糖尿病视网膜病变中光学相干断层扫描血管造影指标的定量分析
Quantitative analysis of optical coherence tomography angiography metrics in diabetic retinopathy.
作者信息
Safi Hamid, Anvari Pasha, Naseri Dariush, Shenazandi Hamideh, Kazemi Pegah, Farsi Pirouzeh, Jafari Sanaz, Sedaghat Ahad, Yaseri Mehdi, Ghasemi Falavarjani Khalil
机构信息
Eye Research Center, Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Ther Adv Ophthalmol. 2020 Jan 10;12:2515841419897459. doi: 10.1177/2515841419897459. eCollection 2020 Jan-Dec.
PURPOSE
To evaluate the correlation of the visual acuity and diabetic retinopathy stage using optical coherence tomography and optical coherence tomography angiography metrics.
METHODS
In this prospective study, optical coherence tomography and optical coherence tomography angiography images of patients with different stages of diabetic retinopathy were obtained. In optical coherence tomography angiography images, the size of foveal avascular zone, central macular thickness, and vessel density at superficial and deep capillary layers of the macula were measured. In optical coherence tomography images, the presence of intraretinal cyst, disorganization of retinal inner layer, and ellipsoid zone and external limiting membrane disruption were evaluated. The associations between the variables with visual acuity and diabetic retinopathy stage were analyzed.
RESULTS
In total, 68 eyes of 38 patients with a mean age of 58.96 ± 10.59 years were included. In total, 34 eyes were categorized as non-proliferative diabetic retinopathy, 14 as active, and 20 as regressed proliferative diabetic retinopathy. Univariate analysis showed deep parafoveal vessel density, central macular thickness, ellipsoid zone disruption, disorganization of retinal inner layer, and external limiting membrane disruption had a significant relationship with visual acuity. However, in multivariate analysis, only central macular thickness and ellipsoid zone disruption had significant association with visual acuity ( = 0.02 and = 0.01, respectively). There was a significant difference in deep parafoveal vessel density ( = 0.04), but not in foveal avascular zone area, between different stages of diabetic retinopathy.
CONCLUSION
In this study, the foveal avascular zone area did not correlate with visual acuity and different stages of diabetic retinopathy. Structural abnormalities on optical coherence tomography images with especial focus on outer retinal disruption provided more reliable predictors for visual acuity outcomes in patients with diabetic retinopathy.
目的
使用光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA）指标评估视力与糖尿病视网膜病变分期之间的相关性。
方法
在这项前瞻性研究中，获取了不同阶段糖尿病视网膜病变患者的OCT和OCTA图像。在OCTA图像中，测量黄斑无血管区大小、中心黄斑厚度以及黄斑浅层和深层毛细血管层的血管密度。在OCT图像中，评估视网膜内囊肿的存在、视网膜内层结构紊乱、椭圆体带和外界膜破坏情况。分析这些变量与视力和糖尿病视网膜病变分期之间的关联。
结果
总共纳入了38例患者的68只眼，平均年龄为58.96±10.59岁。其中，34只眼被归类为非增殖性糖尿病视网膜病变，14只眼为增殖期，20只眼为增殖前期。单因素分析显示，黄斑旁深层血管密度、中心黄斑厚度、椭圆体带破坏、视网膜内层结构紊乱和外界膜破坏与视力有显著关系。然而，多因素分析显示，只有中心黄斑厚度和椭圆体带破坏与视力有显著关联（分别为P = 0.02和P = 0.01）。糖尿病视网膜病变不同阶段之间，黄斑旁深层血管密度有显著差异（P = 0.04），但黄斑无血管区面积无显著差异。
结论
在本研究中，黄斑无血管区面积与视力及糖尿病视网膜病变的不同阶段无关。OCT图像上的结构异常，尤其是外层视网膜破坏，为糖尿病视网膜病变患者的视力预后提供了更可靠的预测指标。
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