应用于临床检测糖尿病视网膜病变患者隐匿性视网膜新生血管的光学相干断层扫描血管成像技术的效用。
Utility of En Face OCT for the Detection of Clinically Unsuspected Retinal Neovascularization in Patients with Diabetic Retinopathy.
机构信息
Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon; Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon.
出版信息
Ophthalmol Retina. 2023 Aug;7(8):683-691. doi: 10.1016/j.oret.2023.03.002. Epub 2023 Mar 12.
PURPOSE
To assess the value of en face OCT for detecting clinically unsuspected retinal neovascularization (RNV) in patients with nonproliferative diabetic retinopathy (NPDR).
DESIGN
A retrospective, cross-sectional study.
PARTICIPANTS
Treatment-naïve patients clinically graded as NPDR in an ongoing prospective observational OCT angiography (OCTA) study at a tertiary care center.
METHODS
Each patient underwent imaging of 1 eye with a spectral-domain OCTA, generating a 17 × 17-mm widefield image by montaging four 9 × 9-mm scans. Two independent graders examined a combination of en face OCT, en face OCTA with a custom vitreoretinal interface slab, and cross-sectional OCTA to determine the presence of RNV. We measured the area of RNV flow within RNV lesions on en face OCTA.
MAIN OUTCOME MEASURES
Detection rate of clinically occult RNV with OCT and OCTA.
RESULTS
Of 63 enrolled eyes, 27 (43%) were clinically graded as severe NPDR, 16 (25%) as moderate NPDR, and 20 (32%) as mild NPDR. Using the combination of en face OCT, en face OCTA, and cross-sectional OCTA, the graders detected 42 RNV lesions in 12 (19%) eyes, of which 8 (67%) were graded as severe NPDR, 2 (17%) as moderate NPDR, and 2 (17%) as mild NPDR. The sensitivity of en face OCT alone for detecting eyes with RNV was similar to that of en face OCTA alone (100% vs. 92%; P = 0.32), whereas the specificity of en face OCT alone was significantly lower than that of en face OCTA alone (32% vs. 73%; P < 0.001). For detecting individual RNV lesions, the en face OCT was 100% sensitive, compared with 67% sensitivity for the en face OCTA (P < 0.001). The area of RNV lesions that manual grading with en face OCTA alone missed was significantly smaller than that of manually detectable RNV (Mean [standard deviation] RNV flow area, 0.015 [0.020] mm vs. 0.16 [0.36] mm; P < 0.001).
CONCLUSION
The combination of en face OCT and OCTA can detect clinically occult RNV with high sensitivity. For screening these small lesions, en face OCT may be a useful imaging modality.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
目的
评估针对非增生性糖尿病视网膜病变（NPDR）患者的临床无症状性视网膜新生血管（RNV）的面 OCT 的价值。
设计
回顾性、横断面研究。
参与者
在一家三级保健中心进行的一项正在进行的前瞻性 OCT 血管造影（OCTA）研究中，临床分级为 NPDR 的未经治疗的患者。
方法
每位患者均对 1 只眼进行了光谱域 OCTA 成像，通过对 4 个 9×9mm 扫描进行拼接生成了 17×17mm 宽视野图像。2 名独立的阅片者检查了面 OCT、带有自定义玻璃体视网膜界面板的面 OCTA 和横断面 OCTA 的组合，以确定 RNV 的存在。我们在面 OCTA 上测量了 RNV 病变内的 RNV 流量面积。
主要观察指标
OCT 和 OCTA 检测临床隐匿性 RNV 的检出率。
结果
在纳入的 63 只眼中，27 只（43%）临床分级为重度 NPDR，16 只（25%）为中度 NPDR，20 只（32%）为轻度 NPDR。使用面 OCT、面 OCTA 和横断面 OCTA 的组合，阅片者在 12 只眼（19%）中检测到 42 个 RNV 病变，其中 8 只（67%）为重度 NPDR，2 只（17%）为中度 NPDR，2 只（17%）为轻度 NPDR。单独使用面 OCT 检测到 RNV 眼的敏感性与单独使用面 OCTA 相似（100%比 92%；P=0.32），而单独使用面 OCT 的特异性明显低于单独使用面 OCTA（32%比 73%；P<0.001）。对于检测单个 RNV 病变，面 OCT 的敏感性为 100%，而面 OCTA 的敏感性为 67%（P<0.001）。单独使用面 OCTA 手动分级漏诊的 RNV 病变面积明显小于手动可检测的 RNV（Mean[standard deviation]RNV 流量面积，0.015[0.020]mm 比 0.16[0.36]mm；P<0.001）。
结论
面 OCT 和 OCTA 的组合可高灵敏度地检测临床隐匿性 RNV。对于筛查这些小病变，面 OCT 可能是一种有用的成像方式。
金融披露
参考文献之后可能会发现专有或商业披露。
Zotero 插件