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在无临床视网膜病变证据的糖尿病患者中,视网膜中周部毛细血管无灌注区扩大。

Retinal Mid-Peripheral Capillary Free Zones Are Enlarged in Diabetic Patients With No Evidence of Clinical Retinopathy.

作者信息

Arthur Edmund, Ravichandran Swetha, Rothstein Andrew, Brown Keisha, Jonnadula Ganesh B, Murchison Charles F, Grant Maria B

机构信息

School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA.

Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

Transl Vis Sci Technol. 2025 Jul 1;14(7):10. doi: 10.1167/tvst.14.7.10.

DOI:10.1167/tvst.14.7.10
PMID:40673733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12282639/
Abstract

PURPOSE

To compare the width of the mid-peripheral capillary free zones (CFZs; periarteriole and perivenule) between diabetics with no diabetic retinopathy (DR) versus controls.

METHODS

The 20° × 20° optical coherence tomography angiography images of paired arterioles, venules, and their adjacent capillaries within the macular and inferomacular regions of the superficial vascular plexus were obtained from 46 eyes of 28 diabetics with no DR (mean age, 59 years; range, 40-71 years) and 46 eyes of 31 controls (mean age, 59 years; range, 46-78 years). There was no significant difference in age between groups (P = 0.77). The macular and inferomacular images were montaged to generate a wider field of view, followed by the application of a vesselness filter and Otsu thresholding. The mid-peripheral CFZ width was calculated using previously established MATLAB algorithms. Generalized linear mixed models were used to compare the mid-peripheral CFZs between groups, accounting for correlation between eyes.

RESULTS

The periarteriole CFZ width was greater in diabetics with no DR (73.3 ± 6.49 µm) compared to controls (67.3 ± 7.08 µm; P < 0.001, Cohen's d = 0.88). Similarly, the perivenule CFZ width was larger in diabetics with no DR (60.8 ± 6.40 µm) compared to controls (54.8 ± 4.58 µm; P < 0.001, Cohens' d = 1.08).

CONCLUSIONS

Our results demonstrate larger mid-peripheral CFZ width in diabetics with no DR. The mid-peripheral CFZs show promise as a potential novel retinal vascular biomarker for early DR detection.

TRANSLATIONAL RELEVANCE

Our study shows the potential clinical utility of the mid-peripheral CFZs for early DR detection.

摘要

目的

比较无糖尿病视网膜病变(DR)的糖尿病患者与对照组中周毛细血管无灌注区(CFZ;小动脉周围和小静脉周围)的宽度。

方法

从28例无DR的糖尿病患者(平均年龄59岁;范围40 - 71岁)的46只眼中,以及31例对照组(平均年龄59岁;范围46 - 78岁)的46只眼中,获取浅表血管丛黄斑和黄斑下区域内成对小动脉、小静脉及其相邻毛细血管的20°×20°光学相干断层扫描血管造影图像。两组间年龄无显著差异(P = 0.77)。将黄斑和黄斑下图像拼接以生成更宽的视野,随后应用血管增强滤波器和大津阈值法。使用先前建立的MATLAB算法计算中周CFZ宽度。采用广义线性混合模型比较两组间的中周CFZ,同时考虑眼间的相关性。

结果

无DR的糖尿病患者小动脉周围CFZ宽度(73.3±6.49μm)大于对照组(67.3±7.08μm;P < 0.001;Cohen's d = 0.88)。同样,无DR的糖尿病患者小静脉周围CFZ宽度(60.8±6.40μm)大于对照组(54.8±4.58μm;P < 0.001;Cohens' d = 1.08)。

结论

我们的结果表明,无DR的糖尿病患者中周CFZ宽度更大。中周CFZ有望成为早期DR检测的潜在新型视网膜血管生物标志物。

转化相关性

我们的研究表明中周CFZ在早期DR检测中的潜在临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/2fadaa0917bc/tvst-14-7-10-f007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/8d51c7355a53/tvst-14-7-10-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/a3370e35c3fc/tvst-14-7-10-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/e07b8aaab4fa/tvst-14-7-10-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/f89d36c85f69/tvst-14-7-10-f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/ad690ea0ab63/tvst-14-7-10-f005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/8050f84f2fdf/tvst-14-7-10-f006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/2fadaa0917bc/tvst-14-7-10-f007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/8d51c7355a53/tvst-14-7-10-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/a3370e35c3fc/tvst-14-7-10-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/e07b8aaab4fa/tvst-14-7-10-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/f89d36c85f69/tvst-14-7-10-f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/ad690ea0ab63/tvst-14-7-10-f005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/8050f84f2fdf/tvst-14-7-10-f006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a159/12282639/2fadaa0917bc/tvst-14-7-10-f007.jpg

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本文引用的文献

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Invest Ophthalmol Vis Sci. 2024 May 1;65(5):5. doi: 10.1167/iovs.65.5.5.
2
Retinal mid-peripheral capillary free zones are enlarged in cognitively unimpaired older adults at high risk for Alzheimer's disease.认知正常的高龄阿尔茨海默病高危人群存在视网膜周边中部毛细血管无灌注区扩大。
Alzheimers Res Ther. 2023 Oct 12;15(1):172. doi: 10.1186/s13195-023-01312-8.
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OCTA reveals remodeling of the peripheral capillary free zones in normal aging.
OCTA 显示正常衰老中周边毛细血管无灌注区的重构。
Sci Rep. 2021 Aug 2;11(1):15593. doi: 10.1038/s41598-021-95230-0.
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Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy.宽视野光学相干断层扫描血管造影在糖尿病视网膜病变中的应用。
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Portable, non-invasive video imaging of retinal blood flow dynamics.便携式、非侵入性的视网膜血流动力学视频成像。
Sci Rep. 2020 Nov 19;10(1):20236. doi: 10.1038/s41598-020-76407-5.
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Geometric Perfusion Deficits: A Novel OCT Angiography Biomarker for Diabetic Retinopathy Based on Oxygen Diffusion.几何性灌注缺损:基于氧扩散的糖尿病视网膜病变新型 OCT 血管造影生物标志物
Am J Ophthalmol. 2021 Feb;222:256-270. doi: 10.1016/j.ajo.2020.09.007. Epub 2020 Sep 9.
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Optical Coherence Tomography Angiography Projection Artifact Removal: Impact on Capillary Density and Interaction with Diabetic Retinopathy Severity.光学相干断层扫描血管造影投影伪影去除:对毛细血管密度的影响及其与糖尿病视网膜病变严重程度的相互作用。
Transl Vis Sci Technol. 2020 Jun 5;9(7):10. doi: 10.1167/tvst.9.7.10. eCollection 2020 Jun.
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Distances From Capillaries to Arterioles or Venules Measured Using OCTA and AOSLO.使用 OCTA 和 AOSLO 测量毛细血管到小动脉或小静脉的距离。
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