Retina, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
Retina, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, Massachusetts, USA; Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Am J Ophthalmol. 2020 Jul;215:72-80. doi: 10.1016/j.ajo.2020.03.004. Epub 2020 Mar 20.
To compare different scan protocols of wide-field swept-source optical coherence tomography angiography (SS-OCTA) for the detection of diabetic retinopathy (DR) lesions.
Comparison of diagnostic approaches.
A prospective, observational study was conducted at Massachusetts Eye and Ear from December 2018 to July 2019. Proliferative diabetic retinopathy (PDR), nonproliferative diabetic retinopathy (NPDR), and diabetic patients without DR were included. All patients were imaged using SS-OCTA using the following scan protocol: 3- × 3-mm Angio centered on the fovea; 6- × 6-mm Angio centered on the fovea and the optic disc; 15- × 9-mm Montage; and 12- × 12-mm Angio centered on the fovea and the optic disc. Images were independently evaluated by 2 graders for the presence or absence of DR lesions including microaneurysms, intraretinal microvascular abnormalities, neovascularization, nonperfusion areas, venous looping, and hard exudates. All statistical analyses were performed using commercial software.
A total of 176 eyes in 119 participants were included in the study. The detection rate of neovascularization on 6- × 6-mm Angio centered on the fovea was approximately one-half that on 15- × 9-mm Montage (P < .05) imaging. Combining 6- × 6-mm Angio imaging centered on the fovea and the optic disc could increase the rate to approximately two-thirds (P < .05). The 12- × 12-mm Angio imaging centered on the combination of fovea and optic disc had detection rates comparable to those of 15- × 9-mm Montage imaging for all DR lesions (P > .05). For microaneurysms, 6- × 6-mm Angio had better performance than 15- × 9-mm Montage (P < .05).
Wide-field SS-OCTA images were useful in detecting DR lesions. The 12- × 12-mm Angio imaging centered on the fovea and on the optic disc may be an optimal balance between speed and efficacy for evaluation of DR in clinical practice.
比较宽视野扫频源光相干断层扫描血管造影术（SS-OCTA）的不同扫描方案对糖尿病视网膜病变（DR）病变的检测效果。
诊断方法的比较。
这是一项 2018 年 12 月至 2019 年 7 月在马萨诸塞州眼耳医院进行的前瞻性、观察性研究。纳入增殖性糖尿病视网膜病变（PDR）、非增殖性糖尿病视网膜病变（NPDR）和无糖尿病视网膜病变的糖尿病患者。所有患者均使用 SS-OCTA 进行以下扫描方案成像：3×3mm Angio 以黄斑为中心；6×6mm Angio 以黄斑和视盘为中心；15×9mm 蒙太奇；12×12mm Angio 以黄斑和视盘为中心。由 2 名评分者独立评估图像是否存在 DR 病变，包括微动脉瘤、视网膜内微血管异常、新生血管形成、无灌注区、静脉环和硬性渗出物。所有统计分析均使用商业软件进行。
研究共纳入 119 名参与者的 176 只眼。以黄斑为中心的 6×6mm Angio 成像对新生血管的检出率约为 15×9mm 蒙太奇成像的一半（P<.05）。结合以黄斑和视盘为中心的 6×6mm Angio 成像可将检出率提高至约三分之二（P<.05）。以黄斑和视盘为中心的 12×12mm Angio 成像对所有 DR 病变的检出率与 15×9mm 蒙太奇成像相当（P>.05）。对于微动脉瘤，6×6mm Angio 的性能优于 15×9mm 蒙太奇（P<.05）。
宽视野 SS-OCTA 图像有助于检测 DR 病变。以黄斑和视盘为中心的 12×12mm Angio 成像可能是一种在临床实践中评估 DR 时在速度和效果之间取得最佳平衡的方案。
