Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Front Public Health. 2022 Nov 2;10:1047608. doi: 10.3389/fpubh.2022.1047608. eCollection 2022.
To compare the detection rate of diabetic retinopathy (DR) lesions and the agreement of DR severity grading using the ultra-widefield color fundus photography (UWF CFP) combined with high-speed ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) or fluorescein angiography (FFA).
This prospective, observational study recruited diabetic patients who had already taken the FFA examination from November 2021 to June 2022. These patients had either no DR or any stage of DR. All participants were imaged with a 200° UWF CFP and UWF SS-OCTA using a 24 × 20 mm scan model. Images were independently evaluated for the presence or absence of DR lesions including microaneurysms (MAs), intraretinal hemorrhage (IRH), non-perfusion areas (NPAs), intraretinal microvascular abnormalities (IRMAs), venous beading (VB), neovascularization elsewhere (NVE), neovascularization of the optic disc (NVD), and vitreous or preretinal hemorrhage (VH/PRH). Agreement of DR severity grading based on UWF CFP plus UWF SS-OCTA and UWF CFP plus FFA was compared. All statistical analyses were performed using SPSS V.26.0.
One hundred and fifty-three eyes of 86 participants were enrolled in the study. The combination of UWF CFP with UWF SS-OCTA showed a similar detection rate compared with UWF CFP plus FFA for all the characteristic DR lesions (>0.05), except NPAs ( = 0.039). Good agreement was shown for the identification of VB (κ = 0.635), and very good agreement for rest of the DR lesions between the two combination methods (κ-value ranged from 0.858 to 0.974). When comparing the grading of DR severity, very good agreement was achieved between UWF CFP plus UWF SS-OCTA and UWF CFP plusr FFA (κ = 0.869).
UWF CFP plus UWF SS-OCTA had a very good agreement in detecting DR lesions and determining the severity of DR compared with UWF CFP plus FFA. This modality has the potential to be used as a fast, reliable, and non-invasive method for DR screening and monitoring in the future.
比较超广角彩色眼底照相术（UWF CFP）联合高速超广角扫频源光相干断层扫描血管造影术（UWF SS-OCTA）或荧光素血管造影术（FFA）对糖尿病视网膜病变（DR）病变的检出率及 DR 严重程度分级的一致性。
本前瞻性观察性研究于 2021 年 11 月至 2022 年 6 月招募了已接受 FFA 检查的糖尿病患者。这些患者要么没有 DR，要么处于任何阶段的 DR。所有参与者均使用 200°超广角 CFP 和 24×20mm 扫描模型进行 UWF SS-OCTA 成像。使用独立的眼底照相评估存在或不存在 DR 病变，包括微动脉瘤（MA）、视网膜内出血（IRH）、无灌注区（NPA）、视网膜内微血管异常（IRMA）、静脉串珠（VB）、其他部位新生血管（NVE）、视盘新生血管（NVD）和玻璃体积血或视网膜前出血（VH/PRH）。比较 UWF CFP 联合 UWF SS-OCTA 和 UWF CFP 联合 FFA 的 DR 严重程度分级的一致性。所有统计分析均使用 SPSS V.26.0 进行。
纳入了 86 名患者的 153 只眼。与 UWF CFP 联合 FFA 相比，UWF CFP 联合 UWF SS-OCTA 对所有特征性 DR 病变的检出率相似（均>0.05），除 NPA（=0.039）外。两种联合方法在 VB 的识别方面具有良好的一致性（κ=0.635），在其余 DR 病变的识别方面具有极好的一致性（κ 值范围为 0.858 至 0.974）。比较 DR 严重程度分级时，UWF CFP 联合 UWF SS-OCTA 与 UWF CFP 联合 FFA 之间具有极好的一致性（κ=0.869）。
与 UWF CFP 联合 FFA 相比，UWF CFP 联合 UWF SS-OCTA 在检测 DR 病变和确定 DR 严重程度方面具有极好的一致性。这种方式有可能成为未来 DR 筛查和监测的一种快速、可靠、非侵入性的方法。
