Macular OCT-angiography parameters to predict the clinical stage of nonproliferative diabetic retinopathy: an exploratory analysis
Macular OCT-angiography parameters to predict the clinical stage of nonproliferative diabetic retinopathy: an exploratory analysis
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DOI：
10.1038/s41433-019-0401-7
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发表时间：
2019-08-01
期刊：
影响因子：
3.9
通讯作者：
Silva, Rufino
中科院分区：
文献类型：
--
作者：
Rodrigues, Tiago M.;Marques, Joao P.;Silva, Rufino
背景根据黄金标准ETDRS分级方案，测试光学相干断层扫描血管造影（OCTA）评估的单一或复合组黄斑血管密度参数是否能够预测非增殖性糖尿病视网膜病变（NPDR）分期。非增殖性DR糖尿病眼黄斑结构和血管参数的横断面研究使用OCTA（Avanti RTVue-XR 100，Optovue Inc，Fremont，CA）评价（最高ETDRS 53级）。根据ETDRS分级方案拍摄眼底的7个视野照片进行DR分期。使用自动软件计算浅表和深毛细血管丛（分别为SCP和DCP）以及脉络膜毛细血管（CC）中的血管密度。采用单因素和多因素有序Logistic回归模型进行分析。结果56例受试者101只眼，平均年龄62.64（11.74）岁，男性占57.4%。在单因素分析中，发现几个OCTA参数与较高的ETDRS水平相关（脑旁SCP密度：OR = 0.87（95% CI 0.76-0.99），p = 0.039;脑旁DCP密度：OR = 0.79（95%CI 0.72-0.87），p < 0.001; CC密度：OR = 0.89（95%CI 0.80-0.99）），p = 0.036）。在最终的模型中，同时也调整了相关的临床特征，只有在DCP的血管密度仍然是一个显着的预测NPDR ETDRS水平（OR = 0.54（95%CI 0.32-0.92），p = 0.024）。结论我们的研究结果表明，在DCP的血管密度是最稳健的参数与ETDRS水平。OCTA分析可以提供客观的影像学生物标志物，以监测NPDR的临床进展。
Background To test whether a single or a composite set of macular vascular density parameters, evaluated with optical coherence tomography angiography (OCTA), are able to predict nonproliferative diabetic retinopathy (NPDR) staging according to the gold-standard ETDRS-grading scheme.Methods Prospectively defined, cross-sectional study in which macular structural and vascular parameters of diabetic eyes with nonproliferative DR (up to ETDRS Level 53) were evaluated with OCTA (Avanti RTVue-XR 100, Optovue Inc, Fremont, CA). Seven-field photographs of the fundus were taken for DR staging according to the ETDRS-grading scheme. The vessel density in the superficial and deep capillary plexus (SCP and DCP, respectively), as well as in the choriocapillaris (CC), were calculated using automated software. Univariate and multivariate ordered logistic regression models were used in the analysis. P < 0.05 was considered statistically significant.Results We included 101 eyes from 56 subjects (mean (SD) age 62.64 (11.74) years; 57.4% were male). On univariate analysis, several OCTA parameters were found to be associated with higher ETDRS level (parafoveal SCP density: OR = 0.87 (95% CI 0.76-0.99), p = 0.039; parafoveal DCP density: OR = 0.79 (95% CI 0.72-0.87), p < 0.001; CC density: OR = 0.89 (95% CI 0.80-0.99)), p = 0.036). In the final model, while also adjusting for relevant clinical features, only parafoveal vessel density in the DCP remained as a significant predictor of NPDR ETDRS level (OR = 0.54 (95% CI 0.32-0.92), p = 0.024).Conclusion Our results suggest that parafoveal vessel density in the DCP is the parameter most robustly associated with ETDRS level. OCTA analysis may provide objective imaging biomarkers to monitor NPDR clinical progression.