Vitreoretinal Unit, Bristol Eye Hospital, University of Bristol, Bristol, UK.
Eye Clinic, Polytechnic University of Marche, 60126, Ancona, Italy.
Acta Diabetol. 2019 Dec;56(12):1293-1303. doi: 10.1007/s00592-019-01410-w. Epub 2019 Aug 29.
To evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) perfusion in macular and near/mid periphery regions in diabetic patients using widefield swept-source optical coherence tomography angiography (WSS-OCTA).
Ninety-four diabetic patients (94 eyes) classified as diabetics without diabetic retinopathy (no DR) (25 eyes), mild DR (23 eyes), moderate/severe DR (26 eyes), proliferative DR (20 eyes) and a control group of 25 healthy subjects (25 eyes) were imaged with the WSS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Quantitative analysis was performed in the macular and peripheral regions. The main outcome measures were perfusion density (PD) and vessel length density of SCP, DCP and CC.
Peripheral retina (all sectors) showed lower SCP and DCP PD compared to the macular region (p < 0.001). In diabetics without DR and DR in different stages, SCP and DCP PD significantly decreased at advancing stages of DR (p < 0.001). At DCP level, central PD was significantly directly related to peripheral PD (superior, R = 0.682 and 0.479; temporal, R = 0.918 and 0.554; inferior, R = 0.711). A good sensitivity and an excellent specificity were found in terms of prediction of disease worsening, especially for central and temporal sectors in all plexuses and for all sectors both central and peripheral of DCP.
The widefield OCTA is useful for the study of central and peripheral retina in diabetic patients with or without diabetic retinopathy, assessing good correlation between central and peripheral retina.
利用宽视野扫频源光学相干断层扫描血管造影术（WSS-OCTA）评估糖尿病患者黄斑区及近/中周部浅层毛细血管丛（SCP）、深层毛细血管丛（DCP）和脉络膜毛细血管（CC）灌注。
对 94 例糖尿病患者（94 只眼）进行了成像，这些患者分为无糖尿病视网膜病变（无 DR）（25 只眼）、轻度 DR（23 只眼）、中度/重度 DR（26 只眼）、增殖性 DR（20 只眼）和 25 名健康对照组（25 只眼）。使用 WSS-OCTA 系统（PLEX Elite 9000，Carl Zeiss Meditec Inc.，Dublin，CA，USA）进行定量分析。在黄斑区和周边区域进行主要观察指标是灌注密度（PD）和 SCP、DCP 和 CC 的血管长度密度。
周边视网膜（所有象限）的 SCP 和 DCP PD 均低于黄斑区（p<0.001）。在无 DR 和不同阶段 DR 的糖尿病患者中，随着 DR 阶段的进展，SCP 和 DCP PD 显著降低（p<0.001）。在 DCP 水平，中央 PD 与周边 PD 呈显著直接相关（上方，R=0.682 和 0.479；颞侧，R=0.918 和 0.554；下方，R=0.711）。在预测疾病恶化方面，无论是在所有丛中的中央和颞侧区域，还是在 DCP 的所有中央和周边区域，都发现了良好的敏感性和极佳的特异性。
宽视野 OCTA 可用于评估有无糖尿病视网膜病变的糖尿病患者的中央和周边视网膜，评估中央和周边视网膜之间的良好相关性。
