Optical Coherence Tomography Angiography Reveals Spatial Bias of Macular Capillary Dropout in Diabetic Retinopathy
Optical Coherence Tomography Angiography Reveals Spatial Bias of Macular Capillary Dropout in Diabetic Retinopathy
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DOI：
10.1167/iovs.17-22306
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发表时间：
2017-09-01
影响因子：
4.4
通讯作者：
Sonoda, Koh-Hei
中科院分区：
文献类型：
--
作者：
Kaizu, Yoshihiro;Nakao, Shintaro;Sonoda, Koh-Hei
目的。我们的目的是利用光学相干断层扫描血管造影（OCTA）评估糖尿病视网膜病变（DR）伴发黄斑毛细血管脱落的空间偏差。这项研究包括47名糖尿病患者和29名接受OCTA治疗的健康人。使用ImageJ和NI Vision分别测量2.6 +/- 2.6或5.2 +/- 5.2 mm中央窝区域的视网膜毛细血管流动密度（FD）以及在浅毛细血管丛和深毛细血管丛（DCP）处没有中央窝无血管区（FAZ）的四个分割区域（上、下、颞、鼻）。研究了FD的空间偏倚（取向偏倚比和层次偏倚比）以及FAZ与FD的相关性。OCTA显示DR患者局灶性毛细血管脱落。NPDR中FD的定向偏倚显著高于DCP中的NDR （P = 0.03）。随着DR的进展，FD的分层偏倚显著转向DCP优势（P < 0.01）。DR患者双神经丛FD和FAZ面积呈显著负相关，健康者无显著负相关（P < 0.01）。区域分割OCTA量化显示黄斑毛细血管脱落随DR发病出现空间偏倚，提示DR相关性黄斑毛细血管脱落是局部随机发生的。未来的研究需要确定DR中毛细血管脱落的空间模式的临床相关性。
PURPOSE. Our purpose is to evaluate the spatial bias of macular capillary dropout accompanying diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).METHODS. This study included 47 patients with diabetes and 29 healthy individuals who underwent OCTA. Retinal capillary flow density (FD) of 2.6 +/- 2.6 or 5.2 +/- 5.2 mm foveal area as well as the four divided areas (superior, inferior, temporal, nasal) without a foveal avascular zone (FAZ) at the superficial capillary plexus and deep capillary plexus (DCP) were measured respectively using ImageJ and NI Vision. Spatial biases of FD (orientation bias ratio and hierarchical bias ratio) and the correlation between FAZ and FD were examined.RESULTS. OCTA showed focal capillary dropout in DR patients. The orientation bias of FD was significantly higher in NPDR compared to NDR in the DCP (P = 0.03). The hierarchical bias of FD was significantly shifted to a DCP dominance with progression of DR (P < 0.01). In addition, the FD and FAZ area were significantly inversely correlated in both plexus in DR patients but not in healthy subjects (P < 0.01).CONCLUSIONS. Area-divided OCTA quantification shows the appearance of spatial biases of macular capillary dropout with the onset of DR, suggesting that DR-related macular capillary dropout occurs locally and randomly. Future studies are necessary to determine the clinical relevance of the spatial pattern of capillary dropout in DR.