Department of Ophthalmology, Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Ophthalmology, Changshu No. 1 People's Hospital, Suzhou, China.
Diabetes Metab Res Rev. 2024 May;40(4):e3812. doi: 10.1002/dmrr.3812.
To evaluate the effectiveness of optical coherence tomography angiography (OCTA) in detecting early intraocular microvascular changes in diabetic patients.
A systematic study search was performed on PubMed, Medline, Embase, and the Cochrane Library, ranging from January 2012 to March 2023. Controlled studies compared diabetes mellitus (DM) patients with non-diabetic retinopathy (NDR) or patients with mild non-proliferative diabetic retinopathy (mild NPDR) to healthy people. These studies included parameters of OCTA such as foveal avascular zone (FAZ), vessel density of superficial capillary plexus (VDscp), vessel density of deep capillary plexus (VDdcp), and peripapillary VD. The relevant effect model was used according to the heterogeneity, and the mean difference and 95% confidence intervals were calculated.
A total of 18 studies with 2101 eyes were eventually included in this meta-analysis. Our results demonstrated that early alterations of VDscp, VDdcp, and peripapillary VD in NDR patients had a significant difference compared with healthy people by OCTA (VDscp: WMD = -1.34, 95% CI: -1.99 to -0.68, P < 0.0001. VDdcp: WMD = -2.00, 95% CI: -2.95 to -1.04, P < 0.0001. Peripapillary VD: WMD = -1.07, 95% CI: -1.70 to -0.43, P = 0.0010). However, there was no statistically significant difference in total FAZ between them (WMD = -0.00, 95% CI: -0.02-0.01, P = 0.84). In addition, for patients with mild NPDR, OCTA could illustrate prominent changes in VDscp, VDdcp, and total FAZ compared with healthy people (VDscp: WMD = -6.11, 95% CI: -9.90 to -2.32, P = 0.002. VDdcp: WMD = -4.26, 95% CI: -5.95 to -2.57, P < 0.00001. FAZ: WMD = 0.06, 95% CI: 0.01-0.11, P = 0.03).
In diabetic patients with or without retinopathy, the parameters of OCTA such as VDscp, VDdcp, and peripapillary vessel density were demonstrated as potential biomarkers in monitoring the early alterations of retinal microangiopathy, while total FAZ may have no significant changes in diabetic patients without retinopathy.
评估光相干断层扫描血管造影术（OCTA）在检测糖尿病患者早期眼内微血管变化中的有效性。
对 PubMed、Medline、Embase 和 Cochrane 图书馆进行了系统的文献检索，检索范围为 2012 年 1 月至 2023 年 3 月。对照研究比较了糖尿病患者（DM）与非糖尿病性视网膜病变（NDR）或轻度非增殖性糖尿病视网膜病变（mild NPDR）患者与健康人群。这些研究包括 OCTA 参数，如中央凹无血管区（FAZ）、浅层毛细血管丛血管密度（VDscp）、深层毛细血管丛血管密度（VDdcp）和视盘周围血管密度。根据异质性使用了相关的效应模型，并计算了平均值差异和 95%置信区间。
共有 18 项研究，2101 只眼最终纳入本荟萃分析。我们的结果表明，NDR 患者的浅层毛细血管丛血管密度（VDscp）、深层毛细血管丛血管密度（VDdcp）和视盘周围血管密度的早期改变与健康人相比有显著差异（VDscp：WMD=-1.34，95%CI：-1.99 至-0.68，P<0.0001。VDdcp：WMD=-2.00，95%CI：-2.95 至-1.04，P<0.0001。视盘周围血管密度：WMD=-1.07，95%CI：-1.70 至-0.43，P=0.0010）。然而，它们之间的总 FAZ 没有统计学上的显著差异（WMD=-0.00，95%CI：-0.02 至 0.01，P=0.84）。此外，对于轻度 NPDR 患者，OCTA 可以说明与健康人相比，浅层毛细血管丛血管密度（VDscp）、深层毛细血管丛血管密度（VDdcp）和总 FAZ 有明显的变化（VDscp：WMD=-6.11，95%CI：-9.90 至-2.32，P=0.002。VDdcp：WMD=-4.26，95%CI：-5.95 至-2.57，P<0.00001。FAZ：WMD=0.06，95%CI：0.01 至 0.11，P=0.03）。
在患有或不患有视网膜病变的糖尿病患者中，OCTA 参数，如浅层毛细血管丛血管密度、深层毛细血管丛血管密度和视盘周围血管密度，被证明是监测视网膜微血管早期改变的潜在生物标志物，而总 FAZ 在没有视网膜病变的糖尿病患者中可能没有明显变化。
