通过SMI和OCTA对糖尿病视网膜病变患者眼部血管进行定量评估及相关性分析。
Quantitative evaluation of ocular vascularity and correlation analysis in patients with diabetic retinopathy by SMI and OCTA.
作者信息
Wei Jin, Chen Chong, Shen Yinchen, Li Fang, Yiyang Shu, Liu Haiyun
机构信息
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 20080, China.
National Clinical Research Center for Eye Diseases, Shanghai, 20080, China.
出版信息
BMC Ophthalmol. 2024 Feb 19;24(1):76. doi: 10.1186/s12886-024-03338-4.
AIMS
To find potential relation between retrobulbar vessels and fundus microvessels and to detect sensitive and effective clinical indicators in predicting the progress of diabetic retinopathy (DR), ocular hemodynamics were measured using superb microvascular imaging (SMI) and ultrawide-field optical coherence tomography angiography (UWF-OCTA).
METHODS
Observational, cross-sectional study evaluating ocular hemodynamics in patients with DR by SMI (Aplio i900, Canon Medical) and UWF-OCTA (BM-400 K BMizar, Tupai Medical Technology). The peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) of the central retinal artery (CRA), posterior ciliary artery (PCA), and ophthalmic artery (OA) were measured by SMI. UWF-OCTA evaluated the fundus vascular parameters. A correlation analysis was used to determine the correlation between SMI and UWF-OCTA parameters.
RESULTS
One hundred thirty-nine eyes of 139 diabetic patients were included: 29 without DR (NDR), 36 with mild to moderate nonproliferative DR (M-NPDR), 37 with severe NPDR (S-NPDR), and 37 with proliferative DR (PDR). PSV and EDV of retrobulbar vessels decreased from NDR to S-NPDR while increasing PDR. RI of OA showed a decreasing trend in the progression of DR, but other vessels didn't show the same trend. ROC curve analysis showed that CRA, CRA, PCA, OA and OA had diagnostic value distinguishing M-NPDR and S-NPDR. The correlation analysis observed a significant association between the SMI parameters of CRA and PCA and UWF-OCTA parameters. CRA hemodynamics were more associated with fundus vascular parameters, especially the retina, in the NDR group than in the M-NPDR group. In contrast, PCA consistently correlated with fundus vascular parameters, especially in the choroid, from the NDR to the M-NPDR group. However, OA showed a poor correlation with OCTA parameters.
CONCLUSION
The velocity of retrobulbar vessels, mainly the CRA, may serve as a valuable predictor for assessing the progress of DR. The use of SMI in diabetic patients may help identify patients at risk of developing retinopathy.
目的
为了找出球后血管与眼底微血管之间的潜在关系，并检测预测糖尿病视网膜病变（DR）进展的敏感且有效的临床指标，采用超微血管成像（SMI）和超广角光学相干断层扫描血管造影（UWF - OCTA）测量眼部血流动力学。
方法
通过SMI（佳能医疗Aplio i900）和UWF - OCTA（图湃医疗科技BM - 400K BMizar）对DR患者的眼部血流动力学进行观察性横断面研究。通过SMI测量视网膜中央动脉（CRA）、睫状后动脉（PCA）和眼动脉（OA）的收缩期峰值速度（PSV）、舒张末期速度（EDV）和阻力指数（RI）。UWF - OCTA评估眼底血管参数。采用相关性分析来确定SMI和UWF - OCTA参数之间的相关性。
结果
纳入139例糖尿病患者的139只眼：29例无DR（NDR），36例轻度至中度非增殖性DR（M - NPDR），37例重度NPDR（S - NPDR），37例增殖性DR（PDR）。球后血管的PSV和EDV从NDR到S - NPDR降低，而在PDR时升高。OA的RI在DR进展过程中呈下降趋势，但其他血管未呈现相同趋势。ROC曲线分析表明，CRA、CRA、PCA、OA和OA在区分M - NPDR和S - NPDR方面具有诊断价值。相关性分析观察到CRA和PCA的SMI参数与UWF - OCTA参数之间存在显著关联。与M - NPDR组相比，NDR组中CRA血流动力学与眼底血管参数，尤其是视网膜的参数相关性更强。相反，从NDR组到M - NPDR组，PCA始终与眼底血管参数，尤其是脉络膜的参数相关。然而，OA与OCTA参数的相关性较差。
结论
球后血管的速度，主要是CRA的速度，可能作为评估DR进展的有价值预测指标。在糖尿病患者中使用SMI可能有助于识别有发生视网膜病变风险的患者。
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