Hsiao Chia-Chieh, Hsu Hsueh-Min, Yang Chung-May, Yang Chang-Hao
Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chun-Shan S. Rd., Taipei City, 100, Taiwan.
Department of Ophthalmology, National Taiwan University College of Medicine, No. 7, Chun-Shan S. Rd., Taipei City, 100, Taiwan.
Graefes Arch Clin Exp Ophthalmol. 2019 Jul;257(7):1401-1410. doi: 10.1007/s00417-019-04321-2. Epub 2019 Apr 17.
To evaluate the anatomic versus functional changes in diabetic retinopathy (DR) by studying the correlation of retinal vascular perfusion density and dark adaptation (DA).
Optical coherence tomography angiography (OCTA) and DA tests were performed in diabetic patients and nondiabetic controls. DA was measured using AdaptDx dark adaptometer and the rod intercept was recorded. Macular OCTA images were acquired using the RTVue XR Avanti with AngioVue.
Eighty-six eyes from 57 patients with diabetes (19 with no DR, 19 with non-proliferative DR [NPDR], and 19 with proliferative DR [PDR] who had undergone photocoagulation) and 10 eyes from 10 patients without diabetes were recruited. A significant decrease in vascular density and a prolonged rod intercept were found as DR progressed (P < .01). A negative trend was found between vascular density and the rod intercept. The negative trend in the deep layer (R = 0.28) was more substantial than that in the superficial layer (R = 0.14). A prolonged rod intercept was associated with elevated HbA1c (R = 0.08).
The vascular density of the macula could be assessed by OCTA and the functional change in the outer retina could be measured non-invasively by DA. The severity of decreasing vascular density and prolongation of DA are proportional to progression of DR. Decreased deep retinal vascular perfusion density and impaired DA response are correlated and show a negative trend according to the severity of DR.
通过研究视网膜血管灌注密度与暗适应（DA）的相关性，评估糖尿病视网膜病变（DR）中的解剖学与功能变化。
对糖尿病患者和非糖尿病对照者进行光学相干断层扫描血管造影（OCTA）和DA测试。使用AdaptDx暗适应仪测量DA并记录视杆细胞截距。使用配备AngioVue的RTVue XR Avanti获取黄斑OCTA图像。
招募了57例糖尿病患者的86只眼（19例无DR，19例非增殖性DR [NPDR]，19例增殖性DR [PDR]且已接受光凝治疗）以及10例非糖尿病患者的10只眼。随着DR进展，发现血管密度显著降低且视杆细胞截距延长（P < 0.01）。在血管密度与视杆细胞截距之间发现了负相关趋势。深层的负相关趋势（R = 0.28）比浅层（R = 0.14）更显著。视杆细胞截距延长与糖化血红蛋白（HbA1c）升高相关（R = 0.08）。
黄斑的血管密度可通过OCTA评估，视网膜外层的功能变化可通过DA进行无创测量。血管密度降低的严重程度和DA延长与DR进展成正比。视网膜深层血管灌注密度降低与DA反应受损相关，并根据DR的严重程度呈负相关趋势。
