Toma Caterina, Cavallari Elena, Varano Paola, Servillo Andrea, Gatti Valentina, Ferrante Daniela, Torti Emanuele, Muraca Andrea, De Cillà Stefano
Eye Clinic, University Hospital Maggiore della Carità, Novara, Italy.
Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.
Acta Diabetol. 2024 Oct 24. doi: 10.1007/s00592-024-02394-y.
To evaluate different quantitative non-invasive retinal biomarkers of microvascular impairment and neurodegeneration in patients affected by mild and moderate non proliferative diabetic retinopathy (NPDR) with or without macular microaneurysms (MAs).
A cross-sectional case-control study. Ninety-seven eyes with NPDR, 49 with no central MAs and 48 with central MAs, underwent color fundus photography and optical coherence tomography (OCT)/OCT-angiography (OCT-A). Thickness of central macula, retinal nerve fiber layer (NFL), ganglion cell layer (GCL+) and NFL + GCL + was evaluated on OCT. FAZ metrics (ImageJ), perfusion and vessel density (PD/VD), and fractal dimension (FD) (MATLAB) were evaluated on 3 × 3 OCT-A slabs of both superficial and deep capillary plexuses (SCP/DCP). All evaluations were performed on the full image and after subdivision in 4 quadrants.
In the MA group, 77 MAs were detected (45.5% in the DCP). The MA group showed: increased FAZ area and perimeter in the SCP (p < 0.01) and DCP (p = 0.02), and reduced circularity index in the SCP (p = 0.03); reduced VD in the SCP (p < 0.01) and reduced PD, VD (p < 0.01) and FD (p = 0.02) in the DCP; decreased VD and FD in the SCP (p = 0.02 and p = 0.05), and in VD and FD in the DCP in the inferior quadrant (p = 0.04 and p = 0.03); a decrease in VD in the SCP in the nasal quadrant (p = 0.05). No differences have been detected in OCT parameters.
Our results suggest that the presence of central MAs in patients with NPDR may correlate with more pronounced macular microvascular impairment, particularly during the mild and moderate stages of the disease.
评估轻度和中度非增殖性糖尿病视网膜病变（NPDR）伴或不伴黄斑微动脉瘤（MA）患者微血管损伤和神经退行性变的不同定量非侵入性视网膜生物标志物。
一项横断面病例对照研究。97只患有NPDR的眼睛，其中49只无中心MA，48只伴有中心MA，接受了彩色眼底照相和光学相干断层扫描（OCT）/光学相干断层扫描血管造影（OCT-A）。在OCT上评估中心黄斑、视网膜神经纤维层（NFL）、神经节细胞层（GCL+）以及NFL+GCL+的厚度。在浅表和深部毛细血管丛（SCP/DCP）的3×3 OCT-A图像块上评估FAZ指标（ImageJ）、灌注和血管密度（PD/VD）以及分形维数（FD）（MATLAB）。所有评估均在完整图像上以及将图像分为4个象限后进行。
在MA组中，共检测到77个MA（45.5%位于DCP）。MA组表现为：SCP（p<0.01）和DCP（p = 0.02）中FAZ面积和周长增加，SCP中圆形度指数降低（p = 0.03）；SCP中VD降低（p<0.01），DCP中PD、VD（p<0.01）和FD降低（p = 0.02）；SCP中VD和FD降低（p = 0.02和p = 0.05），下象限DCP中VD和FD降低（p = 0.04和p = 0.03）；鼻象限SCP中VD降低（p = 0.05）。OCT参数未检测到差异。
我们的结果表明，NPDR患者中中心MA的存在可能与更明显的黄斑微血管损伤相关，尤其是在疾病的轻度和中度阶段。
