Guo Chuyun, Xiao Ning, Li Fang, Han Yue, Chen Li, Chen Hongzhuang, Shen Yadan, Ning Xinru, Ling Ruolan, Wang Xi, Zhang Lin, Wang You, Zhong Jie, Li Jie
Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Front Endocrinol (Lausanne). 2025 Apr 8;16:1521837. doi: 10.3389/fendo.2025.1521837. eCollection 2025.
To compare the detection of non-perfusion areas (NPAs) in diabetic retinopathy (DR) using 24×20 mm widefield swept-source optical coherence tomography angiography (SS-OCTA) and ultra-widefield fluorescein angiography (UWFA), and to explore NPA distribution patterns.
This retrospective study included 64 eyes from 48 DR patients who underwent 24×20 mm SS-OCTA and UWFA examinations. NPAs were manually annotated, and the detection rates and distribution patterns across retinal quadrants were analyzed and compared between the two imaging modalities.
Compared to UWFA, the 24×20 mm SS-OCTA scan range missed 53.40% of total NPAs. The detection rates within the SS-OCTA scan range varied across quadrants: 50.58% (superior temporal), 55.33% (inferior temporal), 43.99% (superior nasal), and 43.45% (inferior nasal). NPAs were most prevalent in the inferior nasal region (40.16% of total NPAs). The ischemic index (ISI) derived independently from NPAs identified by the two imaging modalities showed a very strong positive correlation.
Within the scan range of 24×20 mm SS-OCTA, over 50% of total NPAs were missed compared to UWFA. However, OCTA can accurately reveal the degree of retinal ischemia within its field of view. NPA is unevenly distributed in the retina, with the predominant area being the inferior nasal region. This study suggests that this area should be prioritized for assessment in DR management.
比较使用24×20 mm宽场扫频源光学相干断层扫描血管造影（SS-OCTA）和超广角荧光素血管造影（UWFA）检测糖尿病视网膜病变（DR）中非灌注区（NPA）的情况，并探索NPA的分布模式。
这项回顾性研究纳入了48例接受24×20 mm SS-OCTA和UWFA检查的DR患者的64只眼睛。手动标注NPA，并分析和比较两种成像方式在视网膜象限中的检测率和分布模式。
与UWFA相比，24×20 mm SS-OCTA扫描范围遗漏了53.40%的总NPA。SS-OCTA扫描范围内的检测率在各象限有所不同：颞上象限为50.58%，颞下象限为55.33%，鼻上象限为43.99%，鼻下象限为43.45%。NPA在鼻下区域最为常见（占总NPA的40.16%）。由两种成像方式识别的NPA独立得出的缺血指数（ISI）显示出非常强的正相关性。
在24×20 mm SS-OCTA的扫描范围内，与UWFA相比，超过50%的总NPA被遗漏。然而，OCTA可以在其视野范围内准确揭示视网膜缺血程度。NPA在视网膜中分布不均，主要区域是鼻下区域。本研究表明，在DR管理中应优先评估该区域。
