Tombolini Beatrice, Borrelli Enrico, Sacconi Riccardo, Bandello Francesco, Querques Giuseppe
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Ophthalmology Unit, Division of Head and Neck, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Acta Diabetol. 2022 Jun;59(6):751-759. doi: 10.1007/s00592-021-01844-1. Epub 2022 Feb 8.
Since its relevance on diagnosis and prognosis of diabetic retinopathy (DR), this review will examine a multimodal imaging approach to detect diabetic macular ischemia (DMI).
A PubMed engine search was carried out using the term "macular ischemia" paired with "diabetes," and "diabetic macular ischemia" paired to "fluorescein angiography," "ultra-wide field fluorescein angiography," "optical coherence tomography angiography," "octa," "2D octa," "ultra-wide field octa," "3D octa," "visual acuity." All studies published in English up to October 2021 irrespective of their publication status were reviewed, and relevant publications were included in this review.
Recently, new technologies have been proposed as an alternative to fluorescein angiography (FA), which is an actual diagnostic gold standard technique. Nowadays, optical coherence tomography angiography (OCTA) has emerged as the most promising and reliable procedure able to provide a qualitative and quantitative description of DMI. Newer three-dimensional (3D) OCTA approach will be discussed too. Moreover, we will discuss how OCTA might identify preclinical alterations before the onset of DR and allow prediction about the progression of disease.
OCTA has significantly expanded our knowledge on diabetic macular ischemia.
鉴于其对糖尿病视网膜病变（DR）诊断和预后的相关性，本综述将探讨一种用于检测糖尿病性黄斑缺血（DMI）的多模态成像方法。
使用“黄斑缺血”与“糖尿病”配对，以及“糖尿病性黄斑缺血”与“荧光素血管造影”、“超广角荧光素血管造影”、“光学相干断层扫描血管造影”、“octa”、“二维octa”、“超广角octa”、“三维octa”、“视力”等词在PubMed数据库中进行检索。对截至2021年10月发表的所有英文研究进行综述，无论其发表状态如何，相关出版物均纳入本综述。
最近，新技术已被提议作为荧光素血管造影（FA）的替代方法，而FA是目前的诊断金标准技术。如今，光学相干断层扫描血管造影（OCTA）已成为最有前景和可靠的方法，能够对DMI进行定性和定量描述。还将讨论更新的三维（3D）OCTA方法。此外，我们将讨论OCTA如何在DR发病前识别临床前改变，并预测疾病的进展。
OCTA显著扩展了我们对糖尿病性黄斑缺血的认识。
