者进行最佳管理。这项前瞻性研究的目的是将宽视场(WF)光学相干断层血管成像(OCTA)所见黄斑和周边视网膜血管异常的严重程度与基于 WF 眼底摄影的 DR 分级联系起来:该研究包括 82 名未接受过治疗的 DR 患者的 150 只眼睛。所有患者均接受了 WF 眼底摄影和扫源 WF OCTA 扫描。根据 OCTA 图像对眼窝无血管区(FAZ)的大小和形状进行定量和定性分析,并测量毛细血管无灌注区(CNP)。混合效应模型用于比较WF摄影的DR分级和WF-OCTA的血管变化,并对分级进行Bonferroni校正:患者的平均年龄为 55.5 (± 标准差 (SD))岁。WF-OCTA显示,FAZ的增大(从0.442(± 0.059)µm到0.933(± 0.086)µm)与DR严重程度的增加相关(由WF摄影确定)。增殖性糖尿病视网膜病变(PDR)患者的深部毛细血管丛、FAZ 大小和 CNP 面积与轻度非增殖性糖尿病视网膜病变(NPDR)患者不同(p 结论:PDR 患者的深部毛细血管丛、FAZ 大小和 CNP 面积与轻度非增殖性糖尿病视网膜病变(NPDR)患者不同:WF-OCTA 测量的 FAZ 和 CNP 面积与糖尿病视网膜病变的严重程度相关。WF-OCTA 还能检测出眼底照相无法看到的细微 NVE 和 NVD。
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The Role of Widefield Optical Coherence Tomography Angiography in Assessing the Severity of Diabetic Retinopathy.

Introduction: Physicians need an accurate understanding of diabetic retinopathy (DR) severity to optimally manage patients. The aim of this prospective study is to correlate the severity of macular and peripheral retinal vascular abnormalities seen on widefield (WF) optical coherence tomography angiography (OCTA) with DR grading based on WF fundus photography.

Methods: The study included 150 eyes from 82 patients with treatment-naïve DR. All patients were imaged with WF fundus photography and swept-source WF OCTA. Quantitative and qualitative analyses of the foveal avascular zone (FAZ) size and shape, and measurement of capillary nonperfusion (CNP) areas, were performed from the OCTA images. The mixed-effects model was used to compare the DR grading from WF photography with the vascular changes seen on WF-OCTA, and Bonferroni correction was applied to the gradings.

Results: The mean [± standard deviation (SD)] age of patients was 55.5 (± 9.4) years. The WF-OCTA showed that an increasing size of the FAZ (from 0.442 (± 0.059) µm to 0.933 (± 0.086) µm) correlated with increasing severity of the DR (as determined with WF photography). The deep capillary plexus, FAZ size, and CNP areas in eyes with proliferative diabetic retinopathy (PDR) differed from those with mild nonproliferative diabetic retinopathy (NPDR) (p < 0.001). Most eyes with severe nonproliferative DR were found to have CNP in four quadrants [superficial capillary plexus (SCP) 60%, deep capillary plexus (DCP) 50%]. The WF-OCTA detected subtle neovascularization of the disc (NVD) in 7 eyes (10%) and neovascularization elsewhere (NVE) in 13 eyes (18%) that had been diagnosed with only moderate NPDR on WF photography.

Conclusions: FAZ and CNP areas as measured by WF-OCTA correlate with DR severity. WF-OCTA can also detect subtle NVE and NVD that cannot be seen with fundus photography.

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Ophthalmology and Therapy
Ophthalmology and Therapy OPHTHALMOLOGY-
CiteScore
4.20
自引率
3.00%
发文量
157
审稿时长
6 weeks
期刊介绍: Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. 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