Krawitz Brian D, Phillips Erika, Bavier Richard D, Mo Shelley, Carroll Joseph, Rosen Richard B, Chui Toco Y P
Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York City, NY, USA.
Transl Vis Sci Technol. 2018 Jul 12;7(4):4. doi: 10.1167/tvst.7.4.4. eCollection 2018 Jul.
To describe a new technique for mapping parafoveal intercapillary areas (PICAs) using optical coherence tomography angiography (OCTA), and demonstrate its utility for quantifying parafoveal nonperfusion in diabetic retinopathy (DR).
Nineteen controls, 15 diabetics with no retinopathy (noDR), 15 with nonproliferative diabetic retinopathy (NPDR), and 15 with proliferative diabetic retinopathy (PDR) were imaged with 10 macular OCTA scans. PICAs were automatically delineated on the averaged superficial OCTA images. Following creation of an eccentricity-specific reference database from the controls, all PICAs greater than 2 SD above the reference means for PICA area and minor axis length were identified as nonperfused areas. Regions of interest (ROI) at 300 μm and 1000 μm from the foveal avascular zone (FAZ) margin were analyzed. Percent nonperfused area was defined as summed nonperfused areas divided by ROI area. Values were compared using Kruskal-Wallis and post-hoc Mann-Whitney tests.
Median values for total percent nonperfused area at the 300-μm ROI were 2.09, 2.44, 18.08, and 27.55 in the control, noDR, NPDR, and PDR groups, respectively. Median values at the 1000-μm ROI were 3.10, 3.31, 13.42, and 23.00. While there were no significant differences between the control and noDR groups, significant differences were observed between all other groups at both ROIs.
Percent nonperfused area can quantify parafoveal nonperfusion in DR and can be calculated through automatic delineation of PICAs in an eccentricity-specific manner using a standard deviation mapping approach.
Percent nonperfused area shows promise as a metric to measure disease severity in diabetic retinopathy.
描述一种使用光学相干断层扫描血管造影（OCTA）绘制黄斑旁毛细血管间区域（PICA）的新技术，并证明其在量化糖尿病视网膜病变（DR）中黄斑旁无灌注情况的实用性。
对19名对照者、15名无视网膜病变的糖尿病患者（无DR）、15名非增殖性糖尿病视网膜病变（NPDR）患者和15名增殖性糖尿病视网膜病变（PDR）患者进行10次黄斑OCTA扫描成像。在平均浅层OCTA图像上自动勾勒出PICA。从对照者创建一个特定偏心度的参考数据库后，所有PICA面积和短轴长度大于参考平均值2个标准差以上的区域被识别为无灌注区域。分析距中心凹无血管区（FAZ）边缘300μm和1000μm处的感兴趣区域（ROI）。无灌注面积百分比定义为无灌注区域总和除以ROI面积。使用Kruskal-Wallis检验和事后Mann-Whitney检验比较数值。
在300μm ROI处，对照组、无DR组、NPDR组和PDR组的总无灌注面积百分比中位数分别为2.09、2.44、18.08和27.55。在1000μm ROI处的中位数分别为3.10、3.31、13.42和23.00。虽然对照组和无DR组之间无显著差异，但在两个ROI处，所有其他组之间均观察到显著差异。
无灌注面积百分比可量化DR中的黄斑旁无灌注情况，并且可以通过使用标准差映射方法以特定偏心度的方式自动勾勒PICA来计算。
无灌注面积百分比有望作为衡量糖尿病视网膜病变疾病严重程度的指标。
