Ra Ho, Kang Nam Yeo, Song Jiyun, Lee Junhyuck, Kim Inkee, Baek Jiwon
Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Ophthalmol. 2021 Feb 9;2021:8871602. doi: 10.1155/2021/8871602. eCollection 2021.
In the present study, the retinal and choroidal vascular densities (VDs) in type 2 diabetes mellitus (DM) patients were analyzed using optical coherence tomography angiography (OCTA).
The study included 282 eyes of 152 patients with type 2 DM (114 without retinopathy, 79 nonproliferative diabetic retinopathy (NPDR), 48 severe NPDR, and 41 proliferative diabetic retinopathy (PDR) eyes). The superficial and deep retinal vessel, choriocapillaris, and choroidal VDs were measured using a binarization method on OCTA images. VDs were compared based on retinopathy severity. Correlations among densities were analyzed.
Retinal and choriocapillaris VDs were lower in PDR than in NPDR (all < 0.05). Correlation analysis showed significant positive correlations among densities of superficial and deep retinal vessels and choriocapillaris (all < 0.001). Choroidal VD showed a negative correlation with superficial and deep retinal vessels and choriocapillaris (all < 0.001). Retinal and choriocapillaris VDs showed a negative correlation with diabetic retinopathy (DR) grade (all < 0.001); however, the choroidal VD showed a weak positive correlation (=0.030).
Choroidal VD increased as retinal and choriocapillaris VDs decreased, indicating that the outer layer of the choroid is less affected by DR severity and VD of larger choroidal vessels may even be increased as a compensatory mechanism for decreased retinal and choriocapillaris VDs in type 2 DM patients.
在本研究中，使用光学相干断层扫描血管造影（OCTA）分析2型糖尿病（DM）患者的视网膜和脉络膜血管密度（VDs）。
该研究纳入了152例2型糖尿病患者的282只眼（114只无视网膜病变，79只非增殖性糖尿病视网膜病变（NPDR），48只重度NPDR，41只增殖性糖尿病视网膜病变（PDR）眼）。使用OCTA图像上的二值化方法测量视网膜浅、深层血管、脉络膜毛细血管和脉络膜的VDs。根据视网膜病变严重程度比较VDs。分析密度之间的相关性。
PDR患者的视网膜和脉络膜毛细血管VDs低于NPDR患者（均P<0.05）。相关性分析显示，视网膜浅、深层血管和脉络膜毛细血管密度之间存在显著正相关（均P<0.001）。脉络膜VD与视网膜浅、深层血管和脉络膜毛细血管呈负相关（均P<0.001）。视网膜和脉络膜毛细血管VDs与糖尿病视网膜病变（DR）分级呈负相关（均P<0.001）；然而，脉络膜VD呈弱正相关（P=0.030）。
随着视网膜和脉络膜毛细血管VDs降低，脉络膜VD增加，表明脉络膜外层受DR严重程度的影响较小，2型糖尿病患者中较大脉络膜血管的VD甚至可能增加，作为视网膜和脉络膜毛细血管VDs降低的一种代偿机制。
