Department of Ophthalmology, Charles Nicolle University Hospital of Tunis, Boulevard du 9-Avril 1938, 1006, Tunis, Tunisia.
Acta Diabetol. 2021 Dec;58(12):1683-1688. doi: 10.1007/s00592-021-01774-y. Epub 2021 Jul 27.
To quantify and to study the relationship between retinal microvascular changes and different stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).
This prospective observational study included the eyes of patients with different stages of DR. OCTA was performed in all eyes using a 9 × 9 mm protocol. We analyzed the superficial and deep retinal capillary plexuses, for the following OCTA parameters: number of microaneurysms (MA), number of intraretinal microvascular abnormalities (IRMA), the total surface of capillary non-perfusion (CNP) areas, and vascular density (VD). The association between those parameters and the severity of DR was studied.
A total of 70 eyes of 45 patients were included. The number of MA in the superficial capillary plexus (SCP) showed a significant association with DR severity (p = 0.03). The number of IRMA and the total surface of CNP areas were associated with the severity of DR in both plexuses (p = 0.019 in the SCP and p = 0.044 in the DCP for IRMA; p < 0.001 in the SCP and p = 0.001 in the DCP for CNP areas). The VD decreased significantly with the severity of DR in the DCP (p = 0.04).
The number of vascular abnormalities and the surface of CNP areas were significantly associated with the severity of DR. The decrease in vascular density in the DCP with increasing disease severity suggests that the DCP is more vulnerable to vascular changes than the SCP. Those parameters might be tools for a future DR severity scale based on OCTA.
In addition to its capability of detecting vascular changes in DR non-invasively, OCTA may also serve as a valuable tool to graduate DR.
利用光相干断层扫描血管造影术（OCTA）定量研究并分析视网膜微血管改变与糖尿病视网膜病变（DR）不同分期之间的关系。
本前瞻性观察性研究纳入了不同分期 DR 患者的眼部。所有患者均采用 9×9mm 方案行 OCTA 检查。我们分析了浅层和深层视网膜毛细血管丛，评估以下 OCTA 参数：微动脉瘤（MA）数量、视网膜内微血管异常（IRMA）数量、无灌注毛细血管总面积（CNP）和血管密度（VD）。研究这些参数与 DR 严重程度之间的关系。
共纳入 45 例 70 只眼。浅层毛细血管丛（SCP）中 MA 数量与 DR 严重程度呈显著相关（p=0.03）。IRMA 数量和 CNP 总面积与两个丛的 DR 严重程度相关（SCP 中 IRMA：p=0.019；DCP 中 IRMA：p=0.044；SCP 中 CNP 总面积：p<0.001；DCP 中 CNP 总面积：p=0.001）。DCP 中的 VD 随 DR 严重程度的增加而显著降低（p=0.04）。
血管异常数量和 CNP 总面积与 DR 严重程度显著相关。随着疾病严重程度的增加，DCP 中的血管密度降低，表明 DCP 比 SCP 更容易发生血管变化。这些参数可能成为基于 OCTA 的未来 DR 严重程度分级的工具。
OCTA 除了能够无创性地检测 DR 中的血管变化外，还可能成为评估 DR 的一种有价值的工具。
