Department of Ophthalmology, University of Washington Eye Institute, Seattle, WA, USA.
Department of Ophthalmology, University of Washington Eye Institute, Seattle, WA, USA.
Diabetes Res Clin Pract. 2020 Sep;167:108361. doi: 10.1016/j.diabres.2020.108361. Epub 2020 Jul 31.
The most common microvascular complication of diabetes is diabetic retinopathy, the leading cause of blindness in adults of working age. Our understanding of the vascular changes in diabetic retinopathy was enhanced by the demonstration of fluorescein angiography (FA) in the human retina for the first time in 1961. It was subsequently integrated with digital fundoscopic imaging to become an invaluable technique in evaluation of the retinal vasculature. The recent development of OCT-angiography (OCT-A) has revolutionized the clinician's ability to examine the retinal vasculature without the need for injection of a contrast dye. By coupling OCT, which can provide noninvasive cross-sectional imaging of the central retina, with angiography in OCT-A, one can reveal retinal perfusion by allowing visualization of the depth-resolved retinal capillary plexus. OCT-A has allowed for more precise delineation of changes in the retinal microvasculature, specifically the alterations of retinal vasculature and loss of capillary perfusion from chronic microvascular occlusion in diabetic retinopathy.
糖尿病最常见的微血管并发症是糖尿病视网膜病变，这是导致工作年龄段成年人失明的主要原因。1961 年，首次在人眼视网膜中进行荧光素血管造影（FA）的演示，增强了我们对糖尿病性视网膜病变中血管变化的理解。随后，它与数字眼底成像相结合，成为评估视网膜血管的宝贵技术。最近 OCT 血管造影（OCT-A）的发展彻底改变了临床医生无需注射造影剂即可检查视网膜血管的能力。通过将 OCT（可提供中央视网膜的非侵入性横截面成像）与 OCT-A 中的血管造影相结合，通过可视化深度分辨的视网膜毛细血管丛，可以显示视网膜灌注，从而可以揭示视网膜灌注。OCT-A 允许更精确地描绘视网膜微血管的变化，特别是糖尿病视网膜病变中慢性微血管阻塞引起的视网膜血管改变和毛细血管灌注丧失。
