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糖尿病视网膜病变的影像学进展——从过去到现在

Progress of Imaging in Diabetic Retinopathy-From the Past to the Present.

作者信息

Horie Shintaro, Ohno-Matsui Kyoko

机构信息

Department of Advanced Ophthalmic Imaging, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.

Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.

出版信息

Diagnostics (Basel). 2022 Jul 11;12(7):1684. doi: 10.3390/diagnostics12071684.

Abstract

Advancement of imaging technology in retinal diseases provides us more precise understanding and new insights into the diseases' pathologies. Diabetic retinopathy (DR) is one of the leading causes of sight-threatening retinal diseases worldwide. Colour fundus photography and fluorescein angiography have long been golden standard methods in detecting retinal vascular pathology in this disease. One of the major advancements is macular observation given by optical coherence tomography (OCT). OCT dramatically improves the diagnostic quality in macular edema in DR. The technology of OCT is also applied to angiography (OCT angiograph: OCTA), which enables retinal vascular imaging without venous dye injection. Similar to OCTA, in terms of their low invasiveness, single blue color SLO image could be an alternative method in detecting non-perfused areas. Conventional optical photography has been gradually replaced to scanning laser ophthalmoscopy (SLO), which also make it possible to produce spectacular ultra-widefield (UWF) images. Since retinal vascular changes of DR are found in the whole retina up to periphery, it would be one of the best targets in UWF imaging. Additionally, evolvement of artificial intelligence (AI) has been applied to automated diagnosis of DR, and AI-based DR management is one of the major topics in this field. This review is trying to look back on the progress of imaging of DR comprehensively from the past to the present.

摘要

视网膜疾病成像技术的进步使我们对这些疾病的病理有了更精确的理解和新的认识。糖尿病性视网膜病变(DR)是全球范围内导致视力威胁性视网膜疾病的主要原因之一。彩色眼底摄影和荧光素血管造影长期以来一直是检测该疾病视网膜血管病变的金标准方法。其中一项重大进展是光学相干断层扫描(OCT)对黄斑的观察。OCT显著提高了DR黄斑水肿的诊断质量。OCT技术也应用于血管造影(OCT血管造影:OCTA),无需静脉注射染料就能实现视网膜血管成像。与OCTA类似,就其低侵入性而言,单蓝色扫描激光眼底镜(SLO)图像可能是检测无灌注区域的另一种方法。传统光学摄影已逐渐被扫描激光眼底镜(SLO)取代,这也使得生成壮观的超广角(UWF)图像成为可能。由于DR的视网膜血管变化在整个视网膜直至周边都能发现,它将是UWF成像的最佳目标之一。此外,人工智能(AI)的发展已应用于DR的自动诊断,基于AI的DR管理是该领域的主要课题之一。本综述试图全面回顾DR成像从过去到现在的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca67/9319818/fda663c4feb1/diagnostics-12-01684-g001.jpg

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