Tey Kai Yuan, Teo Kelvin, Tan Anna C S, Devarajan Kavya, Tan Bingyao, Tan Jacqueline, Schmetterer Leopold, Ang Marcus
Hobart Clinical School, Level 3, 43 Collins Street, Hobart, TAS 7000 Australia.
2Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751 Singapore.
Eye Vis (Lond). 2019 Nov 18;6:37. doi: 10.1186/s40662-019-0160-3. eCollection 2019.
Diabetic retinopathy (DR) is a leading cause of vision loss in adults. Currently, the standard imaging technique to monitor and prognosticate DR and diabetic maculopathy is dye-based angiography. With the introduction of optical coherence tomography angiography (OCTA), it may serve as a potential rapid, non-invasive imaging modality as an adjunct.
Recent studies on the role of OCTA in DR include the use of vascular parameters e.g., vessel density, intercapillary spacing, vessel diameter index, length of vessels based on skeletonised OCTA, the total length of vessels, vascular architecture and area of the foveal avascular zone. These quantitative measures may be able to detect changes with the severity and progress of DR for clinical research. OCTA may also serve as a non-invasive imaging method to detect diabetic macula ischemia, which may help predict visual prognosis. However, there are many limitations of OCTA in DR, such as difficulty in segmentation between superficial and deep capillary plexus; and its use in diabetic macula edema where the presence of cystic spaces may affect image results. Future applications of OCTA in the anterior segment include detection of anterior segment ischemia and iris neovascularisation associated with proliferative DR and risk of neovascular glaucoma.
OCTA may potentially serve as a useful non-invasive imaging tool in the diagnosis and monitoring of diabetic retinopathy and maculopathy in the future. Future studies may demonstrate how quantitative OCTA measures may have a role in detecting early retinal changes in patients with diabetes.
糖尿病视网膜病变（DR）是成年人视力丧失的主要原因。目前，用于监测和预测DR及糖尿病性黄斑病变的标准成像技术是基于染料的血管造影。随着光学相干断层扫描血管造影（OCTA）的引入，它可能作为一种潜在的快速、非侵入性成像方式作为辅助手段。
近期关于OCTA在DR中作用的研究包括使用血管参数，例如血管密度、毛细血管间距、血管直径指数、基于OCTA骨架化的血管长度、血管总长度、血管结构以及黄斑无血管区面积。这些定量测量可能能够检测随着DR的严重程度和进展而发生的变化，用于临床研究。OCTA还可作为一种非侵入性成像方法来检测糖尿病性黄斑缺血，这可能有助于预测视力预后。然而，OCTA在DR中存在许多局限性，例如难以区分浅表和深层毛细血管丛；以及在糖尿病性黄斑水肿中的应用，其中囊腔的存在可能会影响图像结果。OCTA在前节的未来应用包括检测与增殖性DR相关的前节缺血和虹膜新生血管形成以及新生血管性青光眼的风险。
OCTA未来可能潜在地成为诊断和监测糖尿病视网膜病变及黄斑病变的有用非侵入性成像工具。未来的研究可能会证明定量OCTA测量如何在检测糖尿病患者的早期视网膜变化中发挥作用。
