Research Unit of Ophthalmology, University of Southern Denmark, Odense, Denmark.
Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
Acta Ophthalmol. 2019 Feb;97(1):7-14. doi: 10.1111/aos.13859. Epub 2018 Sep 20.
To use optical coherence tomography angiography (OCTA) to evaluate foveal microvascular changes in diabetes by comparing the area of foveal avascular zone (FAZ) in healthy controls and patients with diabetes with no diabetic retinopathy (NDR) as well as different stages of diabetic retinopathy (DR). A systematic literature search was performed based on the population, intervention, comparison and outcome (PICO) strategy by two independent reviewers. The search was performed in PubMed, Embase and Cochrane Library, including keywords 'diabetes mellitus', 'DR' and 'OCTA'. Of 358 studies initially identified, 215 studies were screened after duplicate removal. Of these, we included 12 (nine cross-sectional and three retrospective) studies in this review. With the data at hand, it was not possible to perform a meta-analysis. The selected studies included patients with NDR (n = 8), non-proliferative diabetic retinopathy (NPDR, n = 8) and proliferative diabetic retinopathy (PDR, n = 6). Several of the studies provided information for more than one diabetic group. In general, there was a trend towards a larger area of FAZ in patients with diabetes. As compared to healthy controls, this was reported in patients with NDR (five of eight studies), NPDR (seven of eight studies) and PDR (six of six studies). Optical coherence tomography angiography (OCTA) is non-invasively able to identify foveal capillary non-perfusion as an early event in DR. In some studies, this has even been identified in patients without clinically identifiable microvascular lesions. Longitudinal studies would be needed to examine if OCTA-findings are able to predict long-term structural and functional outcome.
采用光学相干断层扫描血管造影术（OCTA）比较健康对照者与无糖尿病视网膜病变（NDR）以及不同糖尿病视网膜病变（DR）阶段的糖尿病患者的中心凹无血管区（FAZ）面积，评估糖尿病患者中心凹微血管的变化。两位独立审查员基于人群、干预、比较和结局（PICO）策略进行了系统的文献检索。检索了 PubMed、Embase 和 Cochrane Library，关键词为“糖尿病”、“DR”和“OCTA”。最初确定的 358 项研究中，有 215 项在重复后进行了筛选。其中，我们在这篇综述中纳入了 12 项（9 项横断面研究和 3 项回顾性研究）。根据现有数据，无法进行荟萃分析。所选研究包括 NDR（n=8）、非增生性糖尿病视网膜病变（NPDR，n=8）和增生性糖尿病视网膜病变（PDR，n=6）患者。一些研究提供了超过一个糖尿病组的信息。总的来说，糖尿病患者的 FAZ 面积有增大的趋势。与健康对照者相比，NDR（8 项研究中的 5 项）、NPDR（8 项研究中的 7 项）和 PDR（6 项研究中的 6 项）患者均有此报告。OCTA 可无创识别糖尿病视网膜病变的中心凹毛细血管无灌注，这是 DR 的早期事件。在一些研究中，甚至在没有临床可识别的微血管病变的患者中也发现了这种情况。需要进行纵向研究，以检查 OCTA 结果是否能够预测长期的结构和功能结局。
