Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, United States.
Department of Ophthalmology, Shinshu University School of Medicine, Nagano, Japan.
Br J Ophthalmol. 2019 Feb;103(2):216-221. doi: 10.1136/bjophthalmol-2018-311942. Epub 2018 Apr 29.
To evaluate quantitative metrics of the retinal microvasculature in eyes with diabetic retinopathy (DR) using various en face swept-source optical coherence tomography angiography (SS-OCTA) image sizes.
Non-segmented and segmented images were acquired using an SS-OCTA device (PLEX Elite 9000; Carl Zeiss Meditec, Dublin, California, USA). The scanning protocols included the 3×3 mm, 6×6 mm and 12×12 mm fields of view. Quantitative analysis of the perfusion density (PD), vessel length density (VLD) and fractal dimension (FD) was performed. The area under the receiver operating characteristic curve was estimated to assess the ability of each image size to predict DR.
This prospective, cross-sectional study included 60 eyes, (non-DR, 13 eyes; non-proliferative DR (NPDR), 24 eyes; proliferative DR (PDR), 23 eyes) of 46 patients with diabetes and 21 eyes of 16 healthy individuals. In the 12×12 mm images, the PD of healthy individuals was significantly greater than that of patients with NPDR or PDR for all layers (NPDR, p<0.05; PDR, p<0.001 0.001; FD, p<0.001) or PDR (VLD, p<0.001; FD, p<0.001 for all layers). The results were similar for the 3×3 mm and 6×6 mm images. Overall, PD, VLD and FD progressively decreased with worsening DR severity in segmented and non-segmented layers for all SS-OCTA scan sizes. For detecting DR, 3×3 mm images best predicted DR for all evaluated quantitative parameters.
Vascular changes in DR can be monitored in detail through quantitative evaluations that combine different SS-OCTA scan sizes and parameters.
使用各种广角光相干断层扫描血管造影（SS-OCTA）图像大小评估糖尿病视网膜病变（DR）眼中视网膜微血管的定量指标。
使用 SS-OCTA 设备（PLEX Elite 9000；美国加利福尼亚州都柏林的 Carl Zeiss Meditec）采集非分段和分段图像。扫描方案包括 3×3mm、6×6mm 和 12×12mm 视野。对灌注密度（PD）、血管长度密度（VLD）和分形维数（FD）进行定量分析。评估每个图像大小预测 DR 的能力，计算受试者工作特征曲线下的面积。
本前瞻性、横断面研究纳入 60 只眼（非 DR，13 只眼；非增殖性 DR（NPDR），24 只眼；增殖性 DR（PDR），23 只眼），来自 46 名糖尿病患者和 21 名健康个体。在 12×12mm 图像中，健康个体的 PD 显著大于 NPDR 或 PDR 患者的所有层（NPDR，p<0.05；PDR，p<0.001 和 p<0.001；FD，p<0.001）或 PDR（VLD，p<0.001；FD，所有层均 p<0.001）。3×3mm 和 6×6mm 图像的结果相似。总体而言，在所有 SS-OCTA 扫描大小的分段和非分段层中，随着 DR 严重程度的恶化，PD、VLD 和 FD 逐渐降低。对于检测 DR，3×3mm 图像对于所有评估的定量参数均最佳预测 DR。
通过结合不同 SS-OCTA 扫描大小和参数的定量评估，可以详细监测 DR 中的血管变化。
