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糖尿病视网膜病变患者光学相干断层扫描血管造影参数与视力的相关性

Correlations Between Optical Coherence Tomography Angiography Parameters and the Visual Acuity in Patients with Diabetic Retinopathy.

作者信息

Abdelshafy Marwa, Abdelshafy Ahmed

机构信息

Ophthalmology Department, Benha Faculty of Medicine, Benha University, Benha, Egypt.

出版信息

Clin Ophthalmol. 2020 Apr 23;14:1107-1115. doi: 10.2147/OPTH.S248881. eCollection 2020.

Abstract

AIM

The aim of this study was to assess the correlation between different optical coherence tomography angiography (OCTA) parameters and the best corrected visual acuity (BCVA) in patients with diabetic retinopathy (DR).

PATIENTS AND METHODS

Sixty eyes of 60 participants were included in this prospective study: 40 diabetic patients [20 with non-proliferative diabetic retinopathy (NPDR group), 20 with proliferative diabetic retinopathy (PDR group)] and 20 age- and gender-matched normal healthy subjects (control group). After full ophthalmological examination and fundus fluorescein angiography, OCTA was performed for all participants. Quantitative OCTA parameters, such as the foveal avascular zone (FAZ) area, the superficial capillary plexus vessel density (%) (SCP-VD) and the deep capillary plexus vessel density (%) (DCP-VD) in, whole and parafoveal areas were measured. Correlations between BCVA and OCTA parameters were analyzed.

RESULTS

There were no statistically significant differences between groups regarding age, gender, refraction, macular thickness or intraocular pressure. The median (IQR) FAZ area was 0.42 (0.39-0.46) mm in the NPDR group, 0.54 (0.45-0.65) mm in the PDR group and 0.24 (0.21-0.26) mm in the control group (<0.001). The FAZ area increased with increasing severity of DR. SCP-VD and DCP-VD showed significant differences between groups (<0.001). Vessel density (VD) was decreased in both DCP and SCP as DR progressed. There was a significant positive correlation between BCVA (LogMAR) and FAZ area. There were significant negative correlations between BCVA (LogMAR) and VD in both SCP and DCP. Stepwise multiple linear regression analysis demonstrated that SCP-VD in the whole area and DCP-VD in the parafoveal area were the best predictive factors for BCVA in the NPDR and PDR groups.

CONCLUSION

With progression of DR, the VD decreased and the FAZ area increased, and both parameters were correlated with poor visual acuity. OCTA is a non-invasive tool which can be used to detect diabetic macular ischemia and help in the prediction of visual prognosis.

摘要

目的

本研究旨在评估糖尿病视网膜病变(DR)患者不同光学相干断层扫描血管造影(OCTA)参数与最佳矫正视力(BCVA)之间的相关性。

患者与方法

本前瞻性研究纳入了60名参与者的60只眼:40名糖尿病患者[20名患有非增殖性糖尿病视网膜病变(NPDR组),20名患有增殖性糖尿病视网膜病变(PDR组)]以及20名年龄和性别匹配的正常健康受试者(对照组)。在进行全面眼科检查和眼底荧光血管造影后,对所有参与者进行OCTA检查。测量定量OCTA参数,如黄斑无血管区(FAZ)面积、全层和黄斑旁区域的浅表毛细血管丛血管密度(%)(SCP-VD)和深层毛细血管丛血管密度(%)(DCP-VD)。分析BCVA与OCTA参数之间的相关性。

结果

在年龄、性别、屈光、黄斑厚度或眼压方面,各组之间无统计学显著差异。NPDR组的FAZ面积中位数(IQR)为0.42(0.39 - 0.46)mm,PDR组为0.54(0.45 - 0.65)mm,对照组为0.24(0.21 - 0.26)mm(<0.001)。FAZ面积随DR严重程度增加而增大。SCP-VD和DCP-VD在各组之间存在显著差异(<0.001)。随着DR进展,DCP和SCP的血管密度(VD)均降低。BCVA(LogMAR)与FAZ面积之间存在显著正相关。BCVA(LogMAR)与SCP和DCP中的VD均存在显著负相关。逐步多元线性回归分析表明,全层区域的SCP-VD和黄斑旁区域的DCP-VD是NPDR组和PDR组中BCVA的最佳预测因素。

结论

随着DR进展,VD降低,FAZ面积增大,且这两个参数均与视力不佳相关。OCTA是一种可用于检测糖尿病性黄斑缺血并有助于预测视力预后的非侵入性工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f45/7186882/b72c97ba0d8f/OPTH-14-1107-g0001.jpg

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