Harvard Retinal Imaging Lab, Boston, MA, USA.
Wenzhou Medical University Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Graefes Arch Clin Exp Ophthalmol. 2023 Jul;261(7):1861-1870. doi: 10.1007/s00417-022-05957-3. Epub 2023 Jan 30.
To investigate the prevalence and clinical characteristics of diabetic patients with retinal venous loops (RVLs) and to assess the association with retinal ischemia using widefield swept-source optical coherence tomography angiography (WF SS-OCTA).
In this retrospective, cross-sectional study, a total of 195 eyes of 132 diabetic patients (31 eyes with no diabetic retinopathy (DR), 76 eyes with nonproliferative DR (NPDR), and 88 eyes with proliferative DR (PDR)) were imaged with WF SS-OCTA using Angio 6 × 6 mm and Montage 15 × 15 mm scans. Quantitative ischemia-related parameters, including ischemia index (ratio of nonperfusion area to total retinal area), foveal avascular zone (FAZ), and neovascularization features, were evaluated. RVLs were classified as type I or type II according to the branching level of the feeder vessel. A multivariate generalized estimating equations (GEE) logistic regression model was used to analyze the association of systemic parameters and ischemia-related metrics with RVLs in PDR eyes.
Forty-eight RVLs were identified in 22 eyes (11.28%). The prevalence of RVLs was higher in PDR compared to NPDR eyes (21.59% vs. 3.95%, P < 0.05). Type II RVLs accounted for a higher proportion than type I (89.58% vs. 10.42%, P < 0.001). RVLs were more likely to originate from superior (vs. inferior) and temporal (vs. nasal) veins (P < 0.05). The GEE model showed that neovascularization (NV) flow area and diastolic blood pressure were associated with RVLs in the PDR group (P < 0.05).
WF SS-OCTA is useful for the identification of RVLs in patients with DR. NV flow area and diastolic blood pressure were associated with the presence of RVLs in eyes with PDR. Ischemia index, FAZ, and other WF SS-OCTA parameters were not associated with RVLs. Further longitudinal studies are needed to identify the role of RVLs in DR progression.
利用广角扫频源光学相干断层血管造影术（WF SS-OCTA）研究视网膜静脉环（RVL）在糖尿病患者中的患病率和临床特征，并评估其与视网膜缺血的关系。
在这项回顾性、横断面研究中，对 132 名糖尿病患者的 195 只眼（31 只无糖尿病视网膜病变（DR）、76 只非增殖性 DR（NPDR）和 88 只增殖性 DR（PDR））进行了 WF SS-OCTA 成像，使用 Angio 6×6mm 和 Montage 15×15mm 扫描。评估了定量缺血相关参数，包括缺血指数（无灌注区与总视网膜面积的比值）、中心凹无血管区（FAZ）和新生血管特征。根据供血血管的分支水平，将 RVL 分为 I 型或 II 型。采用多变量广义估计方程（GEE）逻辑回归模型分析 PDR 眼中系统参数和缺血相关指标与 RVL 的关系。
在 22 只眼中（11.28%）发现了 48 个 RVL。与 NPDR 眼相比，PDR 眼中 RVL 的患病率更高（21.59% vs. 3.95%，P<0.05）。II 型 RVL 比 I 型更常见（89.58% vs. 10.42%，P<0.001）。RVL 更可能起源于上方（与下方相比）和颞侧（与鼻侧相比）静脉（P<0.05）。GEE 模型显示，PDR 组中新生血管（NV）血流面积和舒张压与 RVL 相关（P<0.05）。
WF SS-OCTA 可用于识别 DR 患者的 RVL。NV 血流面积和舒张压与 PDR 眼 RVL 的存在相关。缺血指数、FAZ 和其他 WF SS-OCTA 参数与 RVL 无关。需要进一步的纵向研究来确定 RVL 在 DR 进展中的作用。
