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使用光学相干断层扫描血管造影术对正常人和糖尿病视网膜病变患者进行视网膜血管灌注密度映射

RETINAL VASCULAR PERFUSION DENSITY MAPPING USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN NORMALS AND DIABETIC RETINOPATHY PATIENTS.

作者信息

Agemy Steven A, Scripsema Nicole K, Shah Chirag M, Chui Toco, Garcia Patricia M, Lee Jessica G, Gentile Ronald C, Hsiao Yi-Sing, Zhou Qienyuan, Ko Tony, Rosen Richard B

机构信息

*Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York; †Icahn School of Medicine at Mount Sinai, New York, New York; ‡Stony Brook University School of Medicine, Stony Brook, New York; §Department of Ophthalmology, Winthrop University Hospital, Mineola, New York; and ¶Optovue, Inc., Fremont, California.

出版信息

Retina. 2015 Nov;35(11):2353-63. doi: 10.1097/IAE.0000000000000862.

Abstract

PURPOSE

To describe a new method of retinal vascular perfusion density mapping using optical coherence tomography angiography and to compare current staging of diabetic retinopathy based on clinical features with a new grading scale based on perifoveal perfusion densities.

METHODS

A retrospective review was performed on subjects with diabetic retinopathy and age-matched controls imaged with a spectral domain optical coherence tomography system (Optovue XR Avanti, Fremont, CA). Split-spectrum amplitude-decorrelation angiography (SSADA) generated optical coherence tomography angiograms of the superficial retinal capillaries, deep retinal capillaries, and choriocapillaris. Skeletonized optical coherence tomography angiograms were used to create color-coded perfusion maps and capillary perfusion density values for each image. Capillary perfusion density values were compared with clinical staging, and groups were compared using analysis of variance and Kruskal-Wallis analyses.

RESULTS

Twenty-one control and 56 diabetic retinopathy eyes were imaged. Diabetic eyes were grouped according to clinical stage. Capillary perfusion density values from each microvascular layer were compared across all groups. Capillary perfusion density values were significantly lower in nearly all layers of all study groups compared with controls. Trend analysis showed a significant decrease in capillary perfusion density values as retinopathy progresses for most layers.

CONCLUSION

Quantitative retinal vascular perfusion density mapping agreed closely with grading based on clinical features and may offer an objective method for monitoring disease progression in diabetic retinopathy.

摘要

目的

描述一种使用光学相干断层扫描血管造影术进行视网膜血管灌注密度绘图的新方法,并将基于临床特征的糖尿病视网膜病变当前分期与基于黄斑中心凹周围灌注密度的新分级量表进行比较。

方法

对患有糖尿病视网膜病变的受试者以及使用光谱域光学相干断层扫描系统(Optovue XR Avanti,加利福尼亚州弗里蒙特)成像的年龄匹配对照组进行回顾性研究。分裂光谱幅度去相关血管造影(SSADA)生成了视网膜浅层毛细血管、视网膜深层毛细血管和脉络膜毛细血管的光学相干断层扫描血管造影图像。使用骨骼化的光学相干断层扫描血管造影图像来创建每个图像的彩色编码灌注图和毛细血管灌注密度值。将毛细血管灌注密度值与临床分期进行比较,并使用方差分析和克鲁斯卡尔 - 沃利斯分析对各组进行比较。

结果

对21只对照眼和56只糖尿病视网膜病变眼进行了成像。糖尿病眼根据临床分期进行分组。比较了所有组中每个微血管层的毛细血管灌注密度值。与对照组相比,所有研究组几乎所有层的毛细血管灌注密度值均显著降低。趋势分析表明,随着视网膜病变进展,大多数层的毛细血管灌注密度值显著下降。

结论

定量视网膜血管灌注密度绘图与基于临床特征的分级密切一致,可能为监测糖尿病视网膜病变的疾病进展提供一种客观方法。

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