糖尿病性视网膜病变中浅层和深层丛血管密度降低与相应视网膜层的结构变化有关。
Reduced vessel density in the superficial and deep plexuses in diabetic retinopathy is associated with structural changes in corresponding retinal layers.
机构信息
Ophthalmology Department, Hôpital Lariboisière, AP-HP, Université Paris Diderot - Sorbonne Paris Cité, Paris, France.
出版信息
PLoS One. 2019 Jul 18;14(7):e0219164. doi: 10.1371/journal.pone.0219164. eCollection 2019.
PURPOSE
To explore the relationships between vessel density (VD) in the retinal vascular plexuses with the thickness and structural changes of their corresponding retinal layers in patients with diabetic retinopathy (DR).
METHODS
Retrospective analysis of 17 eyes of 17 Type 1 diabetes (T1D) patients with severe non-proliferative or proliferative DR and no current or past macular edema. Seventeen age- and sex-matched healthy subjects were included as controls. Using optical coherence tomography (OCT) and OCT-angiography (OCTA), VD was measured in the superficial vascular plexus (SVP) and deep vascular complex (DVC) that includes the intermediate (ICP) and deep capillary plexuses (DCP), and compared to the retinal thickness (RT) of the inner (from the inner limiting membrane to the inner plexiform layer) and intermediate (inner nuclear and outer plexiform layer) retinal layers. The correlation between the inner and intermediate RT and the VD of the corresponding vascular networks (SVP and DVC, respectively) was assessed. All OCT and OCTA examinations were performed using the RTVue XR Avanti (Optovue, Fremont, CA).
RESULTS
The inner RT and VD in all plexuses were significantly reduced in T1D patients compared to healthy subjects. The capillary drop-out patterns were polygonal and well-defined in the SVP while the ICP and DCP showed a more diffuse capillary rarefaction and a VD that varied in the same proportion. The inner RT significantly correlated with VD in the SVP (r = 0.71 in healthy subjects and r = 0.62 in T1D patients, p <0.01). The intermediate RT did not significantly correlate with VD in the DVC.
CONCLUSIONS
In T1D subjects, OCTA allowed observing different capillary drop-out patterns in the SVP and in the ICP-DCP, with different structural changes in the corresponding retinal layers, suggesting that they should be considered as distinct anatomical and functional entities.
目的
探讨糖尿病视网膜病变（DR）患者视网膜血管丛血管密度（VD）与相应视网膜层厚度和结构变化的关系。
方法
回顾性分析 17 例 1 型糖尿病（T1D）患者 17 只眼的资料，这些患者均患有严重的非增生性或增生性 DR，且目前或既往均无黄斑水肿。17 名年龄和性别匹配的健康受试者作为对照。使用光学相干断层扫描（OCT）和 OCT 血管造影（OCTA）测量浅层血管丛（SVP）和深层血管复合体（DVC）中的 VD，后者包括中间（ICP）和深层毛细血管丛（DCP），并与内（从内界膜到内丛状层）和中间（内核和外丛状层）视网膜层的视网膜厚度（RT）进行比较。评估内和中间 RT 与相应血管网络（分别为 SVP 和 DVC）VD 之间的相关性。所有 OCT 和 OCTA 检查均使用 RTVue XR Avanti（Optovue，弗里蒙特，CA）进行。
结果
与健康受试者相比，T1D 患者的所有丛状层内 RT 和 VD 均显著降低。SVP 中的毛细血管脱落模式呈多边形且边界清晰，而 ICP 和 DCP 则显示出更弥散的毛细血管稀疏，且 VD 以相同的比例变化。内 RT 与 SVP 中的 VD 显著相关（健康受试者中 r = 0.71，T1D 患者中 r = 0.62，p <0.01）。中间 RT 与 DVC 中的 VD 无显著相关性。
结论
在 T1D 患者中，OCTA 允许观察到 SVP 和 ICP-DCP 中不同的毛细血管脱落模式，以及相应视网膜层的不同结构变化，这表明它们应被视为不同的解剖和功能实体。
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