Association of Diabetic Macular Nonperfusion With Outer Retinal Disruption on Optical Coherence Tomography.
Association of Diabetic Macular Nonperfusion With Outer Retinal Disruption on Optical Coherence Tomography.
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DOI：
10.1001/jamaophthalmol.2015.2183
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发表时间：
2015-09
影响因子：
8.1
通讯作者：
Fawzi AA
中科院分区：
文献类型：
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作者：
Scarinci F;Jampol LM;Linsenmeier RA;Fawzi AA
糖尿病黄斑无灌注导致中心凹周围毛细血管血流减少，这反过来又导致视网膜组织的慢性缺血。使用点到点之间的相关性光谱域光学相干断层扫描（SD-OCT）和非灌注荧光素血管造影，我们观察到，视网膜毛细血管非灌注与光感受器妥协OCT。这项研究突出了一个新的概念，可能的贡献视网膜深毛细血管丛光感受器妥协在糖尿病视网膜病变的情况下，糖尿病性黄斑水肿。报告糖尿病患者黄斑区黄斑中心凹无血管区扩大和/或毛细血管无灌注相关的视网膜外结构改变。回顾性观察性横断面研究，9例患者于2014年7月8日至2014年12月1日在三级学术转诊中心被诊断为糖尿病视网膜病变，无糖尿病黄斑水肿，并接受了糖尿病视网膜病变的荧光素血管造影和SD-OCT。本分析在2014年12月2日至2015年1月31日期间进行。黄斑缺血区域SD-OCT的外部视网膜变化。该研究包括9名糖尿病患者（4名男性和5名女性，年龄34-58岁）的13只眼睛，平均糖尿病持续时间为14.5年。9只眼显示SD-OCT显示的外部视网膜破裂，共定位于中心凹无血管区和黄斑毛细血管无灌注区的扩大区域。四个正常的黄斑中心凹无血管区的眼睛在SD-OCT上没有显示任何视网膜变化。糖尿病患者的黄斑缺血可能与感光细胞受损有关。糖尿病患者OCT上光感受器的破坏可能是无糖尿病黄斑水肿的眼睛中基础毛细血管无灌注的表现。深部毛细血管丛的缺血可能在这些外部视网膜变化中起重要作用。
Diabetic macular nonperfusion leads to decreased perifoveal capillary blood flow, which in turn causes chronic ischemia of the retinal tissue. Using point-to-point correlation between spectral-domain optical coherence tomography (SD-OCT) and nonperfusion on fluorescein angiography, we observed that retinal capillary nonperfusion is associated with photoreceptor compromise on OCT. This study highlights a new concept of a possible contribution of the retinal deep capillary plexus to photoreceptor compromise in diabetic retinopathy in the absence of diabetic macular edema. To report outer retinal structural changes associated with enlargement of the foveal avascular zone and/or capillary nonperfusion in the macular area of diabetic patients. Retrospective observational cross-sectional study in 9 patients who were diagnosed as having diabetic retinopathy without diabetic macular edema and underwent fluorescein angiography and SD-OCT for diabetic retinopathy from July 8, 2014, to December 1, 2014, at a tertiary academic referral center. This analysis was conducted between December 2, 2014, and January 31, 2015. Outer retinal changes on SD-OCT in areas of macular ischemia. The study included 13 eyes of 9 diabetic patients (4 men and 5 women aged 34–58 years) with a mean duration of diabetes mellitus of 14.5 years. Nine eyes showed outer retinal disruption revealed by SD-OCT that colocalized to areas of enlargement of the foveal avascular zone and macular capillary nonperfusion. Four fellow eyes with normal foveal avascular zones did not show any retinal changes on SD-OCT. Macular ischemia in diabetic patients can be associated with photoreceptor compromise. The presence of disruption of the photoreceptors on OCT in diabetic patients can be a manifestation of underlying capillary nonperfusion in eyes without diabetic macular edema. Ischemia at the deep capillary plexus may play an important role in these outer retinal changes.