Thottarath Sridevi, Tsai Wei-Shan, Gurudas Sarega, Pearce Elizabeth, Chueng Chui Ming Gemmy, Yamaguchi Taffeta Ching Ning, Sivaprasad Sobha
National Institute of Health Research Moorfields Biomedical Research Centre and Clinical Research Facility, Moorfields Eye Hospital, London, UK.
Institute of Ophthalmology, University College London, London, UK.
Eye (Lond). 2025 Apr;39(5):906-912. doi: 10.1038/s41433-024-03505-3. Epub 2024 Nov 27.
To estimate inter-session coefficient of repeatability (CR) of visual function and OCTA metrics over 3 months in diabetic macular ischaemia (DMI) in stable laser-treated proliferative diabetic retinopathy (PDR) patients.
This prospective study recruited patients with stable PDR for at least 6 months following pan-retinal photocoagulation with visual acuity of at least 54 ETDRS letters. DMI was confirmed on OCTA as FAZ area of at least 0.5 mm or parafoveal capillary dropout in at least one quadrant if the FAZ area was less than 0.5 mm. Repeatability was assessed at baseline and 3 months by calculating the coefficients of repeatability (CR) and intraclass correlation coefficient (ICC). The Bland Altman (BA) plots including 95% CI bands for the bias (mean difference) and upper and lower limits of agreement (LOA) were used to visualise the agreement of the measurements.
88 eligible eyes of 63 participants were included in the analysis. The CR for best corrected visual acuity (BCVA) was 10.1 ETDRS letters (95% CI 8.5-11.7 ETDRS letters), and for low luminance visual acuity (LLVA) was 12.4 letters (95% CI 10.4-14.4). The ICC for BCVA and LLVA was 0.81 and 0.75 respectively. For Square Root of Foveal Avascular Zone (SQRT-FAZ) area, CR and ICC was 0.043 mm and 1.00 respectively. The Bland-Altman plots suggest that the level of agreement is wider for vascular density (VD) metrics compared to FAZ parameters.
We recommend using the FAZ metrics for quantitative measurements of DMI outcomes due to the excellent repeatability of manually corrected FAZ area.
评估稳定的激光治疗增殖性糖尿病视网膜病变（PDR）患者糖尿病性黄斑缺血（DMI）3个月内视觉功能和光学相干断层扫描血管造影（OCTA）指标的重复性会话间系数（CR）。
这项前瞻性研究招募了全视网膜光凝术后至少6个月且视力至少为54个ETDRS字母的稳定PDR患者。如果黄斑无血管区（FAZ）面积小于0.5mm，则通过OCTA确认DMI为FAZ面积至少0.5mm或至少一个象限的黄斑旁毛细血管缺失。在基线和3个月时通过计算重复性系数（CR）和组内相关系数（ICC）来评估重复性。使用包含偏差（平均差异）的95%置信区间带以及一致性上限和下限（LOA）的布兰德-奥特曼（BA）图来直观显示测量值的一致性。
63名参与者的88只符合条件的眼睛纳入分析。最佳矫正视力（BCVA）的CR为10.1个ETDRS字母（95%置信区间8.5 - 11.7个ETDRS字母），低亮度视力（LLVA）的CR为12.4个字母（95%置信区间10.4 - 14.4）。BCVA和LLVA的ICC分别为0.81和0.75。对于黄斑无血管区面积平方根（SQRT - FAZ），CR和ICC分别为0.043mm和1.00。布兰德-奥特曼图表明，与FAZ参数相比，血管密度（VD）指标的一致性水平更宽。
由于手动校正的FAZ面积具有出色的重复性，我们建议使用FAZ指标对DMI结果进行定量测量。
