Quantifying Microvascular Density and Morphology in Diabetic Retinopathy Using Spectral-Domain Optical Coherence Tomography Angiography.
Quantifying Microvascular Density and Morphology in Diabetic Retinopathy Using Spectral-Domain Optical Coherence Tomography Angiography.
复制标题
DOI：
10.1167/iovs.15-18904
复制
发表时间：
2016-07-01
影响因子：
4.4
通讯作者：
Kashani AH
中科院分区：
文献类型：
--
作者：
Kim AY;Chu Z;Shahidzadeh A;Wang RK;Puliafito CA;Kashani AH
应用光谱域光学相干断层扫描血管造影（SD-OCTA）定量分析糖尿病视网膜病变（DR）视网膜微血管的变化。回顾性，横断面，观察性研究的健康和糖尿病成人受试者和没有DR。视网膜微血管变化进行了评估，使用SD-OCTA图像和基于强度的光学微血管造影算法。使用半自动程序计算未分割和分割SD-OCTA图像中的微血管密度和形态指数。微血管密度用骨架密度（SD）和血管密度（VD）定量，血管形态用分形维数（FD）和血管直径指数（VVI）定量。通过使用Student t检验或方差分析与事后Tukey诚实显著差异检验进行多重比较进行统计分析。对84只DR眼和14只健康眼进行了研究。斯皮尔曼秩和检验显示DR严重程度与SD、VD和FD呈负相关，与DR呈正相关（分别为ρ =-0.767、-0.7166、-0.768和+0.5051; P < 0.0001）。所有参数在分级者之间显示出高再现性（对于SD、VD、FD和FDG，ICC分别为0.971、0.962、0.937和0.994）。SD、VD、FD和RST的重复性（κ）大于0.99。DR中的血管改变可以客观可靠地用SD、VD、FD和VD来表征。一般而言，毛细血管密度（SD和VD）降低、分支复杂性（FD）和平均血管口径（VCA）增加与DR恶化相关。毛细血管密度和形态学变化与糖尿病性黄斑水肿显著相关。
To quantify changes in retinal microvasculature in diabetic retinopathy (DR) by using spectral-domain optical coherence tomography angiography (SD-OCTA). Retrospective, cross-sectional, observational study of healthy and diabetic adult subjects with and without DR. Retinal microvascular changes were assessed by using SD-OCTA images and an intensity-based optical microangiography algorithm. A semiautomated program was used to calculate indices of microvascular density and morphology in nonsegmented and segmented SD-OCTA images. Microvascular density was quantified by using skeleton density (SD) and vessel density (VD), while vessel morphology was quantified as fractal dimension (FD) and vessel diameter index (VDI). Statistical analyses were performed by using the Student's t-test or analysis of variance with post hoc Tukey honest significant difference tests for multiple comparisons. Eighty-four eyes with DR and 14 healthy eyes were studied. Spearman's rank test demonstrated a negative correlation between DR severity and SD, VD, and FD, and a positive correlation with VDI (ρ = −0.767, −0.7166, −0.768, and +0.5051, respectively; P < 0.0001). All parameters showed high reproducibility between graders (ICC = 0.971, 0.962, 0.937, and 0.994 for SD, VD, FD, and VDI, respectively). Repeatability (κ) was greater than 0.99 for SD, VD, FD, and VDI. Vascular changes in DR can be objectively and reliably characterized with SD, VD, FD, and VDI. In general, decreasing capillary density (SD and VD), branching complexity (FD), and increasing average vascular caliber (VDI) were associated with worsening DR. Changes in capillary density and morphology were significantly correlated with diabetic macular edema.