Department of Ophthalmology, Pureun Eye Center, Jeonju, South Korea.
Department of Ophthalmology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2020 Feb;258(2):281-288. doi: 10.1007/s00417-019-04517-6. Epub 2019 Dec 12.
To compare optical coherence tomography angiography (OCT-A) parameters between type 1 and type 2 diabetic patients with diabetic retinopathy (DR).
A total of 70 patients with type 1 diabetes and 70 with type 2 diabetes were retrospectively analyzed. DR was graded as no DR, mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR (PDR). Using OCT-A, the foveal avascular zone (FAZ) area (mm) and vascular density (VD) (%) were calculated in the superficial capillary plexus (SCP) and deep capillary plexus (DCP).
In both type 1 and 2 diabetes patients, the FAZ area (mm) in both capillary plexuses (CP) increased with DR progression, whereas the VD (%) progressively decreased. The changes in the FAZ area and the VD were significantly greater in the DCP than in the SCP in both types of diabetes patients(p < 0.001). In the analysis of decreasing slope of the VD in the DCP, attenuation was not significant until severe NPDR stage but then abruptly decreased when it progressed to PDR stage in type 1 diabetes. In type 2 diabetes, the DCP VD decreased gradually as DR stage progressed.
As DR progression, the increasing in FAZ area and the decreasing in VD are more severe in the DCP than in the SCP in both types of diabetes. In type 1 diabetes eyes, they were remained in relatively healthy until it gets to the advanced stage of DR, while the gradual deterioration of FAZ area and VD was found from the early stage to the advanced stage of DR in type 2 diabetes.
比较 1 型和 2 型糖尿病患者伴糖尿病视网膜病变（DR）的光学相干断层扫描血管造影（OCT-A）参数。
回顾性分析了 70 例 1 型糖尿病患者和 70 例 2 型糖尿病患者。DR 分级为无视网膜病变（DR）、轻度非增生性 DR（NPDR）、中度 NPDR、重度 NPDR 和增生性 DR（PDR）。使用 OCT-A，计算浅层毛细血管丛（SCP）和深层毛细血管丛（DCP）中黄斑无血管区（FAZ）面积（mm）和血管密度（VD）（%）。
在 1 型和 2 型糖尿病患者中，随着 DR 进展，两个毛细血管丛（CP）的 FAZ 面积（mm）均增加，而 VD（%）逐渐降低。两种类型的糖尿病患者的 FAZ 面积和 VD 的变化在 DCP 中均大于 SCP（p<0.001）。在 DCP 中 VD 下降斜率的分析中，在严重 NPDR 阶段之前，衰减不明显，但在进展为 PDR 阶段时，1 型糖尿病患者的 VD 突然下降。在 2 型糖尿病中，随着 DR 进展，DCP 的 VD 逐渐降低。
随着 DR 的进展，在两种类型的糖尿病中，DCP 中 FAZ 面积的增加和 VD 的减少比 SCP 更严重。在 1 型糖尿病眼中，它们在 DR 的晚期阶段仍然保持相对健康，而在 2 型糖尿病中，从早期阶段到晚期阶段，FAZ 面积和 VD 的逐渐恶化。
