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应用扫描激光检眼镜和光学相干断层扫描结合自适应光学技术检测早期糖尿病性视网膜病变的毛细血管异常。

Detection of capillary abnormalities in early diabetic retinopathy using scanning laser ophthalmoscopy and optical coherence tomography combined with adaptive optics.

机构信息

Department of Ophthalmology, Center for Research in Eye Diseases, Rigshospitalet, Section 37, Valdemar Hansens Vej 13, 2600, Glostrup, Denmark.

Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark.

出版信息

Sci Rep. 2024 Jun 11;14(1):13450. doi: 10.1038/s41598-024-63749-7.


DOI:10.1038/s41598-024-63749-7
PMID:38862584
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11166634/
Abstract

This study tested if a high-resolution, multi-modal, multi-scale retinal imaging instrument can provide novel information about structural abnormalities in vivo. The study examined 11 patients with very mild to moderate non-proliferative diabetic retinopathy (NPDR) and 10 healthy subjects using fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), adaptive optics scanning laser ophthalmoscopy (AO-SLO), adaptive optics OCT and OCTA (AO-OCT(A)). Of 21 eyes of 11 patients, 11 had very mild NPDR, 8 had mild NPDR, 2 had moderate NPDR, and 1 had no retinopathy. Using AO-SLO, capillary looping, inflections and dilations were detected in 8 patients with very mild or mild NPDR, and microaneurysms containing hyperreflective granular elements were visible in 9 patients with mild or moderate NPDR. Most of the abnormalities were seen to be perfused in the corresponding OCTA scans while a few capillary loops appeared to be occluded or perfused at a non-detectable flow rate, possibly because of hypoperfusion. In one patient with moderate NPDR, non-perfused capillaries, also called ghost vessels, were identified by alignment of corresponding en face AO-OCT and AO-OCTA images. The combination of multiple non-invasive imaging methods could identify prominent microscopic abnormalities in diabetic retinopathy earlier and more detailed than conventional fundus imaging devices.

摘要

这项研究旨在测试高分辨率、多模态、多尺度视网膜成像仪是否可以提供关于活体结构异常的新信息。该研究使用眼底照相、光学相干断层扫描 (OCT)、OCT 血管造影 (OCTA)、自适应光学扫描激光检眼镜 (AO-SLO)、自适应光学 OCT 和 OCTA(AO-OCT(A))检查了 11 名轻度至中度非增生性糖尿病视网膜病变 (NPDR) 患者和 10 名健康受试者。在 11 名患者的 21 只眼中,11 只患有非常轻度的 NPDR,8 只患有轻度 NPDR,2 只患有中度 NPDR,1 只患有无视网膜病变。使用 AO-SLO,在 8 名轻度或轻度 NPDR 患者中检测到毛细血管环、弯曲和扩张,在 9 名轻度或中度 NPDR 患者中可见包含高反射性颗粒成分的微动脉瘤。大多数异常在相应的 OCTA 扫描中被视为灌注,而一些毛细血管环似乎被闭塞或以不可检测的流速灌注,可能是由于灌注不足。在一名中度 NPDR 患者中,通过对应面 AO-OCT 和 AO-OCTA 图像的对齐,识别出未灌注的毛细血管,也称为幽灵血管。多种非侵入性成像方法的结合可以比传统的眼底成像设备更早、更详细地识别糖尿病视网膜病变中的明显微观异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/ff5cd533dc0e/41598_2024_63749_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/9df9f7891f29/41598_2024_63749_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/79550d4c589d/41598_2024_63749_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/8328af0a3f7a/41598_2024_63749_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/ee2f9b562490/41598_2024_63749_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/7655dcef6fd6/41598_2024_63749_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/577fe52056e3/41598_2024_63749_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/ff5cd533dc0e/41598_2024_63749_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/9df9f7891f29/41598_2024_63749_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/79550d4c589d/41598_2024_63749_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/8328af0a3f7a/41598_2024_63749_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/ee2f9b562490/41598_2024_63749_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/7655dcef6fd6/41598_2024_63749_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/577fe52056e3/41598_2024_63749_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12fb/11166634/ff5cd533dc0e/41598_2024_63749_Fig7_HTML.jpg

相似文献

[1]
Detection of capillary abnormalities in early diabetic retinopathy using scanning laser ophthalmoscopy and optical coherence tomography combined with adaptive optics.

Sci Rep. 2024-6-11

[2]
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JAMA Ophthalmol. 2020-12-1

[3]
Deep Capillary Macular Perfusion Indices Obtained with OCT Angiography Correlate with Degree of Nonproliferative Diabetic Retinopathy.

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[4]
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[5]
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[6]
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Am J Ophthalmol. 2017-7

[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Automated Cone Photoreceptor Detection in Adaptive Optics Flood Illumination Ophthalmoscopy.

Ophthalmol Sci. 2024-12-12

[2]
Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis.

Biomedicines. 2024-12-30

[3]
Macular vascular and photoreceptor changes for diabetic macular edema at early stage.

Sci Rep. 2024-9-4

本文引用的文献

[1]
Studies of the retinal microcirculation using human donor eyes and high-resolution clinical imaging: Insights gained to guide future research in diabetic retinopathy.

Prog Retin Eye Res. 2023-5

[2]
Insights into Sickle Cell Disease through the Retinal Microvasculature: Adaptive Optics Scanning Light Ophthalmoscopy Correlates of Clinical OCT Angiography.

Ophthalmol Sci. 2022-7-12

[3]
Characterization of Hyperreflective Dots by Structural and Angiographic Optical Coherence Tomography in Patients with Diabetic Retinopathy and Healthy Subjects.

J Clin Med. 2022-11-9

[4]
Ophthalmic imaging in diabetic retinopathy: A review.

Clin Exp Ophthalmol. 2022-12

[5]
Multi-modal and multi-scale clinical retinal imaging system with pupil and retinal tracking.

Sci Rep. 2022-6-10

[6]
Differentiating Microaneurysm Pathophysiology in Diabetic Retinopathy Through Objective Analysis of Capillary Nonperfusion, Inflammation, and Pericytes.

Diabetes. 2022-4-1

[7]
Quantification of intermittent retinal capillary perfusion in sickle cell disease.

Biomed Opt Express. 2021-4-21

[8]
Screening for diabetic retinopathy: new perspectives and challenges.

Lancet Diabetes Endocrinol. 2020-2-27

[9]
Retinal Blood Velocity and Flow in Early Diabetes and Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy.

J Clin Med. 2019-8-3

[10]
Retinal Vessel Diameter Changes in Relation to Dark Adaptation and Acute Hyperglycemia.

J Ophthalmol. 2018-9-18

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