Kuonen A, Bergin C, Ambresin A
Department of Ophthalmology, University of Lausanne, Medical Retina Unit, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
Department of Ophthalmology, University of Lausanne, Medical Retina Unit, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland; RétinElysée, 14 Avenue d'Ouchy, CH-1006 Lausanne, Switzerland.
J Fr Ophtalmol. 2021 Mar;44(3):367-375. doi: 10.1016/j.jfo.2020.09.005. Epub 2021 Jan 23.
The goal of this study was to evaluate the perifoveal capillary bed and to analyze areas of non-flow using optical coherence tomography angiography (OCT-A) in patients presenting with diabetic retinopathy (DR), correlating them to the severity of DR, type of diabetes and visual acuity (VA).
The non-flow area (NFA) and foveal avascular zone (FAZ) in the superficial (SCP) and deep capillary plexus (DCP) were calculated using OCT-A imaging of patients with DR followed between July 2015 and March 2016 at the Jules Gonin Eye Hospital (Lausanne, Switzerland). Disease severity was classified using the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. Analysis of variance was used to correct for correlation between eyes.
Seventy-eight eyes of 53 patients were included (29 men; 44 right eyes). There were 45 eyes with non-proliferative DR (NPDR; stage 1 [n=14], stage 2 [n=7], and stage 3 [n=24]) and 33 with proliferative DR (PDR; stage 1 [n=17], stage 2 [n=16]) included, among which 26 had type I diabetes and 52 type II diabetes. The mean Best Corrected Visual Acuity (BCVA) was 78.5 letters. The mean NFA in the SCP differed according to diabetes type and stage of DR (type 1 diabetes: NPDR, 0.76±0.3, PDR, 1.24±0.7; type 2 diabetes: NPDR, 1.46±0.7, PDR, 1.57±0.7).
The NFA, measured by OCTA, may be a useful indicator of DR severity, especially in the superficial capillary plexus. Loss of visual acuity might be correlated with increasing NFA (excluding the FAZ or not), primarily among patients with type II diabetes and NPDR.
本研究的目的是使用光学相干断层扫描血管造影（OCT-A）评估糖尿病视网膜病变（DR）患者的黄斑周围毛细血管床，并分析无血流区域，将其与DR的严重程度、糖尿病类型和视力（VA）相关联。
对2015年7月至2016年3月在瑞士洛桑朱尔斯·戈宁眼科医院随访的DR患者进行OCT-A成像，计算浅表毛细血管丛（SCP）和深层毛细血管丛（DCP）中的无血流区域（NFA）和黄斑无血管区（FAZ）。使用早期糖尿病视网膜病变研究（ETDRS）分类对疾病严重程度进行分类。采用方差分析校正双眼之间的相关性。
纳入53例患者的78只眼（29例男性；44只右眼）。其中包括45只非增殖性DR（NPDR；1期[n = 14]，2期[n = 7]，3期[n = 24]）和33只增殖性DR（PDR；1期[n = 17]，2期[n = 16]）的眼睛，其中26例为I型糖尿病，52例为II型糖尿病。平均最佳矫正视力（BCVA）为相当于78.5个字母。SCP中的平均NFA根据糖尿病类型和DR分期而有所不同（I型糖尿病：NPDR，0.76±0.3，PDR，1.24±0.7；II型糖尿病：NPDR，1.46±0.7，PDR，1.57±0.7）。
通过OCTA测量的NFA可能是DR严重程度的有用指标，尤其是在浅表毛细血管丛中。视力丧失可能与NFA增加（无论是否排除FAZ）相关，主要发生在II型糖尿病和NPDR患者中。
