Ishibazawa Akihiro, Nagaoka Taiji, Takahashi Atsushi, Omae Tsuneaki, Tani Tomofumi, Sogawa Kenji, Yokota Harumasa, Yoshida Akitoshi
Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
Am J Ophthalmol. 2015 Jul;160(1):35-44.e1. doi: 10.1016/j.ajo.2015.04.021. Epub 2015 Apr 18.
To evaluate how optical coherence tomography (OCT) angiography depicts clinical fundus findings in patients with diabetic retinopathy (DR).
Prospective study evaluating imaging technology.
Forty-seven eyes of 25 patients with DR were scanned using a high-speed 840-nm-wavelength spectral-domain optical coherence tomography instrument (RTVue XR Avanti; Optovue, Inc, Fremont, California, USA). Blood flow was detected using the split-spectrum amplitude-decorrelation angiography algorithm. Fluorescein angiography (FA) images were also obtained in all eyes and the ability to visualize microaneurysms, retinal nonperfused areas, and neovascularization was compared with that of the en face OCT angiograms.
In 42 eyes, microaneurysms detected by FA near the macula appeared as focally dilated saccular or fusiform capillaries on OCT angiograms of the superficial and/or deep capillary plexus. Retinal nonperfused areas visualized by FA appeared as lesions with no or sparse capillaries on OCT angiograms. Area measurement of retinal nonperfusion near the macula in 7 eyes revealed a difference between the extent of nonperfused areas in superficial and deep plexuses. In 4 eyes, the vascular structures of neovascularization at the optic disc were clearly visualized on OCT angiograms. Decreases and re-increases of flow in new vessels were quantified in an eye treated with anti-vascular endothelial growth factor.
OCT angiography can clearly visualize microaneurysms and retinal nonperfused areas and enables closer observation of each layer of the retinal capillaries. Quantitative information on new vessels can also be obtained. OCT angiography may be clinically useful to evaluate the microvascular status and therapeutic effect of treatments for DR.
评估光学相干断层扫描血管造影（OCTA）如何描绘糖尿病视网膜病变（DR）患者的临床眼底表现。
评估成像技术的前瞻性研究。
使用高速840纳米波长的光谱域光学相干断层扫描仪器（RTVue XR Avanti；美国加利福尼亚州弗里蒙特市Optovue公司）对25例DR患者的47只眼进行扫描。采用分裂光谱幅度去相关血管造影算法检测血流。所有眼睛均获得荧光素血管造影（FA）图像，并将微动脉瘤、视网膜无灌注区和新生血管的可视化能力与OCTA正面图像进行比较。
在42只眼中，FA检测到的黄斑附近微动脉瘤在浅层和/或深层毛细血管丛的OCTA图像上表现为局灶性扩张的囊状或梭形毛细血管。FA显示的视网膜无灌注区在OCTA图像上表现为无毛细血管或毛细血管稀疏的病变。对7只眼中黄斑附近视网膜无灌注区的面积测量显示，浅层和深层丛中无灌注区的范围存在差异。在4只眼中，视盘新生血管的血管结构在OCTA图像上清晰可见。在用抗血管内皮生长因子治疗的一只眼中，对新血管中的血流减少和再增加进行了量化。
OCTA可以清晰地显示微动脉瘤和视网膜无灌注区，并能更仔细地观察视网膜毛细血管的每一层。还可以获得关于新血管的定量信息。OCTA在临床上可能有助于评估DR的微血管状态和治疗效果。
