DuPont Mariana, Arthur Edmund, Shihab Yazen, Kenny Madelyn, Ravichandran Swetha, Parsons-Wingerter Patricia, Vyas Ruchi, Murray Matthew C, Predovic Marina, Lim Shiyin, Jacobs Nicole, Ramesh Sneha, Vu Amanda, Sekaran Srinivaas, Chalam Kakarla V, Moorthy Ramana S, Crosson Jason, Mason John, Grant Maria B
Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Department of Hematology-Oncology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Life (Basel). 2024 Jul 18;14(7):893. doi: 10.3390/life14070893.
(1) Background: Previously, VESsel GENeration (VESGEN) software was used to map and quantify vascular changes observed on fluorescein angiography (FA) in subjects (n = 15 eyes) with retinal pathology ranging from mild non-proliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR). In the current study, we used VESGEN for the assessment of individuals with early-stage NPDR imaged by FA (Cohort 1) and by optical coherence tomography angiography (OCTA; Cohort 2). (2) Methods: Cohort 1 included type 2 diabetics (T2D), represented 21 eyes (ranging from no DR to moderate DR), and also included nondiabetic controls (NDC; n = 15 eyes). Cohort 2 consisted of 23 eyes from T2D subjects (including no DR subjects and moderate DR subjects) and NDC (n = 18 eyes). (3) Results: In the FA-VESGEN study, total tortuosity (Tv) of microvessels (G ≥ 6) increased in T2D with mild DR compared to the controls. In contrast, the VESGEN analysis of OCTA images showed that vessel length (characterized as density) was lower in T2D subjects before the diagnosis of DR and following the diagnosis of DR when compared to the controls. Additionally, T2D showed a significant decrease in vessel area (density). (4) Conclusions: FA elucidated the vessel morphology of small-generation microvessels to a greater degree than OCTA; however, OCTA identified changes in vessel density better than FA. VESGEN analysis can be used with both standard FA and OCTA to facilitate our understanding of early events in DR, including before the clinical diagnosis of DR.
(1) 背景：此前，血管生成（VESGEN）软件被用于绘制和量化在患有从轻度非增殖性糖尿病视网膜病变（NPDR）到增殖性糖尿病视网膜病变（PDR）等视网膜病变的受试者（n = 15只眼）的荧光素血管造影（FA）上观察到的血管变化。在本研究中，我们使用VESGEN对通过FA成像的早期NPDR个体（队列1）和通过光学相干断层扫描血管造影（OCTA；队列2）成像的个体进行评估。(2) 方法：队列1包括2型糖尿病患者（T2D），共21只眼（范围从无糖尿病视网膜病变到中度糖尿病视网膜病变），还包括非糖尿病对照组（NDC；n = 15只眼）。队列2由来自T2D受试者的23只眼（包括无糖尿病视网膜病变受试者和中度糖尿病视网膜病变受试者）和NDC（n = 18只眼）组成。(3) 结果：在FA-VESGEN研究中，与对照组相比，轻度糖尿病视网膜病变的T2D患者微血管的总迂曲度（Tv）（G≥6）增加。相比之下，对OCTA图像的VESGEN分析表明，与对照组相比，在糖尿病视网膜病变诊断之前和之后，T2D受试者的血管长度（以密度表示）较低。此外,T2D患者的血管面积（密度）显著降低。(4) 结论：FA比OCTA能更清晰地显示小血管生成的血管形态；然而，OCTA在识别血管密度变化方面比FA更好。VESGEN分析可与标准FA和OCTA一起使用，以促进我们对糖尿病视网膜病变早期事件的理解，包括在糖尿病视网膜病变临床诊断之前的事件。
