Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
Sci Rep. 2019 Nov 1;9(1):15814. doi: 10.1038/s41598-019-52354-8.
To evaluate changes in peripapillary microvascular parameters in diabetes mellitus (DM) patients using optical coherence tomography angiography (OCTA). Seventy-one diabetic patients (40 in the no diabetic retinopathy [DR] group and 31 in the non-proliferative DR [NPDR] group) and 50 control subjects. OCTA (Zeiss HD-OCT 5000 with AngioPlex) 6 × 6 mm scans centered on the optic disc were analyzed. Peripapillary vessel density (VD), perfusion density (PD) in superficial capillary plexus (SCP) were automatically calculated. The average macular ganglion cell-inner plexiform layer (mGC-IPL) and peripapillary retinal nerve fiber layer (pRNFL) thicknesses of the no DR and NPDR groups were significantly thinner than those of the control group. The no DR and NPDR groups showed lower peripapillary VD and PD in SCP compared with the control group. Using univariate regression analyses, the average mGC-IPL thickness, the pRNFL thickness, the no DR group and NPDR group were significant factors that affected the peripapillary VD and PD in SCP. Multivariate regression analyses showed that the grade of DR was a significant factor affecting the peripapillary VD and PD in SCP. OCTA revealed that peripapillary microvascular parameters in the no DR and NPDR groups were lower than those of normal controls. The peripapillary VD and PD in SCP were correlated with the mGC-IPL thickness, the pRNFL thickness, and the no DR and NPDR groups. Changes in peripapillary OCTA parameters may help with understanding the pathophysiology of DM and evaluating a potentially valuable biomarker for patients with subclinical DR.
利用光相干断层扫描血管造影术（OCTA）评估糖尿病患者的视盘周围微血管参数变化。共纳入 71 例糖尿病患者（无糖尿病视网膜病变[DR]组 40 例，非增生性 DR[NPDR]组 31 例）和 50 例对照者。对以视盘为中心的 6×6mm OCTA（蔡司 HD-OCT 5000 与 AngioPlex）进行分析。自动计算视盘周围血管密度（VD）和浅层毛细血管丛（SCP）的灌注密度（PD）。无 DR 组和 NPDR 组的平均黄斑神经节细胞-内丛状层（mGC-IPL）和视盘周围视网膜神经纤维层（pRNFL）厚度明显比对照组薄。与对照组相比，无 DR 组和 NPDR 组的视盘周围 VD 和 SCP 中的 PD 较低。采用单变量回归分析，平均 mGC-IPL 厚度、pRNFL 厚度、无 DR 组和 NPDR 组是影响 SCP 视盘周围 VD 和 PD 的显著因素。多变量回归分析显示，DR 分级是影响 SCP 视盘周围 VD 和 PD 的显著因素。OCTA 显示，无 DR 组和 NPDR 组的视盘周围微血管参数均低于正常对照组。SCP 中的视盘周围 VD 和 PD 与 mGC-IPL 厚度、pRNFL 厚度以及无 DR 组和 NPDR 组相关。视盘 OCTA 参数的变化可能有助于了解糖尿病的病理生理学，并评估亚临床 DR 患者有潜在价值的生物标志物。
