Vitreoretinal Interface Slab in OCT Angiography for Detecting Diabetic Retinal Neovascularization
Vitreoretinal Interface Slab in OCT Angiography for Detecting Diabetic Retinal Neovascularization
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DOI：
10.1016/j.oret.2020.01.004
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发表时间：
2020-06-01
影响因子：
4.5
通讯作者：
Murata, Toshinori
中科院分区：
文献类型：
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作者：
Hirano, Takao;Hoshiyama, Ken;Murata, Toshinori
目的：对2018年6月至2019年10月在新树大学眼科门诊就诊的30例(42眼)增殖型糖尿病视网膜病变(PDR)患者的眼部新生血管进行比较。设计：回顾性研究。包括SS-OCTA和FA。主要观察指标：比较En Face SS-OCTA 15×15 mm VRI平板图像和FA在相同15×15 mm区域检测到的新生血管在数量和结构上的差异。结果：在FA检测到的100个新生血管中，73个在SS-OCTA VRI平板图像上自动分割显示为新生血管。VRI平板图像检测新生血管的敏感性为73%。在仅能通过FA而不能通过VRI平板发现的27例新生血管中，15例为视网膜内微血管异常伴荧光渗漏，1例为糖尿病乳头状病变，11例为内界膜表面的扁平新生血管，因分割错误而被遗漏。相反，在VRI平板图像上检测到的98个新生血管中，有25个没有被FA检测到。其中9个小新生血管在FA上显示的渗漏太少，16个假阳性结果是分割错误的结果。用手工分割方法重建SS-OCTA VRI平板图像后，VRI平板图像检测PDR新生血管的敏感性提高到84%。结论：SS-OCTA VRI平板图像检测PDR新生血管的效果与FA相当。扫描源OCTA VRI平板图像可能比FA更能从新生血管中识别视网膜内微血管异常和糖尿病乳头状病变。然而，值得注意的是，FA和SS-OCTA VRI平板图像在识别小血管和扁平新生血管的病例中显示出不同的识别效果。为了解决这个问题，有必要对SS-OCTA技术进行进一步的探索。(C)2020年由美国眼科学会颁发。
Purpose: To compare neovascularization identified in proliferative diabetic retinopathy (PDR) eyes by widefield swept-source (SS) OCT angiography (OCTA) using vitreoretinal interface (VRI) slab images, composed by automated and manual segmentation, with that identified by fluorescein angiography (FA).Design: Retrospective study.Participants: Forty-two eyes of 30 treatment-naive PDR patients who visited the outpatient clinic of the Department of Ophthalmology, Shinshu University, from June 2018 through October 2019.Methods: All patients underwent comprehensive ophthalmologic examinations, including SS-OCTA and FA.Main Outcome Measures: Neovascularization detected by en face SS-OCTA 15 x 15-mm VRI slab images and by FA in the same 15 x 15-mm areas were compared in terms of number and structure.Results: Among 100 neovascularizations detected by FA, 73 also were visualized as neovascularization in SS-OCTA VRI slab images using automated segmentation. The sensitivity of VRI slab images for detecting neovascularization was 73%. Among the remaining 27 neovascularizations detected only by FA, but not by VRI slab, 15 were intraretinal microvascular abnormalities with fluorescence leakage, 1 was a diabetic papillopathy, and 11 were flat neovascularizations on the internal limiting membrane surface that were missed because of segmentation error. Conversely, among the 98 neovascularizations detected on VRI slab images, 25 were not detected as neovascularizations by FA. They included 9 small neovascularizations that exhibited too little leakage on FA and 16 false-positive results that were the result of segmentation errors. After reconstruction of SS-OCTA VRI slab images by means of manual segmentation, the sensitivity of VRI slab images for detecting neovascularizations increased to 84%.Conclusions: The efficacy of SS-OCTA VRI slab images for detecting neovascularizations in PDR was comparable with that of FA. Swept-source OCTA VRI slab images may be better than FA for identifying intraretinal microvascular abnormalities and diabetic papillopathy from neovascularizations. Notably, however, FA and SS-OCTA VRI slab images demonstrated differences in identification efficacy in cases of small and flat neovascularizations. Further exploration of SS-OCTA technology is warranted to address this issue. (C) 2020 by the American Academy of Ophthalmology.