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糖尿病患者无糖尿病视网膜病变时的黄斑区及周边区脉络膜血管密度的眼内及眼间差异。

INTRAOCULAR AND INTEROCULAR DIFFERENCES IN PARAFOVEAL VASCULAR DENSITY IN DIABETIC PATIENTS WITHOUT DIABETIC RETINOPATHY.

机构信息

Department of Ophthalmology, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, South Korea.

出版信息

Retina. 2021 Jan 1;41(1):170-180. doi: 10.1097/IAE.0000000000002781.

Abstract

PURPOSE

To evaluate the associations among optical coherence tomography angiography-measured vascular density (VD), intraocular and interocular VD differences, and clinical factors in diabetic patients without diabetic retinopathy.

METHODS

We retrospectively reviewed 94 Type 2 diabetic patients without diabetic retinopathy who had undergone optical coherence tomography angiography. Vascular density and vessel skeleton density were measured in a 3-mm central zone in the total capillary plexus, superficial capillary plexus, deep capillary plexus (DCP), and choriocapillaris layers. Intraocular VD difference was determined between the superior and inferior zones, while interocular VD difference was determined between both eyes of the patient. Associations between optical coherence tomography angiography parameters and clinical factors were evaluated.

RESULTS

Vascular density and intraocular and interocular VD differences were significantly associated with signal strength of the image, which was related with age and lens opacity. In multivariate analysis, diabetes duration was negatively associated with skeleton density in total capillary plexus and superficial capillary plexus layers, and positively associated with intraocular VD difference in superficial capillary plexus layer. Estimated glomerular filtration rate was negatively associated with intraocular skeleton density difference in total capillary plexus layer, interocular VD, and skeleton density differences in total capillary plexus layer.

CONCLUSION

Intraocular and interocular VD difference may be an easy and sensitive way to detect subtle early microvascular changes in diabetic patients.

摘要

目的

评估无糖尿病视网膜病变的 2 型糖尿病患者的光学相干断层扫描血管造影(OCTA)测量的血管密度(VD)、眼内和眼间 VD 差异与临床因素之间的关系。

方法

我们回顾性分析了 94 例无糖尿病视网膜病变的 2 型糖尿病患者的病例资料,这些患者均接受了 OCTA 检查。在全毛细血管丛、浅层毛细血管丛、深层毛细血管丛(DCP)和脉络膜毛细血管层的 3mm 中央区域测量了血管密度和血管骨架密度。通过比较上下区域,计算了眼内 VD 差异,通过比较患者双眼,计算了眼间 VD 差异。评估了 OCTA 参数与临床因素之间的关系。

结果

血管密度以及眼内和眼间 VD 差异与图像信号强度显著相关,而信号强度与年龄和晶状体混浊有关。多变量分析显示,糖尿病病程与全毛细血管丛和浅层毛细血管丛层的骨架密度呈负相关,与浅层毛细血管丛层的眼内 VD 差异呈正相关。估算肾小球滤过率与全毛细血管丛层的眼内骨架密度差异、眼间 VD 和全毛细血管丛层的骨架密度差异呈负相关。

结论

眼内和眼间 VD 差异可能是一种简单、敏感的方法,可用于检测糖尿病患者的早期细微微血管变化。

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