Sidorczuk Patryk, Pieklarz Barbara, Konopinska Joanna, Saeed Emil, Mariak Zofia, Dmuchowska Diana
Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, Poland.
Diabetes Metab Syndr Obes. 2021 Jun 28;14:2893-2903. doi: 10.2147/DMSO.S318860. eCollection 2021.
The aim of the study was to compare two non-overlapping blood supply systems of the retina to obtain a better insight into the relation between diabetic macular retinopathy and choroidopathy. Specifically, the study focused on the relationships between (1) retinal vascular changes around the fovea in fluorescein angiography (FA) and (2) choroidal thickness, volume and other parameters assessed by optical coherence tomography (OCT).
The retrospective cross-sectional single-center study included 210 eyes from 152 patients with diabetic retinopathy (mean age 60.7±12.4 years, 49.3% of women; foveal avascular zone [FAZ] outline: 44.3% grade ≤2, 55.7% grade ≥3). The outline of FAZ, a measure of capillary loss due to ischemic processes, was analyzed on FA according to the Early Treatment Diabetic Retinopathy Study Research Group (ETDRS) standards. The eyes were stratified according to the FAZ outline and size and the presence of clinically significant diabetic macular edema (CSME). Then, resultant groups were compared in terms of the spectral domain OCT parameters: choroidal thickness and volume (within ETDRS subfields), luminal, stromal and total choroidal areas and choroidal vascularity index (based on the foveal scan). Statistical analysis was based on univariate models with the choroidal parameters as independent variables, and age, sex, panretinal photocoagulation, the severity of diabetic retinopathy and CSME as covariates.
No significant relationships were found between the FAZ outline and area and choroidal characteristics of patients with diabetic retinopathy. In patients without CSME, no correlation was observed between the FAZ area and choroidal characteristics. In patients with CSME, no correlation was found between the FAZ area and choroidal characteristics other than the choroidal vascularity index.
In patients with diabetic retinopathy, damage to the macular retinal vasculature (FAZ) does not seem to be associated with changes in the choroidal vasculature, and these two processes appear to occur independently.
本研究旨在比较视网膜的两种不重叠血液供应系统，以更深入了解糖尿病性黄斑病变与脉络膜病变之间的关系。具体而言，该研究聚焦于以下两者之间的关系：（1）荧光素血管造影（FA）中黄斑中心凹周围的视网膜血管变化，以及（2）光学相干断层扫描（OCT）评估的脉络膜厚度、体积和其他参数。
这项回顾性横断面单中心研究纳入了152例糖尿病视网膜病变患者的210只眼（平均年龄60.7±12.4岁，女性占49.3%；黄斑无血管区[FAZ]轮廓：44.3%为≤2级，55.7%为≥3级）。根据早期糖尿病性视网膜病变研究组（ETDRS）标准，在FA上分析FAZ的轮廓，FAZ是缺血性过程导致的毛细血管损失的一种度量。根据FAZ轮廓、大小以及是否存在临床显著性糖尿病黄斑水肿（CSME）对眼睛进行分层。然后，就光谱域OCT参数对所得组进行比较：脉络膜厚度和体积（在ETDRS子区域内）、管腔、基质和脉络膜总面积以及脉络膜血管指数（基于黄斑中心凹扫描）。统计分析基于单变量模型，以脉络膜参数作为自变量，年龄、性别、全视网膜光凝、糖尿病视网膜病变的严重程度和CSME作为协变量。
在糖尿病视网膜病变患者中，未发现FAZ轮廓和面积与脉络膜特征之间存在显著关系。在无CSME的患者中，未观察到FAZ面积与脉络膜特征之间存在相关性。在有CSME的患者中，除脉络膜血管指数外，未发现FAZ面积与脉络膜特征之间存在相关性。
在糖尿病视网膜病变患者中，黄斑视网膜血管系统（FAZ）的损伤似乎与脉络膜血管系统的变化无关，这两个过程似乎是独立发生的。
