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广角光相干断层扫描血管造影的无灌注区与糖尿病视网膜病变的黄斑血管参数的关系。

Relationship between nonperfusion area from widefield optical coherence tomography angiography and macular vascular parameters in diabetic retinopathy.

机构信息

Department of Ophthalmology, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan.

Nuclear and Energy Research Institute IPEN-CNEN/SP, Sao Paulo, Brazil.

出版信息

Int Ophthalmol. 2023 Dec;43(12):4803-4814. doi: 10.1007/s10792-023-02882-0. Epub 2023 Oct 18.

Abstract

PURPOSE

To evaluate the relationship between the nonperfusion area (NPA) from widefield optical coherence tomography angiography (OCTA) and macular vascular parameters in diabetic retinopathy (DR).

METHODS

In total, 51 eyes from 51 patients with proliferative DR (PDR) or moderate/severe non-PDR were included. Widefield OCTA using the Zeiss Plex Elite 9000 was performed. A semi-automatic algorithm calculated the percentages of the NPA within the total image. Macular OCTA (3 × 3 mm and 6 × 6 mm area) was scanned using the RTVue-XR Avanti. Vessel density (VD) was automatically separated into the superficial (SCP) and deep capillary plexus (DCP), and foveal avascular zone (FAZ) measurements were computed according to the parafoveal (1-3 mm) and perifoveal (3-6 mm) regions.

RESULTS

A negative correlation was found between the average VD of the SCP and DCP obtained 3 × 3 mm and 6 × 6 mm area and the NPA. Multiple regression analysis revealed that the temporal-perifoveal region most negatively correlated with the NPA (r =  - 0.55, p < 0.0001). No correlation was found between FAZ measurements and DR severity (area, p = 0.07; perimeter, p = 0.13).

CONCLUSION

Diabetic macular nonperfusion was significantly associated with the NPA from widefield OCTA. In particular, the temporal-perifoveal DCP disorder may be a sensitive indicator of wide NPA.

摘要

目的

评估广角光相干断层扫描血管造影(OCTA)中的无灌注区(NPA)与糖尿病视网膜病变(DR)中黄斑血管参数之间的关系。

方法

共纳入 51 只眼,来自 51 例增殖性 DR(PDR)或中重度非 PDR 患者。使用 Zeiss Plex Elite 9000 进行广角 OCTA。使用半自动化算法计算总图像中 NPA 的百分比。使用 RTVue-XR Avanti 扫描黄斑 OCTA(3×3mm 和 6×6mm 区域)。血管密度(VD)自动分为浅层(SCP)和深层毛细血管丛(DCP),并根据旁中心(1-3mm)和中心凹旁(3-6mm)区域计算中心凹无血管区(FAZ)的测量值。

结果

发现 3×3mm 和 6×6mm 区域平均 SCP 和 DCP 的平均 VD 与 NPA 呈负相关。多元回归分析显示,颞侧旁中心区域与 NPA 相关性最强(r=-0.55,p<0.0001)。FAZ 测量值与 DR 严重程度之间无相关性(面积,p=0.07;周长,p=0.13)。

结论

糖尿病性黄斑无灌注与广角 OCTA 中的 NPA 有显著相关性。特别是颞侧旁中心 DCP 紊乱可能是广泛 NPA 的敏感指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbb2/10724328/4c8b41553eb9/10792_2023_2882_Fig1_HTML.jpg

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