超广角成像下糖尿病视网膜病变病变分布的种族差异。
Ethnic Variation in Diabetic Retinopathy Lesion Distribution on Ultra-widefield Imaging.
作者信息
He Ye, Verma Aditya, Nittala Muneeswar G, Velaga Swetha Bindu, Esmaeilkhanian Houri, Li Xiaorong, Su Long, Li Xiao, Jayadev Chaitra, Tsui Irena, Prasad Pradeep, Sadda Srinivas R
机构信息
From the Doheny Eye Institute (Y.H., A.V., M.G.N., S.B.V., H.E., I.T., S.R.S.), David Geffen School of Medicine, University of California Los Angeles, Pasadena, California, USA; Department of Ophthalmology (Y.H., H.E., I.T., P.P., S.R.S.), David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA; Tianjin Key Laboratory of Retinal Functions and Diseases (Y.H., X.L., X.L.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
From the Doheny Eye Institute (Y.H., A.V., M.G.N., S.B.V., H.E., I.T., S.R.S.), David Geffen School of Medicine, University of California Los Angeles, Pasadena, California, USA.
出版信息
Am J Ophthalmol. 2023 Mar;247:61-69. doi: 10.1016/j.ajo.2022.10.023. Epub 2022 Nov 9.
PURPOSE
To evaluate whether the distribution of diabetic retinopathy (DR) lesions differs among various ethnicities.
DESIGN
Multi-center, retrospective cohort study.
METHODS
We accrued a cohort of 226 eyes with DR consisting of 51 East Asian eyes, 102 South Asian eyes, 30 Caucasian eyes, and 43 Latino eyes, all evaluated with ultrawide field pseudocolor images. Images were manually annotated for DR lesions and were classified as having predominantly peripheral lesions (PPL) or predominantly central lesions (PCL) using 4 quantitative methods. The percent distribution of PCL to PPL was compared among different ethnicities.
RESULTS
Using a single-field lesion frequency-based method, East Asian eyes more frequently demonstrated a PPL distribution (86.3%), whereas South Asian eyes more frequently demonstrated a PCL distribution (64.7%). These findings were also observed when considering only the subset of treatment-naïve eyes. Furthermore, in treatment-naïve eyes without proliferative DR, the percent distribution of PPL to PCL in East Asian eyes was significantly different when compared to other ethnicities (P < .0001 South Asian, P = .035 Caucasian, P = .0003 Latino). The majority of patients (60%-78%) in all ethnic groups had moderate nonproliferative diabetic retinopathy(NPDR), and the same difference between East Asian and South Asian eyes was observed in this subgroup.
CONCLUSIONS
The distribution of DR lesions appears to vary among different ethnicities. DR lesions tend to be distributed more peripherally in East Asian eyes compared to other ethnic groups, particularly South Asian eyes, which tend to have more central disease. The prognostic implications of these ethnic differences in DR lesion distribution require further investigation.
目的
评估糖尿病视网膜病变（DR）病变在不同种族中的分布是否存在差异。
设计
多中心回顾性队列研究。
方法
我们纳入了一组226只患有DR的眼睛，其中包括51只东亚人的眼睛、102只南亚人的眼睛、30只白种人的眼睛和43只拉丁裔人的眼睛，所有眼睛均通过超广角伪彩色图像进行评估。对图像进行手动标注以确定DR病变，并使用4种定量方法将其分类为主要为周边病变（PPL）或主要为中心病变（PCL）。比较不同种族中PCL与PPL的百分比分布。
结果
使用基于单视野病变频率的方法，东亚人的眼睛更常表现为PPL分布（86.3%），而南亚人的眼睛更常表现为PCL分布（64.7%）。仅考虑未接受治疗的眼睛子集时，也观察到了这些结果。此外，在未患有增殖性DR的未接受治疗的眼睛中，东亚人眼睛中PPL与PCL的百分比分布与其他种族相比存在显著差异（与南亚人相比P <.0001，与白种人相比P =.035，与拉丁裔人相比P =.0003）。所有种族中的大多数患者（60%-78%）患有中度非增殖性糖尿病视网膜病变（NPDR），并且在该亚组中也观察到了东亚人和南亚人眼睛之间的相同差异。
结论
DR病变的分布在不同种族中似乎有所不同。与其他种族相比，DR病变在东亚人眼睛中更倾向于分布在周边，尤其是南亚人眼睛，其往往有更多的中心性疾病。这些DR病变分布的种族差异对预后的影响需要进一步研究。
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