Horie Shintaro, Suzuki Yudai, Yoshida Takeshi, Ohno-Matsui Kyoko
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Department of Ophthalmology, Tokyo Metropolitan Tama Medical Center, Tokyo 113-8510, Japan.
Diagnostics (Basel). 2024 Jul 2;14(13):1411. doi: 10.3390/diagnostics14131411.
(1) Background: The fundus examination is one of the best and popular methods in the assessment of vascular status in the human body. Direct viewing of retinal vessels by ophthalmoscopy has been utilized in judging hypertensive change or arteriosclerosis. Recently, fundus imaging with the non-mydriatic scanning laser ophthalmoscope (SLO) has been widely used in ophthalmological clinics since it has multimodal functions for optical coherence tomography or angiography with contrast agent dye. The purpose of this study was to examine the utility in detecting arteriosclerosis of retinal vessels in SLO images; (2) Methods: Both color and blue standard field SLO images of eyes with diabetic retinopathy (DR) were examined retrospectively. Retinal arteriosclerosis in color SLO images was graded according to the Scheie classification. Additionally, characteristics of retinal arterioles in blue SLO images were identified and examined for their relevance to arteriosclerosis grades, stages of DR or general complications; (3) Results: Relative to color fundus images, blue SLO images showed distinct hyper-reflective retinal arterioles against a monotone background. Irregularities of retinal arterioles identified in blue SLO images were frequently observed in the eyes of patients with severe arteriosclerosis (Grade 3: 79.0% and Grade 4: 81.8%). Furthermore, the findings on arterioles were more frequently associated with the eyes of DR patients with renal dysfunction ( < 0.05); (4) Conclusions: While color SLO images are equally as useful in assessing retinal arteriosclerosis as photography or ophthalmoscopy, the corresponding blue SLO images show arteriosclerotic lesions with high contrast in a monotone background. Retinal arteriosclerosis in eyes of advanced grades or advanced DR frequently show irregularities of retinal arterioles in the blue images. The findings of low, uneven, or discontinuous attenuation were easier to find in blue than in color SLO images. Consequently, blue SLO images can show pathological micro-sclerosis in retinal arterioles and are potentially one of the safe and practical methods for the vascular assessment of diabetic patients.
(1) 背景：眼底检查是评估人体血管状况的最佳且常用的方法之一。通过检眼镜直接观察视网膜血管已被用于判断高血压变化或动脉硬化。近年来，非散瞳扫描激光眼底镜（SLO）进行的眼底成像在眼科诊所得到了广泛应用，因为它具有用于光学相干断层扫描或造影剂染料血管造影的多模态功能。本研究的目的是探讨SLO图像在检测视网膜血管动脉硬化方面的实用性；(2) 方法：对患有糖尿病视网膜病变（DR）的眼睛的彩色和蓝色标准视野SLO图像进行回顾性检查。彩色SLO图像中的视网膜动脉硬化根据Scheie分类进行分级。此外，识别蓝色SLO图像中视网膜小动脉的特征，并检查它们与动脉硬化分级、DR阶段或一般并发症的相关性；(3) 结果：相对于彩色眼底图像，蓝色SLO图像在单调背景下显示出明显的高反射性视网膜小动脉。在严重动脉硬化患者（3级：79.0%，4级：81.8%）的眼睛中经常观察到蓝色SLO图像中识别出的视网膜小动脉不规则。此外，小动脉的发现更频繁地与患有肾功能障碍的DR患者的眼睛相关（<0.05）；(4) 结论：虽然彩色SLO图像在评估视网膜动脉硬化方面与摄影或检眼镜同样有用，但相应的蓝色SLO图像在单调背景下显示出高对比度的动脉硬化病变。高级别或晚期DR患者眼睛中的视网膜动脉硬化在蓝色图像中经常显示视网膜小动脉不规则。低、不均匀或不连续衰减的发现在蓝色图像中比在彩色SLO图像中更容易发现。因此，蓝色SLO图像可以显示视网膜小动脉的病理性微硬化，并且可能是糖尿病患者血管评估的安全实用方法之一。
