A New Approach to Staging Diabetic Eye Disease: Staging of Diabetic Retinal Neurodegeneration and Diabetic Macular Edema.
A New Approach to Staging Diabetic Eye Disease: Staging of Diabetic Retinal Neurodegeneration and Diabetic Macular Edema.
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糖尿病眼病分期的新方法：糖尿病视网膜神经变性和糖尿病黄斑水肿的分期。
DOI：
10.1016/j.xops.2023.100420
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发表时间：
2024-05
影响因子：
--
通讯作者：
Abramoff, Michael D.
中科院分区：
文献类型：
--
作者：
Channa, Roomasa;Wolf, Risa M.;Simo, Rafael;Brigell, Mitchell;Fort, Patrice;Curcio, Christine;Lynch, Stephanie;Verbraak, Frank;Abramoff, Michael D.
本综述的目的是总结目前关于生物标志物量化糖尿病视网膜神经变性（DRN）和糖尿病黄斑水肿（DME）的证据水平。随着视网膜诊断技术的进步，我们掌握了比以往更多的糖尿病患者数据。然而，糖尿病视网膜疾病的分期系统仍然仅基于彩色眼底照片，我们没有明确的指导方针，如何将相对较新的模式的数据纳入临床实践。在这篇综述中，我们与专家一起使用德尔菲过程来确定最有希望识别DRN和DME的方法。这些包括显微测量、全视场闪光视网膜电图、光谱域OCT、自适应光学和OCT血管造影。然后，我们使用先前发表的确定证据水平的方法来完成每种模式的详细证据网格。我们的研究结果表明，在评估的模式中，量化DRN和DME的证据水平在OCT（1级）中最高，在自适应光学（4级）中最低。对于大多数评估的方式，需要前瞻性研究来阐明它们在糖尿病视网膜疾病的治疗和预后中的作用。专有或商业披露可以在本文末尾的脚注和披露中找到。
The goal of this review was to summarize the current level of evidence on biomarkers to quantify diabetic retinal neurodegeneration (DRN) and diabetic macular edema (DME). With advances in retinal diagnostics, we have more data on patients with diabetes than ever before. However, the staging system for diabetic retinal disease is still based only on color fundus photographs and we do not have clear guidelines on how to incorporate data from the relatively newer modalities into clinical practice. In this review, we use a Delphi process with experts to identify the most promising modalities to identify DRN and DME. These included microperimetry, full-field flash electroretinogram, spectral-domain OCT, adaptive optics, and OCT angiography. We then used a previously published method of determining the evidence level to complete detailed evidence grids for each modality. Our results showed that among the modalities evaluated, the level of evidence to quantify DRN and DME was highest for OCT (level 1) and lowest for adaptive optics (level 4). For most of the modalities evaluated, prospective studies are needed to elucidate their role in the management and outcomes of diabetic retinal diseases. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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影响因子：
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