Lupidi Marco, Coscas Gabriel, Coscas Florence, Fiore Tito, Spaccini Elisa, Fruttini Daniela, Cagini Carlo
Centre de l'Odéon, Paris, France.
Ophthalmic Res. 2017;58(3):131-141. doi: 10.1159/000471885. Epub 2017 May 25.
To perform a qualitative and quantitative assessment of the foveal microvasculature in eyes with diabetic maculopathy using optical coherence tomography angiography (OCT-A).
Retrospective case series of 48 eyes with diabetic maculopathy and 47 healthy eyes evaluated by Spectralis OCT-A. Perifoveal arcade disruptions, linear vascular dilations, microaneurysms, intraretinal microvascular abnormalities and flow-void areas were qualitatively analyzed on OCT angiograms both for the superficial (SCP) and deep (DCP) capillary plexuses. A fully automated microstructural analysis of the foveal avascular zone (FAZ) metrics, vascular and avascular surfaces was performed. Quantitative values from diabetic patients were compared with those of healthy subjects.
A moderate agreement between SCP and DCP in terms of diabetes-induced vascular lesions in the qualitative assessment was shown. The comparative quantitative analysis between SCP and DCP in diabetic patients revealed a statistically significant difference (p < 0.05) in terms of FAZ perimeter and FAZ surface. No statistically significant difference was shown in total vascular and avascular surfaces. A statistically significant difference between the diabetic and control groups was noticed both for SCP and DCP considering FAZ metrics and vascular surfaces.
A qualitative and quantitative OCT-A approach on retinal vascular perfusion may offer an objective and reliable method for monitoring disease progression in diabetic retinopathy.
使用光学相干断层扫描血管造影(OCT-A)对糖尿病性黄斑病变患者的黄斑部微血管进行定性和定量评估。
对48例糖尿病性黄斑病变患者的眼部和47例健康对照者的眼部进行回顾性病例系列研究,采用Spectralis OCT-A进行评估。在OCT血管造影上,对浅表(SCP)和深层(DCP)毛细血管丛的黄斑周围弓状血管中断、线性血管扩张、微动脉瘤、视网膜内微血管异常和无血流区域进行定性分析。对黄斑无血管区(FAZ)指标、血管和无血管表面进行全自动微观结构分析。将糖尿病患者的定量值与健康受试者的定量值进行比较。
在定性评估中,SCP和DCP在糖尿病引起的血管病变方面显示出中等程度的一致性。糖尿病患者SCP和DCP之间的比较定量分析显示,在FAZ周长和FAZ面积方面存在统计学显著差异(p<0.05)。在总血管和无血管表面方面未显示出统计学显著差异。考虑到FAZ指标和血管表面,糖尿病组和对照组之间在SCP和DCP方面均存在统计学显著差异。
对视网膜血管灌注进行定性和定量的OCT-A方法可能为监测糖尿病视网膜病变的疾病进展提供一种客观可靠的方法。