Dodo Yoko, Murakami Tomoaki, Suzuma Kiyoshi, Yoshitake Shin, Yoshitake Tatsuya, Ishihara Kenji, Fujimoto Masahiro, Miwa Yuko, Tsujikawa Akitaka
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Invest Ophthalmol Vis Sci. 2017 Nov 1;58(13):5870-5879. doi: 10.1167/iovs.17-22156.
To evaluate the relationship between lamellar capillary nonperfusion on optical coherence tomography angiography (OCTA) images and neuroglial changes on structural optical coherence tomography (OCT) images in diabetic retinopathy (DR).
We retrospectively reviewed 101 consecutive eyes of 69 patients with DR. OCTA and OCT images within a 3 × 3-mm square centered on the fovea were acquired simultaneously. The nonperfused areas (NPAs) in the superficial capillary layer (sNPA) (from the nerve fiber layer [NFL] to the inner plexiform layer [IPL]), the deep layer (dNPA) (corresponding mainly to the inner nuclear layer [INL]), or both layers (bNPA) were measured individually along 10 transverse lines. The corresponding lamellar neuroglial changes also were evaluated on OCT images.
The transverse lengths of the sNPA, dNPA, and bNPA were 2.34% (interquartile range, 0.81-5.55), 0.61% (0-1.99), and 5.96% (4.02-10.88), respectively. The length of the sNPA was correlated significantly with the lengths of no boundary between the NFL and ganglion cell layer (GCL)/IPL and the spots with inverted OCT reflectivity in the sNPA. The transverse length of the dNPA was associated with the length of cystoid spaces in the INL or Henle's fiber layer (HFL) in the dNPA. There was a significant correlation between the transverse lengths of the bNPA and no boundary between the NFL and GCL/IPL within the bNPA.
Systematic evaluation of the OCTA-OCT association showed structural changes in the neuroglial tissues corresponding to the lamellar NPAs and suggested the feasibility of layer-by-layer evaluation of the capillary nonperfusion in DR.
评估糖尿病视网膜病变（DR）患者光学相干断层扫描血管造影（OCTA）图像上的板层毛细血管无灌注与结构光学相干断层扫描（OCT）图像上的神经胶质变化之间的关系。
我们回顾性分析了69例DR患者的101只连续眼。同时获取以黄斑中心凹为中心的3×3平方毫米正方形区域内的OCTA和OCT图像。分别沿着10条横线测量浅层毛细血管层（sNPA）（从神经纤维层[NFL]到内网状层[IPL]）、深层（dNPA）（主要对应内核层[INL]）或两层（bNPA）中的无灌注区域（NPA）。还在OCT图像上评估了相应的板层神经胶质变化。
sNPA、dNPA和bNPA的横向长度分别为2.34%（四分位间距，0.81 - 5.55）、0.61%（0 - 1.99）和5.96%（4.02 - 10.88）。sNPA的长度与NFL和神经节细胞层（GCL）/IPL之间无边界的长度以及sNPA中OCT反射率倒置的斑点长度显著相关。dNPA的横向长度与dNPA中INL或亨利纤维层（HFL）中的囊样间隙长度相关。bNPA的横向长度与bNPA内NFL和GCL/IPL之间无边界的长度之间存在显著相关性。
对OCTA - OCT关联的系统评估显示，对应于板层NPA的神经胶质组织存在结构变化，并提示了对DR中毛细血管无灌注进行逐层评估的可行性。
