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OCT 血管造影与超广角成像中新血管检测相关的非灌注阈值是否存在于糖尿病视网膜病变中？

Is There a Nonperfusion Threshold on OCT Angiography Associated With New Vessels Detected on Ultra-Wide-Field Imaging in Diabetic Retinopathy?

机构信息

Universite Paris Cité, Paris, France.

Ophthalmology Department, AP-HP, Hôpital Lariboisière, Paris, France.

出版信息

Transl Vis Sci Technol. 2023 Sep 1;12(9):15. doi: 10.1167/tvst.12.9.15.

DOI:10.1167/tvst.12.9.15
PMID:37738057
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10519435/
Abstract

PURPOSE

To determine whether the nonperfusion index (NPI) measured on widefield (WF) optical coherence tomography angiography (OCTA) could be used as an alternative method for the diagnosis of proliferative diabetic retinopathy (PDR) and to study the relationship between the NPI and the location of new vessels (NV) in eyes with PDR.

METHODS

Fifty-one treatment-naïve eyes with either severe nonproliferative DR (NPDR) or PDR were imaged using ultra-wide-field imaging and wide-field OCTA.

RESULTS

The NPI was significantly higher in eyes with PDR (18.94% vs. 7.51%; P < 0.01). Using the NPI on the whole image to assess PDR status, the area under the curve was 0.770, but the area under the curve increased when the NPI of the most peripheral circle was used (area under the curve of 0.792). Four eyes with PDR (17%) had NV outside the OCTA image field, and their mean NPI (6.15 %) did not differ from that measured in severe NPDR eyes (7.51%; P = 0.67) and was lower than in other eyes with PDR (21.49%; P = 0.023). The presence of NV in a sector was associated with a higher NPI in the same sector (29.2% vs. 6.0%; P < 10-15).

CONCLUSIONS

Although the NPI was significantly higher in eyes with PDR compared with severe NPDR eyes, its measurement on the whole wide-field OCTA image was not sensitive enough to replace the detection of NV for the diagnosis of PDR.

TRANSLATIONAL RELEVANCE

Because the presence of new vessels was related to the local nonperfusion index in the same sector, the assessment of nonperfusion outside the optical coherence tomography angiography field is important in diabetic retinopathy.

摘要

目的

确定宽视野（WF）光学相干断层扫描血管造影（OCTA）测量的无灌注指数（NPI）是否可作为增生性糖尿病视网膜病变（PDR）诊断的替代方法，并研究 PDR 眼中 NPI 与新生血管（NV）位置之间的关系。

方法

对 51 例未经治疗的严重非增生性糖尿病视网膜病变（NPDR）或 PDR 患者的眼进行超广角成像和宽视野 OCTA 成像。

结果

PDR 眼中的 NPI 明显更高（18.94%比 7.51%；P<0.01）。使用整个图像的 NPI 评估 PDR 状态，曲线下面积为 0.770，但使用最外周圆的 NPI 时，曲线下面积增加（0.792 的曲线下面积）。4 只 PDR 眼（17%）的 NV 位于 OCTA 图像场之外，其平均 NPI（6.15%）与严重 NPDR 眼的 NPI（7.51%；P=0.67）无差异，且低于其他 PDR 眼（21.49%；P=0.023）。扇区 NV 的存在与同一扇区较高的 NPI 相关（29.2%比 6.0%；P<10-15）。

结论

尽管 PDR 眼中的 NPI 明显高于严重 NPDR 眼，但整个宽视野 OCTA 图像上的测量值不够敏感，无法替代 NV 检测用于 PDR 的诊断。

翻译

许伟杰

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/9bae065d3344/tvst-12-9-15-f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/bba939fcb385/tvst-12-9-15-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/f4b81c3821ce/tvst-12-9-15-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/408f80525b29/tvst-12-9-15-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/9bae065d3344/tvst-12-9-15-f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/bba939fcb385/tvst-12-9-15-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/f4b81c3821ce/tvst-12-9-15-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/408f80525b29/tvst-12-9-15-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39f6/10519435/9bae065d3344/tvst-12-9-15-f004.jpg

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