Quantification of Retinal Microvascular Density in Optical Coherence Tomographic Angiography Images in Diabetic Retinopathy
Quantification of Retinal Microvascular Density in Optical Coherence Tomographic Angiography Images in Diabetic Retinopathy
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DOI：
10.1001/jamaophthalmol.2017.0080
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发表时间：
2017-04-01
影响因子：
8.1
通讯作者：
Cunha-Vaz, Jose
中科院分区：
文献类型：
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作者：
Durbin, Mary K.;An, Lin;Cunha-Vaz, Jose
重要性基于光学相干断层血管造影（OCTA）的定量测量可能在管理糖尿病视网膜病变（DR）中具有价值，但是关于OCTA区分患有DR的眼睛的能力的信息有限。目的评价使用OCTA测量视网膜微血管以区分健康眼睛和患有DR的眼睛的能力。从2015年9月17日至2016年4月6日，OCTA用于检查2型糖尿病伴或不伴DR的参与者的眼睛以及无糖尿病的参与者的眼睛。对视网膜浅层（SRL）和视网膜深层（DRL）图像进行密度图分析，去除DRL图像中的去相关尾部。结果：每个参与者的双眼均通过3 mm OCTA扫描和7视野眼底照相进行检查，使用糖尿病视网膜病变严重程度量表。灌注密度，基于血管面积，血管密度，基于1像素宽度的血管图。自动计算黄斑中心凹无血管区的大小和受试者工作特征曲线下的面积（10名女性和16名男性;平均[SD]年龄，64.9 [7.5]岁）和来自25名无糖尿病参与者的50只健康眼睛（14名女性和11名男性;平均[SD]年龄，64.0 [7.1]岁）进行成像。所有参与者均为白色。SRL中测量的血管密度在受试者工作特征曲线下的面积最高（0.893 [95% CI，0.827-0.959]），与SRL中的灌注密度相比（0.794 [95%CI，0.707-0.881]）、中心凹无血管区面积（0.472 [95%CI，0.356-0.588]）和DRL中的血管密度（0.703 [95%CI，0.601-0.805]）。SRL的血管密度与最佳矫正视力（r = -0.28; P =.05）和DR的严重程度（r = -0.46; P =.001）呈负相关。密度指标与年龄相关。血管密度或中心凹无血管区指标和血红蛋白A（1C）或持续时间的diabetes.CONCLUSIONS和相关性血管密度测量OCTA提供了一个定量度量毛细血管闭合，与DR的严重程度，并允许分期，诊断和监测，不需要主观评价眼底图像。
IMPORTANCE Quantitative measurements based on optical coherence tomographic angiography (OCTA) may have value in managing diabetic retinopathy (DR), but there is limited information on the ability of OCTA to distinguish eyes with DR.OBJECTIVE To evaluate the ability of measurements of retinal microvasculature using OCTA to distinguish healthy eyes from eyes with DR.DESIGN, SETTING, AND PARTICIPANTS In this prospective cross-sectional study, OCTA was used to examine the eyes of participants with type 2 diabetes with or without DR and the eyes of participants without diabetes from September 17, 2015, to April 6, 2016. Density maps based on superficial retinal layer (SRL) and deeper retinal layer (DRL) images were generated after amethod to remove decorrelation tails was applied to the DRL images.EXPOSURES Both eyes of each participant were examined by means of a 3-mm OCTA scan and 7-field fundus photography using the Diabetic Retinopathy Severity Scale.MAIN OUTCOMES AND MEASURES Two measures were examined: perfusion density, based on the area of vessels, and vessel density, based on a map with vessels of 1-pixel width. The size of the foveal avascular zone was also calculated automatically, and so was the area under the receiver operating characteristic curve.RESULTS A total of 50 eyes from 26 participants with diabetes (10 women and 16 men; mean [SD] age, 64.9 [7.5] years) and 50 healthy eyes from 25 participants without diabetes (14 women and 11 men; mean [SD] age, 64.0 [7.1] years) were imaged. All participants were white. Vessel density measured in the SRL had the highest area under the receiver operating characteristic curve (0.893 [95% CI, 0.827-0.959]), compared with perfusion density in the SRL (0.794 [95% CI, 0.707-0.881]), foveal avascular zone area (0.472 [95% CI, 0.356-0.588]), and vessel density in the DRL (0.703 [95% CI, 0.601-0.805]). Vessel density in the SRL negatively correlated with best-corrected visual acuity (r = -0.28; P =.05) and severity of DR (r = -0.46; P =.001). Densitymetrics correlated with age. No correlation was detected between vascular density or foveal avascular zone metrics and hemoglobin A(1C) or duration of diabetes.CONCLUSIONS AND RELEVANCE Vessel density measured by OCTA provides a quantitative metric of capillary closure that correlates with severity of DR and may allow staging, diagnosis, and monitoring that do not require subjective evaluation of fundus images.