Zhang Wenhua, Zhang Feng, Yang Yezhen, Cao Jiamin, Zhu Ziyi
Department of Ophthalmology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People's Republic of China.
Int J Gen Med. 2025 May 20;18:2619-2628. doi: 10.2147/IJGM.S516938. eCollection 2025.
To investigate the changes in macular microvascular structure at different stages of diabetic retinopathy (DR) and the correlation between macular ischemia and visual acuity.
A prospective cross-sectional study was conducted. A total of 173 patients with DR were enrolled and divided into three groups according to DR stage. The control group consisted of 29 gender and age matched healthy individuals. Macular perfusion indexes were measured by optical coherence tomography angiography (OCTA) and compared.
The p-values of central foveal thickness (CFT), focal avascular zone (FAZ) area, and vessel density were less than 0.05 in DR patients and healthy individuals. As the severity of DR increased, there was a corresponding decline in visual acuity, the logMAR best corrected visual acuity (BCVA) was 0.40±0.30 in mild-moderate NPDR, then worsened to 0.48 ± 0.30 (p=0.059) in severe NPDR and further to 0.60 ± 0.34 (p=0.043) in PDR. Superficial capillary plexus (SCP) vessel density correlated negatively with logMAR BCVA (p<0.001, R=-0.267), whereas the severity of DR correlated positively with logMAR BCVA (p<0.001, R=0.199). And increased DR stage was associated with significant reductions in foveal density at 300 μm (FD-300 μm; p=0.004) and deep capillary plexus (DCP) vessel density (p=0.009).
Macular perfusion status decreases as DR progresses. Early changes of macular microvascular structure in different capillary plexus may indicate progression of DR severity and affect visual acuity.
研究糖尿病视网膜病变（DR）不同阶段黄斑微血管结构的变化以及黄斑缺血与视力之间的相关性。
进行了一项前瞻性横断面研究。共纳入173例DR患者，并根据DR分期分为三组。对照组由29名年龄和性别匹配的健康个体组成。通过光学相干断层扫描血管造影（OCTA）测量黄斑灌注指数并进行比较。
DR患者和健康个体的中心凹厚度（CFT）、无血管区（FAZ）面积和血管密度的p值均小于0.05。随着DR严重程度的增加，视力相应下降，轻度至中度非增殖性DR患者的logMAR最佳矫正视力（BCVA）为0.40±0.30，重度非增殖性DR患者恶化至0.48±0.30（p = 0.059），增殖性DR患者进一步恶化至0.60±0.34（p = 0.043）。浅表毛细血管丛（SCP）血管密度与logMAR BCVA呈负相关（p<0.001，R = -0.267），而DR严重程度与logMAR BCVA呈正相关（p<0.001，R = 0.199）。DR分期增加与300μm处的中心凹密度（FD - 300μm；p = 0.004）和深层毛细血管丛（DCP）血管密度显著降低相关（p = 0.009）。
随着DR进展，黄斑灌注状态下降。不同毛细血管丛中黄斑微血管结构的早期变化可能表明DR严重程度的进展并影响视力。
