Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Laboratory, Capital Medical University, Beijing, China.
Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, CA, USA.
Eye (Lond). 2023 Mar;37(4):678-683. doi: 10.1038/s41433-021-01777-7. Epub 2022 Mar 24.
To determine the relationship between baseline retinal non-perfusion area (NPA) and retinal vascular bed area (RVBA) on ultra-wide field fluorescein angiography (UWF FA) and long-term response to intravitreal ranibizumab therapy in diabetic macular oedema (DMO).
A post-hoc, 2-year observational case series. Baseline UWF FA images (Optos 200Tx) of 40 eyes from 29 patients with diabetes mellitus and treatment naïve DMO in the DAVE (NCT01552408) study were montaged and stereographically projected at the Doheny Image Reading Center to adjust for peripheral distortion. The retinal vasculature was automatically extracted to calculate RVBA. NPA was manually delineated by two masked certified graders. RVBA and NPA were computed in mm automatically by adjusting for peripheral distortion and then correlated with the severity of DMO.
While global NPA at baseline was not correlated to retinal thickness measurements, baseline NPA in the superior retina was associated with the macular volume (MV) improvement (P = 0.022). Multivariate analysis revealed a smaller RVBA at baseline was correlated with a better MV outcome at two-year follow-up after adjusting for confounding factors (P = 0.049).
Eyes with smaller baseline RVBA appear to have a better long-term anatomic outcome of DMO.
在糖尿病黄斑水肿（DMO）中，确定超广角荧光素血管造影（UWF FA）上基线视网膜无灌注区（NPA）和视网膜血管床区（RVBA）之间的关系，以及与长期玻璃体腔内雷珠单抗治疗的反应之间的关系。
这是一项 DAVE（NCT01552408）研究中，29 名糖尿病且未经治疗的 DMO 患者的 40 只眼的事后、2 年观察性病例系列。将 DAVE 研究中 40 只眼的基线 UWF FA 图像（Optos 200Tx）进行蒙太奇处理，并在 Doheny 图像阅读中心进行立体投影，以校正周边失真。自动提取视网膜血管以计算 RVBA。由两名经过认证的盲法分级员手动描绘 NPA。通过调整周边失真自动计算 RVBA 和 NPA，并与 DMO 的严重程度相关。
虽然基线时的全视网膜 NPA 与视网膜厚度测量值无关，但上视网膜的基线 NPA 与黄斑体积（MV）改善相关（P=0.022）。多变量分析显示，在调整混杂因素后，基线时较小的 RVBA 与两年随访时 MV 结局更好相关（P=0.049）。
基线时 RVBA 较小的眼睛似乎具有更好的 DMO 长期解剖结局。
