Identification of microvascular and morphological alterations in eyes with central retinal non-perfusion.
Identification of microvascular and morphological alterations in eyes with central retinal non-perfusion.
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DOI：
10.1371/journal.pone.0241753
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Sacu S
中科院分区：
文献类型：
--
作者：
Hajdu D;Told R;Angeli O;Weigert G;Pollreisz A;Schmidt-Erfurth U;Sacu S
目的探讨糖尿病视网膜病变（DR）或视网膜静脉阻塞（RVO）引起的视网膜中央缺血的光学相干断层扫描血管造影（OCTA）特征和形态学改变及其与视力的关系。在这项横断面研究中，分析了中心性视网膜缺血患者的扫描源光学相干断层扫描（SSOCT）和OCTA（Topcon，Triton）数据。评价了以下参数：血管参数、中心凹无血管区（FAZ）、视网膜内囊肿（IRC）、微动脉瘤（MA）、浅丛（SCP）和深丛（DCP）中的血管侧支、高反射灶（HRF）、视网膜前膜（ERM）、外界膜（ELM）和椭圆体区（EZ）破裂以及视网膜内层（DRIL）的解体。同时记录最佳矫正视力（BCVA）、年龄、性别、病程和眼病史。分析了44例44只眼（RVO 22例，DR 22例）。平均年龄为60.55 ± 11.38岁，平均BCVA为0.86 ± 0.36（Snellen，6个月）。DR亚组（非增殖性与增殖性）之间无显著差异。在RVO亚组（CRVO与BRVO）之间，DCP的侧支血管存在显著差异（p = 0.014）。创建合并的DR和RVO组并进行比较。在DR组中发现了显著更多的MA（p = 0.007）和ERM（p = 0.007）。当分析所有视网膜缺血患者时，FAZ和BCVA之间表现出统计学显著的负相关性（p = 0.45）。这项研究表明，最好的预测中心涉及缺血性疾病的视力结果是FAZ的大小。尽管疾病起源完全不同，但除了MA和ERM的存在外，DR和RVO组中所有其他OCT和OCTA参数的存在程度相似。我们的研究结果表明，一旦黄斑区视网膜缺血，它有一个类似的外观和视觉结果独立的基础疾病。
To evaluate the characteristics and morphological alterations in central retinal ischemia caused by diabetic retinopathy (DR) or retinal vein occlusion (RVO) as seen in optical coherence tomography angiography (OCTA) and their relationship to visual acuity. Swept-source optical coherence tomography (SSOCT) and OCTA (Topcon, Triton) data of patients with central involving retinal ischemia were analyzed in this cross-sectional study. The following parameters were evaluated: vessel parameters, foveal avascular zone (FAZ), intraretinal cysts (IRC), microaneurysms (MA), vascular collaterals in the superficial (SCP) and deep plexuses (DCP), hyperreflective foci (HRF), epiretinal membrane (ERM), external limiting membrane (ELM) and ellipsoid zone (EZ) disruption, as well as the disorganization of retinal inner layers (DRIL). Best-corrected visual acuity (BCVA), age, gender, disease duration and ocular history were also recorded. 44 eyes of 44 patients (22 with RVO, 22 with DR) were analyzed. The mean age was 60.55 ± 11.38 years and mean BCVA 0.86 ± 0.36 (Snellen, 6m). No significant difference was found between DR subgroups (non proliferative vs. proliferative). Between RVO subgroups (CRVO vs. BRVO) a significant difference was found in term of collateral vessel of the DCP (p = 0.014). A pooled DR and RVO group were created and compared. Significantly more MAs (p = 0.007) and ERM (p = 0.007) were found in the DR group. Statistically significant negative correlation was demonstrated between FAZ and BCVA (p = 0.45) when analyzing all patients with retinal ischemia. This study has shown that the best predictor of visual outcome in center involved ischemic diseases is the size of FAZ. Besides the presence of MAs and ERM, all other OCT and OCTA parameters were present in a similar extent in DR and RVO group despite the completely different disease origins. Our results suggest that as soon as retinal ischemia in the macular region is present, it has a similar appearance and visual outcome independently of the underlying disease.
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