光学相干断层扫描血管造影评估不同人群中晚期糖尿病视网膜病变行全视网膜光凝后的脉络膜毛细血管和脉络膜。
Optical Coherence Tomography Angiography Assessment of Macular Choriocapillaris and Choroid Following Panretinal Photocoagulation in a Diverse Population With Advanced Diabetic Retinopathy.
机构信息
University of California, San Francisco, Department of Ophthalmology, San Francisco, CA, USA.
Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA.
出版信息
Asia Pac J Ophthalmol (Phila). 2020 Nov 11;10(2):203-207. doi: 10.1097/APO.0000000000000345.
PURPOSE
The aim of this study was to evaluate choroidal and retinal microvasculature with optical coherence tomography angiography (OCTA) after panretinal photocoagulation (PRP) for diabetic retinopathy in a primarily Hispanic and Asian population.
DESIGN
Retrospective study.
METHODS
Eyes were examined by OCTA in the macula (3 × 3 mm) just before PRP treatment and 1 to 3 months afterwards. Choroidal thickness (CT) and central retinal thickness (CRT) were measured. Choroidal flow signal voids (CFSV) and choriocapillaris flow signal voids (CCFSV) were acquired. Retinal microvasculature parameters, including superficial and deep vessel density, superficial and deeper perfusion density, foveal avascular zone area, perimeter and circularity, were calculated. Ocular examinations and demographic information were analyzed.
RESULTS
CT at a location 1000 μm temporal to the fovea increased significantly after PRP (from 278.64 μm to 313.44 μm, P = 0.026). CCFSV increased slightly from (46.72 ± 8.52)% to (47.07 ± 10.77)%, but the difference was not statistically significant (P = 0.782). A similar finding was observed in CFSV (increase from 35.81% to 36.64%, P = 0.165). The change in all retinal microvasculature parameters was also not significant. Best-corrected visual acuity (BCVA) decreased from 0.218 ± 0.153 to 0.262 ± 0.147 (P = 0.034). Increased CRT (from 245.41 ± 33.18 μm to 251.14 ± 38.97 μm, P = 0.007) was observed. The change in CRT positively correlated with pre-PRP CRT (r = 0.434, P = 0.019) and BCVA reduction (r = 0.418, P = 0.024). Neither BCVA reduction nor CRT increase correlated with OCTA metrics.
CONCLUSIONS
OCTA demonstrates redistribution of choroidal circulation from the periphery to the macula after PRP, with increased macular CT and stable choroidal blood flow density. Eyes with greater macular thickness are more likely to experience an increase in CRT.
目的
本研究旨在评估西班牙语裔和亚裔人群中糖尿病视网膜病变行全视网膜光凝（PRP）治疗后的脉络膜和视网膜微血管的情况。
设计
回顾性研究。
方法
在 PRP 治疗前和治疗后 1 至 3 个月，使用光学相干断层扫描血管造影（OCTA）检查黄斑（3×3mm）处的眼睛。测量脉络膜厚度（CT）和中心视网膜厚度（CRT）。采集脉络膜血流信号缺失（CFSV）和脉络膜毛细血管血流信号缺失（CCFSV）。计算视网膜微血管参数，包括浅层和深层血管密度、浅层和深层灌注密度、中心凹无血管区面积、周长和圆形度。分析眼部检查和人口统计学信息。
结果
距黄斑颞侧 1000μm 处的 CT 在 PRP 后明显增加（从 278.64μm增加至 313.44μm，P=0.026）。CCFSV 略有增加（从 46.72%±8.52%增加至 47.07%±10.77%），但差异无统计学意义（P=0.782）。同样，CFSV 也观察到类似的变化（从 35.81%增加至 36.64%，P=0.165）。所有视网膜微血管参数的变化也无统计学意义。最佳矫正视力（BCVA）从 0.218±0.153 下降至 0.262±0.147（P=0.034）。观察到 CRT 增加（从 245.41μm±33.18μm增加至 251.14μm±38.97μm，P=0.007）。CRT 的变化与 PRP 前 CRT（r=0.434，P=0.019）和 BCVA 下降（r=0.418，P=0.024）呈正相关。BCVA 下降或 CRT 增加均与 OCTA 指标无关。
结论
OCTA 显示 PRP 后脉络膜循环从周边向黄斑重新分布，黄斑 CT 增加，脉络膜血流密度稳定。黄斑厚度较大的眼更有可能出现 CRT 增加。
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