光学相干断层扫描血管造影术在检测糖尿病视网膜病变新生血管形成及评估周边缺血方面的敏感性和特异性
Sensitivity and Specificity of the Optical Coherence Tomography Angiography for Detection of Neovascularization and Evaluation of Peripheral Ischemia in Diabetic Retinopathy.
作者信息
Kaderli Sema Tamer, Karalezli Aylin, Kaya Cansu, Korkmaz Safak, Sul Sabahattin
机构信息
Department of Ophthalmology, Mugla Training and Research Hospital, Mugla, Türkiye.
Department of Ophthalmology, Mugla Sitki Kocman University, Mugla, Türkiye.
出版信息
Beyoglu Eye J. 2022 Nov 15;7(4):273-281. doi: 10.14744/bej.2022.92668. eCollection 2022.
OBJECTIVES
The purpose of this study was to identify the sensitivity and specificity of optical coherence tomography angiography (OCTA) parameters for the presence of neovascularization elsewhere (NVE) and to investigate the relationship between ischemic areas.
METHODS
This study included 59 eyes with non-proliferative diabetic retinopathy (NPDR) and 36 eyes with proliferative diabetic retinopathy (PDR). The foveal avascular zone (FAZ), vessel density (VD) for the superficial and the deep capillary plexus (DCP), choriocapillaris flow area (CCP), and non-perfusion area (unit²) were recorded. The area under the curve (AUC) under the receiver operating characteristic curves, sensitivity and specificity were calculated for statistically significant outcomes. Later, based on visual acuity, PDR group was subdivided into group 2A: PDR eyes with VA ≤0.2 logMAR and group 2B: PDR eyes with VA>0.2 logMAR. Non-perfusion area and OCTA features were compared between the subgroups.
RESULTS
The VD in DCP was significantly lower, FAZ and non-perfusion area were larger in PDR group (p=0.001, p<0.001, and p<0.001). The AUC for presence of NVE, for the VD, was 0.710 (p=0.012) with sensitivity and specificity of 64% and 65%, for the FAZ was 0.746 (p<0.001) with sensitivity and specificity of 72% and 72.7%. There was a significant positive correlation between the FAZ and non-perfusion area (For NPDR, p=0.025, for PDR p<0.001). There was a significant negative correlation between the VD in DCP and ischemic area in PDR group. (p<0.001) In group 2B, non-perfusion area and FAZ were larger than group 2A. The VD and CCP flow area were also lower in group 2B (All, p<0.05).
CONCLUSION
In cases with decreased VD in DCP and increased FAZ, the probability of PDR increases. Despite the sensitivity and specificity of the OCTA indices for the prediction of NVE being moderate, the OCTA is very useful in evaluating the microvascular structure in DR.
目的
本研究旨在确定光学相干断层扫描血管造影（OCTA）参数对其他部位新生血管形成（NVE）的敏感性和特异性，并研究缺血区域之间的关系。
方法
本研究纳入了59只非增殖性糖尿病视网膜病变（NPDR）眼和36只增殖性糖尿病视网膜病变（PDR）眼。记录黄斑无血管区（FAZ）、浅表和深层毛细血管丛（DCP）的血管密度（VD）、脉络膜毛细血管血流面积（CCP）和无灌注区（单位²）。计算受试者操作特征曲线下的曲线下面积（AUC）、敏感性和特异性，以得出具有统计学意义的结果。随后，根据视力，将PDR组细分为2A组：视力≤0.2 logMAR的PDR眼和2B组：视力>0.2 logMAR的PDR眼。比较亚组之间的无灌注区和OCTA特征。
结果
PDR组DCP中的VD显著降低，FAZ和无灌注区更大（p = 0.001、p < 0.001和p < 0.001）。对于NVE存在情况，VD的AUC为0.710（p = 0.012），敏感性和特异性分别为64%和65%；FAZ的AUC为0.746（p < 0.001），敏感性和特异性分别为72%和72.7%。FAZ与无灌注区之间存在显著正相关（NPDR组，p = 0.025；PDR组，p < 0.001）。PDR组DCP中的VD与缺血区域之间存在显著负相关（p < 0.001）。在2B组中，无灌注区和FAZ大于2A组。2B组的VD和CCP血流面积也较低（均p < 0.05）。
结论
在DCP中VD降低且FAZ增加的情况下，PDR的可能性增加。尽管OCTA指数预测NVE的敏感性和特异性中等，但OCTA在评估糖尿病视网膜病变的微血管结构方面非常有用。
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