Johnson Danae A, Doble Nathan, Choi Stacey S
College of Optometry, The Ohio State University, Columbus, OH, USA.
Department of Ophthalmology and Vision Science, Havener Eye Institute, The Ohio State University, Columbus, OH, USA.
Curr Eye Res. 2024 Jun;49(6):650-662. doi: 10.1080/02713683.2024.2320787. Epub 2024 Feb 26.
To characterize any differences in the vasculature and cone photoreceptor packing geometry (CPG) between subjects with diabetes without/no diabetic retinopathy (NDR) and healthy controls.
Eight NDR and five controls were enrolled. Optical coherence tomography angiography (OCTA) taken at the macula was used to measure vessel density, vessel length density, and vessel density index (VDI) in three vascular plexuses, namely, the superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus (DCP). The choriocapillaris (CC) flow deficit (FD) was also measured. OCTA images were binarized and processed to extrapolate the parafovea and parafoveal quadrants and the OCTA indices mentioned above. The CC was processed with six different radii to quantify FD. Adaptive optics - scanning laser ophthalmoscopy images were acquired and processed to extract CPG indices, i.e., cone density (CD), cone-to-cone spacing (CS), linear dispersion index, heterogeneity packing index and percent of cells with six neighbors at 3.6° in the temporal retina.
In all eyes, statistically significant differences were found (i) in parafoveal FD across the six radii ( < 0.001) and (ii) in the correlation between the parafoveal temporal quadrant (PTQ) DCP VDI and CS ( = 0.606, = 0.048). No other significant correlations were found. For OCTA or CPG indices, no significant differences were found between the cohorts in the parafovea or parafoveal quadrants.
CS is the most sensitive CPG index for detecting alterations in the cone mosaic. The DCP and the cone photoreceptors are significantly correlated, indicating that alterations in the DCP can affect the cones. Future work elucidating the vascular alterations and neurodegeneration present in diabetic eyes should focus on the DCP and multiple CPG indices, not solely CD. Moreover, such alterations are highly localized, hence using larger regions e.g. parafovea versus smaller areas, such as the PTQ, will potentially mask significant correlations.
描述无糖尿病视网膜病变（NDR）的糖尿病患者与健康对照者在脉管系统和视锥光感受器排列几何结构（CPG）方面的差异。
招募了8名NDR患者和5名对照者。使用黄斑区的光学相干断层扫描血管造影（OCTA）测量三个血管丛，即浅表血管丛、中间毛细血管丛和深层毛细血管丛（DCP）中的血管密度、血管长度密度和血管密度指数（VDI）。还测量了脉络膜毛细血管（CC）血流缺损（FD）。对OCTA图像进行二值化处理，以推断旁中心凹和旁中心凹象限以及上述OCTA指数。用六个不同半径处理CC以量化FD。采集并处理自适应光学扫描激光眼科图像，以提取CPG指数，即视锥密度（CD）、视锥间距（CS）、线性离散指数、异质性排列指数以及颞侧视网膜3.6°处有六个相邻细胞的细胞百分比。
在所有眼睛中，发现（i）六个半径上的旁中心凹FD存在统计学显著差异（<0.001），以及（ii）旁中心凹颞侧象限（PTQ）DCP VDI与CS之间存在相关性（=0.606，=0.048）。未发现其他显著相关性。对于OCTA或CPG指数，各队列在旁中心凹或旁中心凹象限中未发现显著差异。
CS是检测视锥镶嵌改变最敏感的CPG指数。DCP与视锥光感受器显著相关，表明DCP的改变会对视锥产生影响。未来阐明糖尿病眼病中存在的血管改变和神经退行性变的工作应聚焦于DCP和多个CPG指数，而不仅仅是CD。此外，这些改变高度局限，因此使用较大区域（如旁中心凹）与较小区域（如PTQ）相比，可能会掩盖显著的相关性。
