Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Clinical Technology, Delft University of Technology, Delft, The Netherlands.
Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
Surv Ophthalmol. 2022 Mar-Apr;67(2):369-387. doi: 10.1016/j.survophthal.2021.05.012. Epub 2021 Jun 6.
Retinal vascular diseases are a leading cause for blindness and partial sight certifications. By applying adaptive optics (AO) to conventional imaging modalities, the microstructures of the retinal vasculature can be observed with high spatial resolution, hence offering a unique opportunity for the exploration of the human microcirculation. The objective of this systematic review is to describe the current state of retinal vascular biomarkers imaged by AO flood illumination ophthalmoscopy (FIO) and AO scanning laser ophthalmoscopy (SLO). A literature research was conducted in the PubMed and Scopus databases on July 9, 2020. From 217 screened studies, 42 were eligible for this review. All studies underwent a quality check regarding their content. A meta-analysis was performed for the biomarkers reported for the same pathology in at least three studies using the same modality. The most frequently studied vascular biomarkers were the inner diameter (ID), outer diameter (OD), parietal thickness (PT), wall cross-sectional area (WCSA), and wall-to-lumen ratio (WLR). The applicability of AO vascular biomarkers has been mostly explored in systemic hypertension using AO FIO and in diabetes using AO SLO. The result of the meta-analysis for hypertensive patients showed that WLR, PT, and ID were significantly different when compared to healthy controls, while WCSA was not (P < 0.001, P = 0.002, P < 0.001, and P = 0.070, respectively). The presented review shows that, although a substantial number of retinal vascular biomarkers have been explored in AO en face imaging, further clinical research and standardization of procedures is needed to validate such biomarkers for the longitudinal monitoring of arterial hypertension and other diseases.
视网膜血管疾病是导致失明和视力部分丧失的主要原因。通过将自适应光学（AO）应用于传统成像方式，可以以高空间分辨率观察视网膜血管的微观结构，从而为探索人体微循环提供独特的机会。本系统评价的目的是描述通过自适应光学全内反射照明检眼镜（FIO）和自适应光学扫描激光检眼镜（SLO）成像的视网膜血管生物标志物的现状。于 2020 年 7 月 9 日在 PubMed 和 Scopus 数据库中进行了文献检索。从 217 篇筛选出的研究中，有 42 篇符合本综述的纳入标准。所有研究均经过内容质量检查。对于至少有三篇研究使用相同模态报告了相同病理学的生物标志物，使用 Meta 分析进行了分析。研究最多的血管生物标志物是内直径（ID）、外直径（OD）、壁厚度（PT）、壁横截面积（WCSA）和壁腔比（WLR）。AO 血管生物标志物的适用性主要在使用 AO FIO 的系统性高血压和使用 AO SLO 的糖尿病中得到了探索。对高血压患者的 Meta 分析结果表明，与健康对照组相比，WLR、PT 和 ID 差异具有统计学意义，而 WCSA 则无统计学差异（P < 0.001、P = 0.002、P < 0.001 和 P = 0.070）。本综述表明，尽管已经在 AO 正面成像中探索了大量视网膜血管生物标志物，但仍需要进一步的临床研究和程序标准化，以验证这些生物标志物用于动脉高血压和其他疾病的纵向监测。
