Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Division of Ophthalmology, Department of Surgery, Lahey Hospital and Medical Center, Burlington; Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA.
Indian J Ophthalmol. 2023 Aug;71(8):3085-3090. doi: 10.4103/IJO.IJO_3155_22.
To characterize the relationship between diabetic macular ischemia (DMI) delineated by optical coherence tomography angiography (OCTA) and microaneurysms (MAs) identified by fundus fluorescein angiography (FFA).
Patients with diabetic retinopathy (DR) who underwent OCTA and FFA were retrospectively identified. FFA images were cropped and aligned with their respective OCTA images using i2k Align Retina software (Dual-Align, Clifton Park, NY, USA). Foveal avascular zone (FAZ) and ischemic areas were manually delineated on OCTA images, and MAs were marked on the corresponding FFA images before overlaying paired scans for analysis (ImageJ; National Institutes of Health, Bethesda, MD, USA).
Twenty-eight eyes of 20 patients were included. The average number of MAs identified in cropped FFA images was 127 ± 42. More DMI was noted in the superficial capillary plexus (SCP; 36 ± 13%) compared to the deep capillary plexus (DCP; 28 ± 14%, P < 0.001). Similarly, more MAs were associated with ischemic areas in SCP compared to DCP (92.0 ± 35.0 vs. 76.8 ± 36.5, P < 0.001). Most MAs bordered ischemic areas; fewer than 10% localized inside these regions. As DMI area increased, so did associated MAs (SCP: r = 0.695, P < 0.001; DCP: r = 0.726, P < 0.001). Density of MAs surrounding FAZ (7.7 ± 6.0 MAs/mm) was similar to other DMI areas (SCP: 7.0 ± 4.0 MAs/mm, P = 0.478; DCP: 9.2 ± 10.9 MAs/mm, P = 0.394).
MAs identified in FFA strongly associate with, and border areas of, DMI delineated by OCTA. Although more MAs are localized to SCP ischemia, the concentration of MAs associated with DCP ischemia is greater. By contrast, few MAs are present inside low-flow regions, likely because capillary loss is associated with their regression.
描述光学相干断层扫描血管造影（OCTA）所界定的糖尿病性黄斑缺血（DMI）与眼底荧光血管造影（FFA）所识别的微动脉瘤（MA）之间的关系。
回顾性分析了接受 OCTA 和 FFA 检查的糖尿病视网膜病变（DR）患者。使用 i2k Align Retina 软件（Dual-Align，Clifton Park，NY，USA）裁剪 FFA 图像并将其与各自的 OCTA 图像对齐。在 OCTA 图像上手动划定中心凹无血管区（FAZ）和缺血区，并在叠加配对扫描进行分析之前在相应的 FFA 图像上标记 MA（ImageJ；美国国立卫生研究院，贝塞斯达，MD，USA）。
共纳入 20 例 28 只眼。裁剪后的 FFA 图像中平均识别出 127 ± 42 个 MA。与深层毛细血管丛（DCP；28 ± 14%，P < 0.001）相比，浅层毛细血管丛（SCP；36 ± 13%）中 DMI 更多。同样，SCP 中与缺血区相关的 MA 也多于 DCP（92.0 ± 35.0 vs. 76.8 ± 36.5，P < 0.001）。大多数 MA 与缺血区边界相邻；只有不到 10%的 MA 位于这些区域内。随着 DMI 面积的增加，相关的 MA 也随之增加（SCP：r = 0.695，P < 0.001；DCP：r = 0.726，P < 0.001）。围绕 FAZ 的 MA 密度（7.7 ± 6.0 MA/mm）与其他 DMI 区域相似（SCP：7.0 ± 4.0 MA/mm，P = 0.478；DCP：9.2 ± 10.9 MA/mm，P = 0.394）。
FFA 中识别出的 MA 与 OCTA 界定的 DMI 及其周围区域强烈相关。虽然 SCP 缺血区的 MA 更多，但 DCP 缺血区相关 MA 的浓度更高。相比之下，低血流区域内的 MA 较少，这可能是因为毛细血管丢失与它们的退化有关。
