Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, USA.
Deparment of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Br J Ophthalmol. 2018 Sep;102(9):1199-1203. doi: 10.1136/bjophthalmol-2017-311358. Epub 2017 Nov 29.
To examine the feasibility of wide-field en face swept-source optical coherence tomography angiography (SS-OCTA) with extended field imaging (EFI) for evaluation of the retinal vasculature in diabetic retinopathy (DR).
This study included 37 eyes of 27 patients (age, 65±10 years; male patients, 18; female patients, 9) with DR. All patients underwent comprehensive ophthalmological examination, including OCTA and fluorescein angiography (FA). The imaging methods were compared for visible field of view, presence and extent of non-perfused areas (NPAs), presence and number of new blood vessels (NVs), vessel density (VD) and patient comfort level measured by Visual Analogue Scale.
SS-OCTA with EFI allowed capture of larger areas (by 1.80±0.18 times on average) of the fundus than SS-OCTA without EFI. Compared with FA, the sensitivities of SS-OCTA with EFI for detection of NPAs and NVs were 96% and 79%, respectively, with specificities of 100% and 96%, respectively. There was no significant difference in extent of NPAs (61.2±45.8 vs 61.5±55.0 disc areas, P=0.99) or number of NVs (1.5±3.3 vs 0.9±1.8, P=0.68) between FA and SS-OCTA with EFI. VD showed significantly lower values in EFI SS-OCTA than in those acquired without EFI (31.6%±4.3% vs 34.2%±4.3%, P<0.001). Wide-field OCTA with EFI was significantly more comfortable for patients than FA (P0.001).
SS-OCTA with EFI allows acquisition of wide-field en face images of the retinal vasculature in patients with DR, with greater patient comfort than FA.
探讨宽视野扫频源光学相干断层扫描血管造影(SS-OCTA)联合扩展视场成像(EFI)评估糖尿病视网膜病变(DR)患者视网膜血管的可行性。
本研究纳入 27 例(65±10 岁;男 18 例,女 9 例)DR 患者的 37 只眼。所有患者均行全面眼科检查,包括 OCTA 和荧光素血管造影(FA)。比较两种成像方法的可见视野、无灌注区(NPA)的存在和范围、新生血管(NV)的存在和数量、血管密度(VD)以及通过视觉模拟量表评估的患者舒适度。
SS-OCTA 联合 EFI 可捕获比 SS-OCTA 更大的眼底区域(平均大 1.80±0.18 倍)。与 FA 相比,SS-OCTA 联合 EFI 检测 NPA 和 NV 的灵敏度分别为 96%和 79%,特异度分别为 100%和 96%。EFI-SS-OCTA 与 FA 检测 NPA 范围(61.2±45.8 与 61.5±55.0 视盘面积,P=0.99)或 NV 数量(1.5±3.3 与 0.9±1.8,P=0.68)无显著差异。EFI-SS-OCTA 的 VD 显著低于无 EFI 的 SS-OCTA(31.6%±4.3%与 34.2%±4.3%,P<0.001)。EFI-SS-OCTA 比 FA 更受患者欢迎(P<0.001)。
EFI-SS-OCTA 可获得 DR 患者宽视野视网膜血管图像,患者舒适度优于 FA。