利用超广角扫频源光相干断层扫描血管成像术观察糖尿病视网膜病变患者视网膜结构的早期变化。
Early changes to retinal structure in patients with diabetic retinopathy as determined by ultrawide swept-source optical coherence tomography-angiography.
机构信息
Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Ophthalmology, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
出版信息
Front Endocrinol (Lausanne). 2023 May 8;14:1143535. doi: 10.3389/fendo.2023.1143535. eCollection 2023.
PURPOSE
To investigate retinal vascular changes in patients with diabetic retinopathy (DR) using the newly developed ultrawide rapid scanning swept-source optical coherence tomography angiography (SS-OCTA) device.
METHODS
This cross-sectional, observational study enrolled 24 patients (47 eyes) with DR, 45 patients (87 eyes) with diabetes mellitus (DM) without DR, and 36 control subjects (71 eyes). All subjects underwent 24 × 20 mm SS-OCTA examination. Vascular density (VD) and the thickness of the central macula (CM; 1 mm diameter) and temporal fan-shaped areas of 1-3 mm (T3), 3-6 mm (T6), 6-11 mm (T11), 11-16 mm (T16), and 16-21 mm (T21) were compared among groups. The VD and the thicknesses of the superficial vascular complex (SVC) and deep vascular complex (DVC) were analyzed separately. The predictive values of VD and thickness changes in DM and DR patients were evaluated by receiver operating characteristic (ROC) curve analysis.
RESULTS
The average VDs of the SVC in the CM and the T3, T6, T11, T16, and T21 areas were significantly lower in the DR than in the control group, whereas only the average VD of the SVC in the T21 area was significantly lower in the DM group. The average VD of the DVC in the CM was significantly increased in the DR group, whereas the average VDs of the DVC in the CM and T21 area were significantly decreased in the DM group. Evaluation of the DR group showed significant increases in the thicknesses of SVC-nourishing segments in the CM and T3, T6, and T11 areas and significant increases in the thicknesses of DVC-nourishing segments in the CM and T3 and T6 areas. In contrast, none of these parameters showed significant changes in the DM group. ROC curve analysis showed that the average VD of the SVC in the CM, T3, and T21 had better ability to predict DR, with areas under the ROC curves (AUCs) of 0.8608, 0.8505, and 0.8353, respectively. The average VD of the DVC in the CM was also predictive of DR, with an AUC of 0.8407.
CONCLUSIONS
The newly developed ultrawide SS-OCTA device was better able to reveal early peripheral retinal vascular changes than traditional devices.
目的
使用新开发的超广角快速扫描扫频源光相干断层扫描血管造影（SS-OCTA）设备研究糖尿病视网膜病变（DR）患者的视网膜血管变化。
方法
本横断面观察性研究纳入了 24 名（47 只眼）DR 患者、45 名（87 只眼）无 DR 的糖尿病（DM）患者和 36 名对照受试者（71 只眼）。所有受试者均接受了 24×20mm SS-OCTA 检查。比较各组间中央黄斑（CM；直径 1mm）和颞扇形区 1-3mm（T3）、3-6mm（T6）、6-11mm（T11）、11-16mm（T16）和 16-21mm（T21）的血管密度（VD）和中央黄斑厚度（CM）。分别分析浅层血管丛（SVC）和深层血管丛（DVC）的 VD 和厚度。通过接收者操作特征（ROC）曲线分析评估 DM 和 DR 患者 VD 和厚度变化的预测价值。
结果
DR 组 CM 和 T3、T6、T11、T16 和 T21 区 SVC 的平均 VD 明显低于对照组，而 DM 组仅 T21 区 SVC 的平均 VD 明显降低。DR 组 CM 区 DVC 的平均 VD 显著增加，而 DM 组 CM 和 T21 区 DVC 的平均 VD 显著降低。对 DR 组的评估显示，CM 和 T3、T6 和 T11 区 SVC 滋养段的厚度显著增加，CM 和 T3 和 T6 区 DVC 滋养段的厚度显著增加。相反，DM 组的这些参数均无明显变化。ROC 曲线分析显示，CM、T3 和 T21 区 SVC 的平均 VD 对 DR 的预测能力较好，ROC 曲线下面积（AUC）分别为 0.8608、0.8505 和 0.8353。CM 区 DVC 的平均 VD 也可预测 DR，AUC 为 0.8407。
结论
新开发的超广角 SS-OCTA 设备比传统设备更能揭示早期周边视网膜血管变化。
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