糖尿病性视网膜病变未累及者的定量视网膜光学相干断层扫描血管造影

Quantitative Retinal Optical Coherence Tomography Angiography in Patients With Diabetes Without Diabetic Retinopathy.

作者信息

Dimitrova Galina, Chihara Etsuo, Takahashi Hirokazu, Amano Hiroyuki, Okazaki Kazushiro

机构信息

Department of Ophthalmology, City General Hospital "8th September," Skopje, Macedonia.

Sensho-kai Eye Institute, Iseda, Uji, Kyoto, Japan.

出版信息

Invest Ophthalmol Vis Sci. 2017 Jan 1;58(1):190-196. doi: 10.1167/iovs.16-20531.

DOI:10.1167/iovs.16-20531

PMID:28114579

Abstract

PURPOSE

To compare optical coherence tomography (OCT) angiographic parameters in retina and choriocapillaris between control subjects and diabetic patients without diabetic retinopathy (NDR). Correlations were studied between OCT angiography parameters, retinal structure parameters, and systemic characteristics in all subjects.

METHODS

Sixty-two patients were included in the study: control subjects (n = 33) and patients with NDR (n = 29). Optical coherence topography angiographic parameters were as follows: vessel density (%) (in superficial, deep retinal vessel plexus and in choriocapillary layer) and foveal avascular zone (FAZ) area (mm2) in superficial and deep retinal vessel plexus of parafovea. Split-spectrum amplitude decorrelation angiography (SSADA) software algorithm was used for evaluation of vessel density and FAZ area (nonflow area tool). Spectral-domain OCT was used to assess full, inner, and outer retinal thickness and volume in parafovea.

RESULTS

In superficial and deep retina, vessel densities in NDR (44.35% ± 13.31% and 31.03% ± 16.33%) were decreased as compared to control subjects (51.39% ± 13.05%, P = 0.04; and 41.53% ± 14.08%, P < 0.01). Foveal avascular zone in superficial retina of NDR patients (0.37 ± 0.11 mm2) was greater than in controls (0.31 ± 0.10 mm2, P = 0.02). Superficial vessel density significantly correlated with full retinal thickness and volume in parafovea (r = 0.43, P = 0.01; r = 0.43, P = 0.01) and with outer retinal volume in parafovea (r = 0.35, P < 0.05) of healthy subjects. Systolic blood pressure and ocular perfusion pressure significantly correlated with deep vessel density in NDR (r = -0.45, P = 0.02; r = -0.46, P = 0.01), but not in controls.

CONCLUSIONS

Superficial and deep retinal vessel density in parafovea of diabetic patients without diabetic retinopathy are both decreased compared to healthy subjects. The associations between vessel density with retinal tissue thickness and with subject's clinical characteristics differ between healthy subjects and patients with NDR.

摘要

目的

比较对照组与无糖尿病视网膜病变（NDR）的糖尿病患者视网膜和脉络膜毛细血管层的光学相干断层扫描（OCT）血管造影参数。研究所有受试者的OCT血管造影参数、视网膜结构参数和全身特征之间的相关性。

方法

62例患者纳入本研究：对照组（n = 33）和NDR患者（n = 29）。光学相干断层扫描血管造影参数如下：血管密度（%）（在视网膜浅、深血管丛和脉络膜毛细血管层）以及黄斑旁视网膜浅、深血管丛的无血管区（FAZ）面积（mm²）。采用分裂谱幅度去相关血管造影（SSADA）软件算法评估血管密度和FAZ面积（非血流区域工具）。使用光谱域OCT评估黄斑旁视网膜全层、内层和外层厚度及体积。

结果

在视网膜浅层和深层，NDR患者的血管密度（44.35%±13.31%和31.03%±16.33%）低于对照组（51.39%±13.05%，P = 0.04；41.53%±14.08%，P < 0.01）。NDR患者视网膜浅层的无血管区（0.37±0.11 mm²）大于对照组（0.31±0.10 mm²，P = 0.02）。健康受试者中，浅层血管密度与黄斑旁视网膜全层厚度和体积显著相关（r = 0.43，P = 0.01；r = 0.43，P = 0.01），与黄斑旁视网膜外层体积也显著相关（r = 0.35，P < 0.05）。收缩压和眼灌注压与NDR患者的深层血管密度显著相关（r = -0.45，P = 0.02；r = -0.46，P = 0.01），但与对照组无关。