Borrelli Enrico, Palmieri Michele, Viggiano Pasquale, Ferro Giada, Mastropasqua Rodolfo
Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy; and.
Bristol Eye Hospital, Bristol, United Kingdom.
Retina. 2020 Jun;40(6):1062-1069. doi: 10.1097/IAE.0000000000002538.
To investigate the relationship between choriocapillaris (CC) hypoperfusion and photoreceptor alterations in eyes with nonproliferative diabetic retinopathy (NPDR).
In this prospective, observational, case-control study, 30 eyes (30 patients) with NPDR and 30 healthy eyes from 30 controls were enrolled at the University G. d'Annunzio, Chieti-Pescara, Italy. This study cohort underwent an ophthalmologic examination, including optical coherence tomography and optical coherence tomography angiography. The main outcome measures were as follows: 1) "normalized" reflectivity of en face image segmented at the ellipsoid zone level, which was calculated to quantify the photoreceptor damage, and 2) CC perfusion density. Secondary outcome measures were as follows: 1) superficial retinal capillary plexus (SCP), intermediate retinal capillary plexus (ICP), and deep retinal capillary plexus (DCP) perfusion density (based on the area of vessels); 2) SCP, ICP, and DCP vessel length density (based on a map with vessels of 1-pixel width); and 3) SCP, ICP, and DCP vessel diameter.
Mean ± SD age was 58.9 ± 11.1 years (range 38-79 years) in the NPDR group and 61.7 ± 11.3 years (range 39-87 years) in the control group (P > 0.05 for all the comparisons). Compared with controls, NPDR eyes displayed a lower "normalized" reflectivity (0.96 ± 0.25 in controls and 0.73 ± 0.19 in the NPDR group, P < 0.0001). Moreover, the NPDR group was characterized by an impaired perfusion in both the retinal and choroidal vasculature. In multiple regression analysis, ellipsoid zone "normalized" reflectivity displayed a significant direct association with CC perfusion density in patients with NPDR (P = 0.025 and P = 0.476, in NPDR and controls, respectively).
Eyes with NPDR are affected by macular hypoperfusion and photoreceptor damage, the latter investigated as ellipsoid zone "normalized" reflectivity. The diabetic choroidopathy seems to be strongly associated with photoreceptor damage.
研究非增殖性糖尿病视网膜病变（NPDR）患者脉络膜毛细血管（CC）灌注不足与光感受器改变之间的关系。
在意大利基耶蒂-佩斯卡拉的加布里埃莱·德安农齐奥大学进行的这项前瞻性、观察性病例对照研究中，纳入了30例NPDR患者的30只眼以及30名对照者的30只健康眼。该研究队列接受了眼科检查，包括光学相干断层扫描和光学相干断层扫描血管造影。主要观察指标如下：1）在椭圆体带水平分割的正面图像的“标准化”反射率，用于量化光感受器损伤；2）CC灌注密度。次要观察指标如下：1）浅表视网膜毛细血管丛（SCP）、中间视网膜毛细血管丛（ICP）和深部视网膜毛细血管丛（DCP）的灌注密度（基于血管面积）；2）SCP、ICP和DCP的血管长度密度（基于1像素宽血管的地图）；3）SCP、ICP和DCP的血管直径。
NPDR组的平均年龄±标准差为58.9±11.1岁（范围38 - 79岁），对照组为61.7±11.3岁（范围39 - 87岁）（所有比较的P>0.05）。与对照组相比，NPDR眼的“标准化”反射率较低（对照组为0.96±0.25，NPDR组为0.73±0.19，P<0.0001）。此外，NPDR组的视网膜和脉络膜血管灌注均受损。在多元回归分析中，NPDR患者椭圆体带的“标准化”反射率与CC灌注密度呈显著正相关（NPDR组P = 0.025，对照组P = 0.476）。
NPDR患者的眼睛受到黄斑灌注不足和光感受器损伤的影响，后者通过椭圆体带“标准化”反射率进行研究。糖尿病性脉络膜病变似乎与光感受器损伤密切相关。
