糖尿病视网膜病变中的定量超广角荧光素血管造影生物标志物及其与治疗和病情进展的关联
Quantitative ultra-widefield fluorescein angiography biomarkers in diabetic retinopathy and association with treatment and progression.
作者信息
Iyengar Rahul S, Fleifil Salma, Aaberg Michael T, Yu Gina, Patel Tapan P, Powell Corey, Tran Annie K, Paulus Yannis M
机构信息
Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI, USA.
Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine at USC, Los Angeles, CA, USA.
出版信息
Clin Ophthalmol. 2024 Dec 27;18:4019-4028. doi: 10.2147/OPTH.S472071. eCollection 2024.
PURPOSE
To determine if demographic factors and calculated areas of nonperfusion (NP) and neovascularization (NV) on ultra-widefield (UWF) fluorescein angiography (FA) in the eyes of patients with diabetes are associated with treatment with intravitreal injections (IVIs), panretinal photocoagulation (PRP), and diabetic retinopathy (DR) progression.
PATIENTS AND METHODS
This retrospective, cross-sectional study included 363 patients (651 eyes) treated at the University of Michigan Kellogg Eye Center between January 2009 and May 2018. Eligible participants were 18 years or older diagnosed with diabetes who received UWF FA. Patients with previous PRP or poor-quality images were excluded. Main outcome measures included comparison analyses of measured surface areas in millimeters squared (mm) of total and regional retinal nonperfusion and neovascularization, number of IVIs and PRP treatments, and DR progression.
RESULTS
Our cohort received 3,041 IVIs and 878 PRP treatments with a mean follow-up of 915 days (SD ±714). IVIs were positively associated with posterior NP (difference, 1.15 mm; 0.43-1.86; 0.0017). PRP treatments were positively associated with total NP (difference, 27.24 mm; 14.68-39.79; <0.001) and total NV (difference, 1.75 mm; 0.84-2.65; <0.001), as well as regional areas. While progression was not associated with NP/NV area, it was positively associated with a pre-existing diagnosis of type 2 as compared to type 1 diabetes (147% increase; 7-373% increase; =0.03).
CONCLUSION
Areas of NP and NV on UWF FA demonstrated associations with PRP and IVIs in DR patients.
目的
确定糖尿病患者眼中超广角（UWF）荧光素血管造影（FA）的人口统计学因素以及计算得出的无灌注（NP）和新生血管化（NV）面积是否与玻璃体内注射（IVI）、全视网膜光凝（PRP）治疗以及糖尿病视网膜病变（DR）进展相关。
患者与方法
这项回顾性横断面研究纳入了2009年1月至2018年5月在密歇根大学凯洛格眼科中心接受治疗的363例患者（651只眼）。符合条件的参与者为18岁及以上被诊断为糖尿病且接受UWF FA检查的患者。排除既往接受过PRP治疗或图像质量不佳的患者。主要观察指标包括对以平方毫米（mm²）为单位测量的全视网膜和局部视网膜无灌注及新生血管化的表面积、IVI和PRP治疗次数以及DR进展情况进行比较分析。
结果
我们的队列接受了3041次IVI和878次PRP治疗，平均随访915天（标准差±714）。IVI与后部NP呈正相关（差异为1.15 mm²；0.43 - 1.86；P = 0.0017）。PRP治疗与总NP（差异为27.24 mm²；14.68 - 39.79；P < 0.001）、总NV（差异为1.75 mm²；0.84 - 2.65；P < 0.001）以及局部区域均呈正相关。虽然DR进展与NP/NV面积无关，但与2型糖尿病相比，1型糖尿病患者的DR进展呈正相关（增加147%；增加7 - 373%；P = 0.03）。
结论
UWF FA上的NP和NV面积在DR患者中显示出与PRP和IVI相关。
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