Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, USA.
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
Transl Vis Sci Technol. 2023 Apr 3;12(4):3. doi: 10.1167/tvst.12.4.3.
To evaluate the sensitivity of normalized blood flow index (NBFI) for detecting early diabetic retinopathy (DR).
Optical coherence tomography angiography (OCTA) images of healthy controls, diabetic patients without DR (NoDR), and patients with mild nonproliferative DR (NPDR) were analyzed in this study. The OCTA images were centered on the fovea and covered a 6 mm × 6 mm area. Enface projections of the superficial vascular plexus (SVP) and the deep capillary plexus (DCP) were obtained for the quantitative OCTA feature analysis. Three quantitative OCTA features were examined: blood vessel density (BVD), blood flow flux (BFF), and NBFI. Each feature was calculated from both the SVP and DCP and their sensitivities to distinguish the three cohorts of the study were evaluated.
The only quantitative feature capable of distinguishing all three cohorts was NBFI in the DCP image. Comparative study revealed that both BVD and BFF were able to distinguish the controls and NoDR from mild NPDR. However, neither BVD nor BFF was sensitive enough to separate NoDR from the healthy controls.
The NBFI has been demonstrated as a sensitive biomarker of early DR, revealing retinal blood flow abnormality better than traditional BVD and BFF. The NBFI in the DCP was verified as the most sensitive biomarker, supporting that diabetes affects the DCP earlier than SVP in DR.
NBFI provides a robust biomarker for quantitative analysis of DR-caused blood flow abnormalities, promising early detection and objective classification of DR.
评估标准化血流指数（NBFI）检测早期糖尿病视网膜病变（DR）的敏感性。
本研究分析了健康对照者、无 DR 的糖尿病患者（NoDR）和轻度非增生性 DR（NPDR）患者的光学相干断层扫描血管造影（OCTA）图像。OCTA 图像以黄斑为中心，覆盖 6mm×6mm 区域。获得浅层血管丛（SVP）和深层毛细血管丛（DCP）的面投影，用于定量 OCTA 特征分析。检查了三种定量 OCTA 特征：血管密度（BVD）、血流通量（BFF）和 NBFI。每个特征均来自 SVP 和 DCP 计算，并评估了它们区分研究三个队列的敏感性。
唯一能够区分所有三个队列的定量特征是 DCP 中的 NBFI。对比研究表明，BVD 和 BFF 均能够区分对照组和 NoDR 与轻度 NPDR。然而，BVD 和 BFF 都不足以将 NoDR 与健康对照组区分开来。
NBFI 已被证明是早期 DR 的敏感生物标志物，比传统的 BVD 和 BFF 更好地揭示视网膜血流异常。DCP 中的 NBFI 被验证为最敏感的生物标志物，支持糖尿病在 DR 中比 SVP 更早影响 DCP。
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