Yoshida Miyo, Murakami Tomoaki, Ishihara Kenji, Mori Yuki, Tsujikawa Akitaka
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shougoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Jpn J Ophthalmol. 2025 Aug 9. doi: 10.1007/s10384-025-01257-5.
To characterize the progression of capillary nonperfusion in diabetic macular ischemia (DMI) using optical coherence tomography angiography (OCTA) images.
A single-center, prospective case series study.
We acquired 3 × 3 mm swept-source OCTA images and created en face images within a central 2.5 mm circle in 100 eyes of 100 patients with diabetic retinopathy (DR). The circle was divided into 15 × 15-pixel squares; squares without retinal vessels were defined as nonperfusion squares (NPSs). Vessel density (VD) and vessel length density (VLD) were also quantified as perfusion metrics. We compared these metrics at baseline and at the 3-year follow-up visit.
Both VD and VLD decreased, and NPS increased at 3 years in both superficial and deep layers. The baseline superficial and deep non profusion squares' (NPS) counts correlated with the count at 3 years but not with its changes. Multivariate analyses demonstrated that logMAR (β = 0.785, P < 0.001) and PDR (β = 0.206, P = 0.002) at baseline predicted poorer VA at 3 years. PDR (β = 0.275, P = 0.007) and NPS counts in the inferior sector of the superficial layer (β = -0.223, P = 0.027) at baseline were mildly associated with VA deterioration. Age was the only baseline parameter correlated with changes in superficial NPS counts (β = 0.242, P = 0.015). Changes in deep NPS counts were associated with systemic hypertension (β = -0.262, P = 0.005), logMAR (β = 0.307, P = 0.001), and prior vitrectomy (β = -0.209, P = 0.024).
We demonstrated changes in the nonperfusion metrics on OCTA images over 3 years and identified baseline factors associated with the progression of nonperfusion areas.
使用光学相干断层扫描血管造影（OCTA）图像来描述糖尿病性黄斑缺血（DMI）中毛细血管无灌注的进展情况。
单中心前瞻性病例系列研究。
我们获取了100例糖尿病视网膜病变（DR）患者100只眼的3×3mm扫频源OCTA图像，并在中央2.5mm圆内创建了正面图像。该圆被划分为15×15像素的正方形；无视网膜血管的正方形被定义为无灌注正方形（NPS）。血管密度（VD）和血管长度密度（VLD）也被量化为灌注指标。我们比较了这些指标在基线时和3年随访时的情况。
在3年时，浅层和深层的VD和VLD均下降，NPS增加。基线时浅层和深层无灌注正方形（NPS）的计数与3年时的计数相关，但与其变化无关。多因素分析表明，基线时的logMAR（β = 0.785，P < 0.001）和增殖性糖尿病视网膜病变（PDR）（β = 0.206，P = 0.002）可预测3年时较差的视力。基线时的PDR（β = 0.275，P = 0.007）和浅层下方扇形区域的NPS计数（β = -0.223，P = 0.027）与视力恶化轻度相关。年龄是与浅层NPS计数变化相关的唯一基线参数（β = 0.242，P = 0.015）。深层NPS计数的变化与系统性高血压（β = -0.262，P = 0.005）、logMAR（β = 0.307，P = 0.001）和既往玻璃体切除术（β = -0.209，P = 0.024）相关。
我们展示了3年内OCTA图像上无灌注指标的变化，并确定了与无灌注区域进展相关的基线因素。
