Department of Ophthalmology, Military Medical Academy, 5 Klinicheskaya St., St. Petersburg, Russia, 194044.
UPMC Eye Center, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA.
Int Ophthalmol. 2020 Apr;40(4):787-794. doi: 10.1007/s10792-019-01239-w. Epub 2019 Dec 3.
To study the correspondence between fluorescein angiography (FA) and structural en face optical coherence tomography (OCT) in the identification of leaky microaneurysms in diabetic macular edema (DME).
Fourteen eyes of eight patients with DME (6 males and 2 females, mean age 67.3 ± 8.5) were included. For all eyes, a 6 × 6 mm structural en face image of the middle retina was obtained and superimposed on a FA image. The reflectivity, capsulation, and association with intraretinal cystic fluid (IRCF) of microaneurysms on en face were evaluated depending on their leaky status on FA.
Out of the 320 leaky microaneurysms evaluated, 280 (89.0 ± 8.2%) coincided with those on en face OCT image. Twenty-nine (10.6 ± 6.9%) and 20 (6.5 ± 7.8%) out of all leaky microaneurysms were hyperreflective and demonstrated capsular appearance, respectively. A majority of leaky microaneurysms (97.9 ± 3.2%) were associated with IRCF. From 146 microaneurysms which were found only on en face images, 130 (88.2% ± 15.7%) were hyperreflective, 33 (23.9% ± 15.6%) demonstrated capsular structure, and 13 (9.2% ± 15.0%) demonstrated no associated IRCF. After exclusion of microaneurysms of the inner retina, 95.4 ± 5.4% of leaky microaneurysms were identified on en face image. En face imaging demonstrated 83.5% sensitivity and 89.4% specificity (the area under the curve 0.87) in the identification of leaky microaneurysms.
Structural en face imaging is comparable to FA in identification of leaky microaneurysms in diabetic macular edema. Moderate reflectivity, the absence of capsular structure, and neighboring intraretinal cystic fluid indicate leaky microaneurysms.
研究荧光素血管造影（FA）与结构共焦光学相干断层扫描（OCT）在识别糖尿病性黄斑水肿（DME）中渗漏性微动脉瘤的相关性。
纳入 8 例（6 男 2 女）DME 患者的 14 只眼（平均年龄 67.3±8.5 岁）。对所有眼均获得 6×6mm 中视网膜结构共焦图像，并与 FA 图像叠加。根据 FA 上的渗漏状态，评估微动脉瘤在共焦图像上的反射率、包膜和与视网膜内囊液（IRCF）的关系。
在评估的 320 个渗漏性微动脉瘤中，280 个（89.0±8.2%）与共焦 OCT 图像上的微动脉瘤相吻合。所有渗漏性微动脉瘤中，29 个（10.6±6.9%）和 20 个（6.5±7.8%）呈高反射性并显示包膜外观。大多数渗漏性微动脉瘤（97.9±3.2%）与 IRCF 相关。在仅在共焦图像上发现的 146 个微动脉瘤中，130 个（88.2%±15.7%）呈高反射性，33 个（23.9%±15.6%）显示包膜结构，13 个（9.2%±15.0%）无相关 IRCF。排除内视网膜微动脉瘤后，共焦图像上可识别 95.4±5.4%的渗漏性微动脉瘤。共焦成像在识别渗漏性微动脉瘤方面具有 83.5%的敏感性和 89.4%的特异性（曲线下面积 0.87）。
结构共焦成像在识别糖尿病性黄斑水肿中的渗漏性微动脉瘤方面与 FA 相当。中等反射率、无包膜结构和相邻的视网膜内囊液提示存在渗漏性微动脉瘤。
