Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; and.
Department of Biomedical Engineering, Oregon Health and Science University, Portland, Oregon.
Retina. 2020 May;40(5):891-897. doi: 10.1097/IAE.0000000000002487.
To evaluate wide-field optical coherence tomography angiography (OCTA) for detection of clinically unsuspected neovascularization (NV) in diabetic retinopathy (DR).
This prospective observational single-center study included adult patients with a clinical diagnosis of nonproliferative DR. Participants underwent a clinical examination, standard 7-field color photography, and OCTA with commercial and prototype swept-source devices. The wide-field OCTA was achieved by montaging five 6 × 10-mm scans from a prototype device into a 25 × 10-mm image and three 6 × 6-mm scans from a commercial device into a 15 × 6-mm image. A masked grader determined the retinopathy severity from color photographs. Two trained readers examined conventional and wide-field OCTA images for the presence of NV.
Of 27 participants, photographic grading found 13 mild, 7 moderate, and 7 severe nonproliferative DR. Conventional 6 × 6-mm OCTA detected NV in 2 eyes (7%) and none with 3 × 3-mm scans. Both prototype and commercial wide-field OCTA detected NV in two additional eyes. The mean area of NV was 0.38 mm (range 0.17-0.54 mm). All eyes with OCTA-detected NV were photographically graded as severe nonproliferative DR.
Wide-field OCTA can detect small NV not seen on clinical examination or color photographs and may improve the clinical evaluation of DR.
评估广角光相干断层扫描血管造影（OCTA）在检测糖尿病视网膜病变（DR）中临床未发现的新生血管（NV）中的作用。
这项前瞻性观察性单中心研究纳入了临床诊断为非增生性 DR 的成年患者。参与者接受了临床检查、标准的 7 视野彩色摄影以及商用和原型扫频源 OCTA 检查。宽场 OCTA 通过将原型设备的 5 个 6×10mm 扫描拼接成 25×10mm 的图像，以及商用设备的 3 个 6×6mm 扫描拼接成 15×6mm 的图像来实现。一位经过掩蔽的分级员根据彩色照片确定视网膜病变的严重程度。两位经过培训的读者使用常规和宽场 OCTA 图像检查 NV 的存在。
在 27 名参与者中，照相分级发现 13 只眼为轻度非增生性 DR，7 只眼为中度，7 只眼为重度。传统的 6×6mm OCTA 在 2 只眼中检测到 NV（7%），而 3×3mm 扫描则未发现。原型和商用宽场 OCTA 均在另外 2 只眼中检测到 NV。NV 的平均面积为 0.38mm（范围为 0.17-0.54mm）。所有 OCTA 检测到 NV 的眼睛照相分级均为重度非增生性 DR。
宽场 OCTA 可以检测到临床检查或彩色照片上看不到的小 NV，可能会改善 DR 的临床评估。
