Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Sci Rep. 2018 Aug 14;8(1):12146. doi: 10.1038/s41598-018-30699-w.
The relationship between choroidal and retinal microvascular changes has not yet been well described, and there were limited data on diagnostic ability of optical coherence tomography (OCT)-derived vascular parameters for determining diabetic retinopathy (DR) progression. We quantitatively analyzed OCT-derived vascular parameters at superficial (SCP) and deep retinal capillary plexus (DCP), and choroid. We assessed foveal avascular zone (FAZ), vessel density, vessel length density, and choroidal vascularity index in conjunction with DR stage. In this study, patients with diabetes and healthy controls were retrospectively analyzed. One-hundred seventy-four eyes were divided into six groups as follows: Healthy controls, no DR, mild non-proliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR. There were significant quantitative changes in retinal and choroidal vascular parameters with DR progression. The FAZ area and perimeter correlated positively with worsening DR severity; the FAZ circularity index, retinal vessel density, retinal vessel length density, and choroidal vascularity index correlated negatively with worsening severity. Among these, FAZ circulatory index demonstrated good diagnostic performance for DR. Our results cautiously suggest that functional circulatory disturbances in retinal and choroidal vasculatures occur before DR presents. As DR progresses, DCP retinal microvasculature changes precede SCP changes.
脉络膜和视网膜微血管变化之间的关系尚未得到很好的描述，关于光相干断层扫描（OCT）衍生的血管参数在确定糖尿病视网膜病变（DR）进展方面的诊断能力的数据有限。我们定量分析了浅层（SCP）和深层视网膜毛细血管丛（DCP）以及脉络膜的 OCT 衍生血管参数。我们评估了黄斑无血管区（FAZ）、血管密度、血管长度密度和脉络膜血管指数与 DR 分期的关系。在这项研究中，回顾性分析了糖尿病患者和健康对照组。174 只眼分为 6 组：健康对照组、无 DR、轻度非增生性 DR（NPDR）、中度 NPDR、重度 NPDR 和增生性 DR。随着 DR 进展，视网膜和脉络膜血管参数发生了显著的定量变化。FAZ 面积和周长与 DR 严重程度恶化呈正相关；FAZ 圆度指数、视网膜血管密度、视网膜血管长度密度和脉络膜血管指数与严重程度恶化呈负相关。其中，FAZ 循环指数对 DR 具有良好的诊断性能。我们的结果谨慎地表明，视网膜和脉络膜血管的功能循环障碍在 DR 出现之前就已经发生。随着 DR 的进展，DCP 视网膜微血管的变化先于 SCP 的变化。
