Retinal Blood Velocity and Flow in Early Diabetes and Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy
Retinal Blood Velocity and Flow in Early Diabetes and Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy
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DOI：
10.3390/jcm8081165
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发表时间：
2019-08-01
影响因子：
3.9
通讯作者：
Fawzi, Amani A.
中科院分区：
文献类型：
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作者：
Palochak, Cherilyn Mae A.;Lee, Hee Eun;Fawzi, Amani A.
采用自适应光学扫描激光检眼镜（AOSLO），我们测量了正常对照眼和糖尿病视网膜病变患者的视网膜血流速度和流量。这项横断面研究包括30例糖尿病（DM）患者的39只眼，伴有轻度非增殖性糖尿病视网膜病变（NPDR）或无视网膜病变（DM无DR），以及17例健康年龄匹配的对照组的21只眼。参与者使用商业光学相干断层扫描血管造影（OCTA）设备（RTVue-XR Avanti）和AOSLO设备（Apaeros视网膜成像系统，Boston Micromachines）进行成像。我们分析了基于AOSLO的视网膜血流速度和流量，以及基于OCTA的浅层（SCP）、深层视网膜毛细血管丛（DCP）和全视网膜的血管密度。与对照组相比，在所有血管直径上，无DR的DM眼的视网膜血流速度显著较高，而NPDR眼的视网膜血流速度较低。与对照组相比，糖尿病无DR组视网膜血流量显著升高，而血管直径达60 μ m的NPDR组视网膜血流量显著降低。当比较流量异常值（低流量DM无DR眼睛和高流量NPDR眼睛）时，我们发现它们与各组中的其余眼睛相比具有显著不同的视网膜血管密度。与年龄匹配的健康对照组相比，无DR的DM患者的视网膜血流速度和流量增加，而轻度NPDR患者的这些参数降低。两个糖尿病组中离群值之间OCTA血管密度的相似性表明，随着临床视网膜病变的进展，血流量和OCTA血管密度最初增加，随后进行性下降，这需要进一步研究。
Using adaptive optics scanning laser ophthalmoscopy (AOSLO), we measured retinal blood velocity and flow in healthy control eyes and eyes of diabetic patients with or without retinopathy. This cross-sectional study included 39 eyes of 30 patients with diabetes (DM) with mild non-proliferative diabetic retinopathy (NPDR) or without retinopathy (DM no DR) and 21 eyes of 17 healthy age-matched controls. Participants were imaged with a commercial optical coherence tomography angiography (OCTA) device (RTVue-XR Avanti) and AOSLO device (Apaeros Retinal Imaging System, Boston Micromachines). We analyzed AOSLO-based retinal blood velocity and flow, and OCTA-based vessel density of the superficial (SCP), deep retinal capillary plexus (DCP), and full retina. Retinal blood velocity was significantly higher in eyes with DM no DR and lower in NPDR across all vessel diameters compared to controls. Retinal blood flow was significantly higher in DM no DR and lower in NPDR in vessel diameters up to 60 mu m compared to controls. When comparing flow outliers (low-flow DM no DR eyes and high-flow NPDR eyes), we found they had a significantly different retinal vessel density compared to the remaining eyes in the respective groups. Retinal blood velocity and flow is increased in eyes with DM no DR, while these parameters are decreased in eyes with mild NPDR compared to healthy age-matched controls. The similarity of OCTA vessel density among outliers in the two diabetic groups suggests an initial increase followed by progressive decline in blood flow and OCTA vessel density with progression to clinical retinopathy, which warrants further investigation.