Gao Min, Hormel Tristan T, Guo Yukun, Tsuboi Kotaro, Flaxel Christina J, Huang David, Hwang Thomas S, Jia Yali
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon.
ArXiv. 2023 Oct 9:arXiv:2303.13611v2.
Microaneurysms (MAs) have distinct, oval-shaped, hyperreflective walls on structural OCT, and inconsistent flow signal in the lumen with OCT angiography (OCTA). Their relationship to regional macular edema in diabetic retinopathy (DR) has not been quantitatively explored.
Retrospective, cross-sectional study.
A total of 99 participants, including 23 with mild, nonproliferative DR (NPDR), 25 with moderate NPDR, 34 with severe NPDR, and 17 with proliferative DR.
We obtained 3 × 3-mm scans with a commercial device (Solix, Visionix/Optovue) in 99 patients with DR. Trained graders manually identified MAs and their location relative to the anatomic layers from cross-sectional OCT. Microaneurysms were first classified as perfused if flow signal was present in the OCTA channel. Then, perfused MAs were further classified into fully and partially perfused MAs based on the flow characteristics in OCTA. The presence of retinal fluid based on OCT near MAs was compared between perfused and nonperfused types. We also compared OCT-based MA detection to fundus photography (FP)- and fluorescein angiography (FA)-based detection.
OCT-identified MAs can be classified according to colocalized OCTA flow signal into fully perfused, partially perfused, and nonperfused types. Fully perfused MAs may be more likely to be associated with diabetic macular edema (DME) than those without flow.
We identified 308 MAs (166 fully perfused, 88 partially perfused, 54 nonperfused) in 42 eyes using OCT and OCTA. Nearly half of the MAs identified in this study straddle the inner nuclear layer and outer plexiform layer. Compared with partially perfused and nonperfused MAs, fully perfused MAs were more likely to be associated with local retinal fluid. The associated fluid volumes were larger with fully perfused MAs compared with other types. OCT/OCTA detected all MAs found on FP. Although not all MAs seen with FA were identified with OCT, some MAs seen with OCT were not visible with FA or FP.
OCT-identified MAs with colocalized flow on OCTA are more likely to be associated with DME than those without flow.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. ;■- © (http://creativecommons.org/licenses/by-nc-nd/4.0/).
在结构光学相干断层扫描（OCT）中，微动脉瘤（MA）具有独特的椭圆形、高反射性壁，在OCT血管造影（OCTA）中其管腔内的血流信号不一致。尚未对其与糖尿病性视网膜病变（DR）中局部黄斑水肿的关系进行定量研究。
回顾性横断面研究。
共有99名参与者，包括23例轻度非增殖性DR（NPDR）、25例中度NPDR、34例重度NPDR和17例增殖性DR。
我们使用商用设备（Solix，Visionix/Optovue）对99例DR患者进行了3×3毫米的扫描。训练有素的分级人员从横断面OCT中手动识别MA及其相对于解剖层的位置。如果OCTA通道中存在血流信号，则将MA首先分类为灌注型。然后，根据OCTA中的血流特征，将灌注型MA进一步分为完全灌注型和部分灌注型MA。比较灌注型和非灌注型MA附近基于OCT的视网膜积液情况。我们还将基于OCT的MA检测与基于眼底照相（FP）和荧光素血管造影（FA）的检测进行了比较。
基于OCT识别的MA可根据共定位的OCTA血流信号分为完全灌注型、部分灌注型和非灌注型。与无血流的MA相比，完全灌注型MA可能更易与糖尿病性黄斑水肿（DME）相关。
我们使用OCT和OCTA在42只眼中识别出308个MA（166个完全灌注型、88个部分灌注型、54个非灌注型）。本研究中识别出的MA近一半跨越内核层和外丛状层。与部分灌注型和非灌注型MA相比，完全灌注型MA更易与局部视网膜积液相关。与其他类型相比，完全灌注型MA的相关积液量更大。OCT/OCTA检测到了FP上发现的所有MA。虽然并非所有FA所见的MA都能被OCT识别，但一些OCT所见的MA在FA或FP上不可见。
与无血流的MA相比，基于OCT识别且在OCTA上共定位有血流的MA更易与DME相关。
在本文末尾的脚注和披露中可能会发现专有或商业披露信息。;■ - © (http://creativecommons.org/licenses/by-nc-nd/4.0/)
