糖尿病视网膜病变中定量对比敏感度函数与视乳头周围光学相干断层扫描血管造影之间的结构-功能关联
Structure-Function Associations Between Quantitative Contrast Sensitivity Function And Peripapillary Optical Coherence Tomography Angiography in Diabetic Retinopathy.
作者信息
Ha Sierra K, Ding Xinyi, Romano Francesco, Overbey Katherine M, Vingopoulos Filippos, Garg Itika, Bennett Cade F, Stettler Isabella, Ploumi Ioanna, Baldwin Grace, Finn Matthew J, Razavi Peyman, Vavvas Demetrios G, Husain Deeba, Patel Nimesh A, Kim Leo A, Miller John B
机构信息
Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States.
Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States.
出版信息
Invest Ophthalmol Vis Sci. 2025 Apr 1;66(4):69. doi: 10.1167/iovs.66.4.69.
PURPOSE
To assess changes in radial peripapillary capillary (RPC) microvasculature and their impact on visual function, measured by visual acuity (VA) and contrast sensitivity, in diabetic retinopathy (DR).
METHODS
This was a cross-sectional study in 96 eyes of 67 patients, including controls, diabetes without DR (DMnoDR), nonproliferative DR (NPDR), and proliferative DR (PDR) groups. Participants underwent same-day quantitative contrast sensitivity function (qCSF) and 6 × 6 mm OCT angiography (OCTA) centered on the optic disc. The Peripapillary Nerve Fiber Layer Microvasculature Density algorithm (ARI Network) was used to calculate capillary perfusion density (total area of perfused microvasculature per unit area), capillary flux index (CFI, total weighted area of perfused microvasculature per unit area), and retinal nerve fiber layer (RNFL) thickness surrounding the optic disc. Mixed-effects multivariable regression models, controlling for age, hypertension, and lens status, evaluated associations between RPC OCTA metrics, DR severity, VA, and qCSF.
RESULTS
Significant RPC microvascular changes were observed across DR stages. Capillary perfusion density decreased with DR severity and even before retinopathy onset in DMnoDR versus controls (βavg = -0.42, P = 0.021). PDR compared to NPDR showed a significant decrease in CFI (β = -1.02 to -0.92, P < 0.01) and in RNFL (βavg = -0.71, P = 0.033). CFI had significant associations with qCSF at various spatial frequencies (β = 0.20 to 0.34, P = 0.002 to 0.042), but not with VA.
CONCLUSIONS
Radial peripapillary capillary perfusion density worsens with onset of diabetes and increasing severity of DR while capillary flux index is more significantly affected later in disease. Structure-function associations suggest that DR-induced peripapillary microvascular changes are more strongly associated with contrast sensitivity changes than with visual acuity.
目的
评估糖尿病视网膜病变（DR）患者视盘周围放射状毛细血管（RPC）微血管系统的变化及其对视功能的影响，视功能通过视力（VA）和对比敏感度进行测量。
方法
这是一项对67例患者的96只眼睛进行的横断面研究，包括对照组、无DR的糖尿病患者（DMnoDR）、非增殖性DR（NPDR）和增殖性DR（PDR）组。参与者在同一天接受了定量对比敏感度功能（qCSF）检查以及以视盘为中心的6×6 mm光学相干断层扫描血管造影（OCTA）检查。使用视盘周围神经纤维层微血管系统密度算法（ARI Network）计算毛细血管灌注密度（每单位面积灌注微血管的总面积）、毛细血管通量指数（CFI，每单位面积灌注微血管的总加权面积）以及视盘周围视网膜神经纤维层（RNFL）厚度。混合效应多变量回归模型在控制年龄、高血压和晶状体状态的情况下，评估RPC OCTA指标、DR严重程度、VA和qCSF之间的关联。
结果
在DR各阶段均观察到RPC微血管有显著变化。与对照组相比，DMnoDR患者的毛细血管灌注密度随着DR严重程度的增加而降低，甚至在视网膜病变发生之前就已降低（βavg = -0.42，P = 0.021）。与NPDR相比，PDR患者的CFI（β = -1.02至 -0.92，P < 0.01）和RNFL（βavg = -0.71，P = 0.033）显著降低。CFI在不同空间频率下与qCSF有显著关联（β = 0.20至0.34，P = 0.002至0.042），但与VA无关。
结论
视盘周围放射状毛细血管灌注密度随着糖尿病的发生和DR严重程度的增加而恶化，而毛细血管通量指数在疾病后期受到的影响更为显著。结构 - 功能关联表明，DR引起的视盘周围微血管变化与对比敏感度变化的相关性比与视力的相关性更强。
Zotero 插件