Huang Ryan S, Mihalache Andrew, Popovic Marko M, Munn Colyn, Melo Isabela Martins, Pecaku Aurora, Friedman Alon, Pimentel Miguel Cruz, Tang Tina, Yan Peng, Wong David T, Muni Rajeev H
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Retina. 2025 Jun 1;45(6):1125-1133. doi: 10.1097/IAE.0000000000004424.
To investigate the association between baseline clinical characteristics of patients with diabetic macular edema (DME) and quantitative intravenous fluorescein angiography (IVFA) parameters.
Consecutive patients with DME presenting with a central macular thickness (CMT) ≥310 µ m were recruited from 2017 to 2023. Ultra-widefield IVFA images were analyzed with the RETICAD algorithm to extract quantitative measures of blood-retinal barrier (BRB) permeability, retinal perfusion, and blood flow. Univariable and multivariable regression models were used to investigate associations between IVFA parameters and baseline best-corrected visual acuity (BCVA), CMT, and macular volume.
The study population consisted of 56 eyes with DME, and seven eyes from healthy controls. In our multivariable analysis, BRB permeability measured in the central and peripheral retina was significantly associated with BCVA ( P = 0.003 and 0.002, respectively) and macular volume ( P = 0.025 and 0.045, respectively). Both central and peripheral BRB permeability were significantly higher in DME eyes relative to healthy controls ( P < 0.001).
Increased BRB permeability measured on IVFA in DME eyes was associated with a greater baseline macular volume and worse BCVA, suggesting its potential in providing an objective assessment of disease severity. Future research should explore the clinical utility of quantitative IVFA measurements in diverse patient populations.
探讨糖尿病性黄斑水肿（DME）患者的基线临床特征与定量静脉荧光素血管造影（IVFA）参数之间的关联。
招募2017年至2023年期间连续就诊的中心黄斑厚度（CMT）≥310μm的DME患者。使用RETICAD算法分析超广角IVFA图像，以提取血视网膜屏障（BRB）通透性、视网膜灌注和血流的定量测量值。采用单变量和多变量回归模型研究IVFA参数与基线最佳矫正视力（BCVA）、CMT和黄斑体积之间的关联。
研究人群包括56只DME眼和7只健康对照眼。在我们的多变量分析中，中央和周边视网膜测量的BRB通透性与BCVA（分别为P = 0.003和0.002）和黄斑体积（分别为P = 0.025和0.045）显著相关。与健康对照相比，DME眼中中央和周边BRB通透性均显著更高（P < 0.001）。
DME眼中IVFA测量的BRB通透性增加与更大的基线黄斑体积和更差的BCVA相关，表明其在客观评估疾病严重程度方面的潜力。未来研究应探索定量IVFA测量在不同患者群体中的临床应用。
