Department of Ophthalmology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Department of Ophthalmology, University Vita-Salute IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
Acta Diabetol. 2024 May;61(5):533-541. doi: 10.1007/s00592-024-02238-9. Epub 2024 Feb 20.
Optical coherence tomography angiography (OCTA) has become part of the clinical practice and its growing applications are in continuous development. Coherently with the growing concern about the human and economic cost of diabetes, diabetic retinopathy (DR) was the most popular topic for OCTA studies in the past year. The analysis of the literature reveals that applications of OCTA in DR are in continuous growth. In particular, ultrawide field (UWF) OCTA and artificial intelligence (AI) based on OCTA images are affirming as the new frontiers of scientific research in the field. Diagnostic accuracy of AI methods based on OCTA is equal or superior to the one based on OCT methods and also bears potential to detect systemic associations. UWF OCTA is noninvasive method that is reaching similar accuracy of FA in detection of neovascularization and intraretinal microvascular abnormalities (IRMAs) and has allowed better characterization of microvascular peripherical changes in DR. Lastly, deep capillary plexus (DCP) characteristics seem to play a pivotal role in the development of diabetic macular edema (DME) and refinement of biomarkers for different phenotypes of DME and diabetic macular ischemia (DMI) is currently on its way.
光学相干断层扫描血管造影术（OCTA）已成为临床实践的一部分，其不断增加的应用也在不断发展。与人们对糖尿病的人力和经济成本的日益关注相一致，糖尿病视网膜病变（DR）是过去一年 OCTA 研究中最受欢迎的主题。文献分析表明，OCTA 在 DR 中的应用正在不断增长。特别是超广角（UWF）OCTA 和基于 OCTA 图像的人工智能（AI）正在成为该领域科学研究的新前沿。基于 OCTA 的 AI 方法的诊断准确性与基于 OCT 方法的诊断准确性相当，甚至更高，并且有可能检测到系统性关联。UWF OCTA 是一种非侵入性方法，其在检测新生血管和视网膜内微血管异常（IRMAs）方面的准确性与 FA 相似，并且能够更好地描述 DR 周边微血管的变化。最后，深层毛细血管丛（DCP）的特征似乎在糖尿病性黄斑水肿（DME）的发展中起着关键作用，目前正在对不同表型的 DME 和糖尿病性黄斑缺血（DMI）的生物标志物进行精细化研究。
