Department of Ophthalmology and Optometry, Vienna Clinical Trial Centre (VTC), Medical University of Vienna, Vienna, Austria.
Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
PLoS One. 2020 Nov 10;15(11):e0241753. doi: 10.1371/journal.pone.0241753. eCollection 2020.
To evaluate the characteristics and morphological alterations in central retinal ischemia caused by diabetic retinopathy (DR) or retinal vein occlusion (RVO) as seen in optical coherence tomography angiography (OCTA) and their relationship to visual acuity.
Swept-source optical coherence tomography (SSOCT) and OCTA (Topcon, Triton) data of patients with central involving retinal ischemia were analyzed in this cross-sectional study. The following parameters were evaluated: vessel parameters, foveal avascular zone (FAZ), intraretinal cysts (IRC), microaneurysms (MA), vascular collaterals in the superficial (SCP) and deep plexuses (DCP), hyperreflective foci (HRF), epiretinal membrane (ERM), external limiting membrane (ELM) and ellipsoid zone (EZ) disruption, as well as the disorganization of retinal inner layers (DRIL). Best-corrected visual acuity (BCVA), age, gender, disease duration and ocular history were also recorded.
44 eyes of 44 patients (22 with RVO, 22 with DR) were analyzed. The mean age was 60.55 ± 11.38 years and mean BCVA 0.86 ± 0.36 (Snellen, 6m). No significant difference was found between DR subgroups (non proliferative vs. proliferative). Between RVO subgroups (CRVO vs. BRVO) a significant difference was found in term of collateral vessel of the DCP (p = 0.014). A pooled DR and RVO group were created and compared. Significantly more MAs (p = 0.007) and ERM (p = 0.007) were found in the DR group. Statistically significant negative correlation was demonstrated between FAZ and BCVA (p = 0.45) when analyzing all patients with retinal ischemia.
This study has shown that the best predictor of visual outcome in center involved ischemic diseases is the size of FAZ. Besides the presence of MAs and ERM, all other OCT and OCTA parameters were present in a similar extent in DR and RVO group despite the completely different disease origins. Our results suggest that as soon as retinal ischemia in the macular region is present, it has a similar appearance and visual outcome independently of the underlying disease.
评估由糖尿病视网膜病变（DR）或视网膜静脉阻塞（RVO）引起的中央性视网膜缺血的特征和形态改变，这些改变在光相干断层扫描血管造影（OCTA）中可见，并与视力相关。
对本横断面研究中涉及中央性视网膜缺血的患者进行了扫频源光学相干断层扫描（SSOCT）和 OCTA（Topcon，Triton）数据的分析。评估了以下参数：血管参数、中心无血管区（FAZ）、视网膜内囊（IRC）、微动脉瘤（MA）、浅层（SCP）和深层丛（DCP）的血管侧支、高反射灶（HRF）、视网膜内界膜（ERM）、外界膜（ELM）和椭圆体带（EZ）中断以及视网膜内层（DRIL）的紊乱。还记录了最佳矫正视力（BCVA）、年龄、性别、疾病持续时间和眼部病史。
分析了 44 例患者的 44 只眼（22 例 RVO，22 例 DR）。平均年龄为 60.55 ± 11.38 岁，平均 BCVA 为 0.86 ± 0.36（Snellen，6m）。DR 亚组（非增殖性与增殖性）之间无显著差异。在 RVO 亚组（CRVO 与 BRVO）中，DCP 的侧支血管存在显著差异（p = 0.014）。创建了一个包括 DR 和 RVO 的合并组，并进行了比较。发现 DR 组的 MA（p = 0.007）和 ERM（p = 0.007）明显更多。当分析所有有视网膜缺血的患者时，发现 FAZ 与 BCVA 之间存在显著的负相关（p = 0.45）。
本研究表明，在中心性缺血性疾病中，视力预后的最佳预测指标是 FAZ 的大小。除 MA 和 ERM 外，尽管疾病起源完全不同，但在 DR 和 RVO 组中，所有其他 OCT 和 OCTA 参数的存在程度相似。我们的研究结果表明，只要黄斑区存在视网膜缺血，无论潜在疾病如何，它的表现和视力结果都相似。
