糖尿病患者深层毛细血管丛中与定量光学相干断层扫描血管造影指标相关的临床相关因素。
Clinically relevant factors associated with quantitative optical coherence tomography angiography metrics in deep capillary plexus in patients with diabetes.
作者信息
Tang Fang Yao, Chan Erica O, Sun Zihan, Wong Raymond, Lok Jerry, Szeto Simon, Chan Jason C, Lam Alexander, Tham Clement C, Ng Danny S, Cheung Carol Y
机构信息
1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Kowloon, China.
2Hong Kong Eye Hospital, Hong Kong Special Administrative Region, Kowloon, China.
出版信息
Eye Vis (Lond). 2020 Feb 3;7:7. doi: 10.1186/s40662-019-0173-y. eCollection 2020.
BACKGROUND
To test clinically relevant factors associated with quantitative artifact-free deep capillary plexus (DCP) metrics in patients with diabetes mellitus (DM).
METHODS
563 eligible eyes (221 with no diabetic retinopathy [DR], 135 with mild DR, 130 with moderate DR, and 77 with severe DR) from 334 subjects underwent optical coherence tomography-angiography (OCT-A) with a swept-source OCT (Triton DRI-OCT, Topcon, Inc., Tokyo, Japan). Strict criteria were applied to exclude from analysis those DCP images with artifacts and of poor quality, including projection artifacts, motion artifacts, blurriness, signal loss, B-scan segmentation error, or low-quality score. A customized MATLAB program was then used to quantify DCP morphology from the artifact-free DCP images by calculating three metrics: foveal avascular zone (FAZ), vessel density (VD), and fractal dimension (FD).
RESULTS
166 (29.5%) eyes were excluded after quality control, leaving in the analysis 397 eyes (170 with no DR, 101 with mild DR, 90 with moderate DR, 36 with severe DR) from 250 subjects. In the multiple regression models, larger FAZ area was associated with more severe DR (β = 0.687; = 0.037), shorter axial length (AL) (β = - 0.171; = 0.003), thinner subfoveal choroid thickness (β = - 0.122; = 0.031), and lower body mass index (BMI) (β = - 0.090; = 0.047). Lower VD was associated with more severe DR (β = - 0.842; = 0.001), shorter AL (β = 0.107; = 0.039), and poorer visual acuity (VA) (β = - 0.133; = 0.021). Lower FD was associated with more severe DR (β = - 0.891; < 0.001) and with older age (β = - 0.142; = 0.004).
CONCLUSIONS
Quantitative artifact-free DCP metrics are associated with VA, DR severity, AL, subfoveal choroidal thickness, age, and BMI in diabetic patients. The effects of ocular and systemic factors should be considered for meaningful interpretations of DCP changes in DM patients.
背景
为了检测与糖尿病（DM）患者定量无伪影的深层毛细血管丛（DCP）指标相关的临床相关因素。
方法
对来自334名受试者的563只符合条件的眼睛（221只无糖尿病视网膜病变[DR]，135只轻度DR，130只中度DR，77只重度DR）进行了扫频光学相干断层扫描血管造影（OCT-A）（Triton DRI-OCT，拓普康公司，东京，日本）。应用严格标准从分析中排除那些有伪影和质量差的DCP图像，包括投影伪影、运动伪影、模糊、信号丢失、B扫描分割误差或低质量评分。然后使用定制的MATLAB程序通过计算三个指标：黄斑无血管区（FAZ）、血管密度（VD）和分形维数（FD），从无伪影的DCP图像中量化DCP形态。
结果
质量控制后排除了166只（29.5%）眼睛，分析中保留了来自250名受试者的397只眼睛（170只无DR，101只轻度DR，90只中度DR，36只重度DR）。在多元回归模型中，更大的FAZ面积与更严重的DR相关（β = 0.687；P = 0.037）、眼轴长度（AL）较短（β = -0.171；P = 0.003）、黄斑下脉络膜厚度较薄（β = -0.122；P = 0.031）以及体重指数（BMI）较低（β = -0.090；P = 0.047）。较低的VD与更严重的DR相关（β = -0.842；P = 0.001）、较短的AL（β = 0.107；P = 0.039）以及较差的视力（VA）（β = -0.133；P = 0.021）。较低的FD与更严重的DR相关（β = -0.891；P < 0.001）以及年龄较大（β = -0.142；P = 0.004）。
结论
定量无伪影的DCP指标与糖尿病患者的VA、DR严重程度、AL、黄斑下脉络膜厚度、年龄和BMI相关。对于有意义地解释DM患者DCP变化，应考虑眼部和全身因素的影响。
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