Kaizu Yoshihiro, Nakao Shintaro, Yoshida Shigeo, Hayami Takehito, Arima Mitsuru, Yamaguchi Muneo, Wada Iori, Hisatomi Toshio, Ikeda Yasuhiro, Ishibashi Tatsuro, Sonoda Koh-Hei
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Intelligent Mechanical Systems, Graduate School of Natural Science and Technology, Okayama University, Okayama, Japan.
Invest Ophthalmol Vis Sci. 2017 Sep 1;58(11):4889-4897. doi: 10.1167/iovs.17-22306.
Our purpose is to evaluate the spatial bias of macular capillary dropout accompanying diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).
This study included 47 patients with diabetes and 29 healthy individuals who underwent OCTA. Retinal capillary flow density (FD) of 2.6 × 2.6 or 5.2 × 5.2 mm foveal area as well as the four divided areas (superior, inferior, temporal, nasal) without a foveal avascular zone (FAZ) at the superficial capillary plexus and deep capillary plexus (DCP) were measured respectively using ImageJ and NI Vision. Spatial biases of FD (orientation bias ratio and hierarchical bias ratio) and the correlation between FAZ and FD were examined.
OCTA showed focal capillary dropout in DR patients. The orientation bias of FD was significantly higher in NPDR compared to NDR in the DCP (P = 0.03). The hierarchical bias of FD was significantly shifted to a DCP dominance with progression of DR (P < 0.01). In addition, the FD and FAZ area were significantly inversely correlated in both plexus in DR patients but not in healthy subjects (P < 0.01).
Area-divided OCTA quantification shows the appearance of spatial biases of macular capillary dropout with the onset of DR, suggesting that DR-related macular capillary dropout occurs locally and randomly. Future studies are necessary to determine the clinical relevance of the spatial pattern of capillary dropout in DR.
我们的目的是使用光学相干断层扫描血管造影（OCTA）评估糖尿病视网膜病变（DR）伴随的黄斑毛细血管缺失的空间偏差。
本研究纳入了47例糖尿病患者和29名健康个体，他们均接受了OCTA检查。分别使用ImageJ和NI Vision测量2.6×2.6或5.2×5.2mm黄斑区的视网膜毛细血管血流密度（FD），以及浅表毛细血管丛和深部毛细血管丛（DCP）中四个无黄斑无血管区（FAZ）的划分区域（上、下、颞、鼻）。检查FD的空间偏差（方向偏差率和分层偏差率）以及FAZ与FD之间的相关性。
OCTA显示DR患者存在局灶性毛细血管缺失。在DCP中，与非糖尿病性视网膜病变（NDR）相比，非增殖性糖尿病性视网膜病变（NPDR）中FD的方向偏差显著更高（P = 0.03）。随着DR的进展，FD的分层偏差显著转向以DCP为主（P < 0.01）。此外，DR患者的两个毛细血管丛中FD与FAZ面积均呈显著负相关，而健康受试者中则无此相关性（P < 0.01）。
分区OCTA定量显示随着DR的发生，黄斑毛细血管缺失出现空间偏差，提示与DR相关的黄斑毛细血管缺失是局部且随机发生的。未来有必要开展研究以确定DR中毛细血管缺失空间模式的临床相关性。
