Channa Roomasa, Wolf Risa M, Simo Rafael, Brigell Mitchell, Fort Patrice, Curcio Christine, Lynch Stephanie, Verbraak Frank, Abramoff Michael D
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin.
Department of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ophthalmol Sci. 2023 Oct 31;4(3):100420. doi: 10.1016/j.xops.2023.100420. eCollection 2024 May-Jun.
The goal of this review was to summarize the current level of evidence on biomarkers to quantify diabetic retinal neurodegeneration (DRN) and diabetic macular edema (DME).
With advances in retinal diagnostics, we have more data on patients with diabetes than ever before. However, the staging system for diabetic retinal disease is still based only on color fundus photographs and we do not have clear guidelines on how to incorporate data from the relatively newer modalities into clinical practice.
In this review, we use a Delphi process with experts to identify the most promising modalities to identify DRN and DME. These included microperimetry, full-field flash electroretinogram, spectral-domain OCT, adaptive optics, and OCT angiography. We then used a previously published method of determining the evidence level to complete detailed evidence grids for each modality.
Our results showed that among the modalities evaluated, the level of evidence to quantify DRN and DME was highest for OCT (level 1) and lowest for adaptive optics (level 4).
For most of the modalities evaluated, prospective studies are needed to elucidate their role in the management and outcomes of diabetic retinal diseases.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
本综述的目的是总结目前关于生物标志物量化糖尿病视网膜神经变性（DRN）和糖尿病性黄斑水肿（DME）的证据水平。
随着视网膜诊断技术的进步，我们拥有了比以往更多的糖尿病患者数据。然而，糖尿病视网膜疾病的分期系统仍然仅基于彩色眼底照片，并且我们对于如何将相对较新的检查方式所获得的数据纳入临床实践并没有明确的指导原则。
在本综述中，我们采用德尔菲法与专家共同确定识别DRN和DME最有前景的检查方式。这些检查方式包括微视野检查、全视野闪光视网膜电图、光谱域光学相干断层扫描、自适应光学以及光学相干断层扫描血管造影。然后，我们使用先前发表的确定证据水平的方法，为每种检查方式完成详细的证据表格。
我们的结果显示，在所评估的检查方式中，量化DRN和DME的证据水平对于光学相干断层扫描最高（1级），对于自适应光学最低（4级）。
对于大多数所评估的检查方式，需要进行前瞻性研究以阐明它们在糖尿病视网膜疾病管理和预后中的作用。
在本文末尾的脚注和披露中可能会找到专有或商业披露信息。
