Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Retina. 2021 Aug 1;41(8):1587-1596. doi: 10.1097/IAE.0000000000003146.
Wide-field (WF) swept-source (SS) optical coherence tomography angiography (SS-OCTA) was used to image diabetic tractional retinal detachments (TRDs) before and after pars plana vitrectomy. The clinical utility of SS-OCTA was assessed.
Patients with diabetic TRDs were imaged prospectively with SS-OCTA. Ultrawide-field imaging was obtained when possible. Postoperative WF SS-OCTA imaging was performed.
From January 2018 through December 2019, 31 eyes of 21 patients with diabetic TRDs were imaged. Wide-field SS-OCTA en-face images captured all areas of TRD and fibrovascular proliferation within the posterior pole that were visualized on ultrawide-field imaging. Optical coherence tomography angiography B-scans revealed the vascularity of preretinal membranes and identified areas of vitreoretinal traction and posterior vitreous detachment. Ten eyes underwent pars plana vitrectomy. Postoperative SS-OCTA imaging demonstrated removal of fibrovascular membranes, relief of traction, and resolution of TRDs. Retinal ischemia before and after surgical repair appeared similar.
All clinically relevant features of diabetic TRDs were identified at baseline and assessed longitudinally after pars plana vitrectomy using WF SS-OCTA, which showed resolution of vitreoretinal traction and no apparent change in the status of retinal perfusion after surgery. If the media are clear and fixation is adequate, WF SS-OCTA is likely the only imaging modality needed for the diagnosis and longitudinal evaluation of diabetic TRDs.
宽视野（WF）扫频源（SS）光相干断层扫描血管造影（SS-OCTA）用于在接受玻璃体切除术前后对糖尿病牵引性视网膜脱离（TRD）进行成像。评估 SS-OCTA 的临床实用性。
前瞻性地对患有糖尿病 TRD 的患者进行 SS-OCTA 成像。如果可能，进行超广角成像。进行术后 WF SS-OCTA 成像。
从 2018 年 1 月至 2019 年 12 月，对 21 例 31 只患有糖尿病 TRD 的患者进行了成像。宽视野 SS-OCTA 面成像捕获了 TRD 和后极部纤维血管增生的所有区域，这些区域在超广角成像上可见。OCTA B 扫描显示了视网膜前膜的血管化，并确定了玻璃体视网膜牵引和后玻璃体脱离的区域。10 只眼睛接受了玻璃体切除术。术后 SS-OCTA 成像显示纤维血管膜被清除，牵引得到缓解，TRD 得到解决。手术修复前后的视网膜缺血情况相似。
使用 WF SS-OCTA 在基线时可识别出糖尿病 TRD 的所有临床相关特征，并在接受玻璃体切除术治疗后进行纵向评估，结果显示玻璃体视网膜牵引得到缓解，手术后视网膜灌注状态无明显变化。如果介质清晰且固定良好，WF SS-OCTA 可能是诊断和糖尿病 TRD 纵向评估所需的唯一成像方式。
