Regional Patterns of Retinal Oxygen Saturation and Microvascular Hemodynamic Parameters Preceding Retinopathy in Patients With Type II Diabetes
Regional Patterns of Retinal Oxygen Saturation and Microvascular Hemodynamic Parameters Preceding Retinopathy in Patients With Type II Diabetes
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DOI：
10.1167/iovs.17-22523
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发表时间：
2017-10-01
影响因子：
4.4
通讯作者：
Schmidt-Erfurth, Ursula
中科院分区：
文献类型：
--
作者：
Hafner, Julia;Ginner, Laurin;Schmidt-Erfurth, Ursula
目的：视网膜氧代谢和视网膜微循环的改变是糖尿病视网膜病变（DR）的先兆。然而，如果特定的视网膜区域主要受到影响是迄今为止未知的。本研究的目的是调查，如果视网膜氧饱和度（SO2）和微血管血流动力学参数遵循一个独特的区域模式的糖尿病患者，但没有DR。方法：无临床明显DR的II型糖尿病患者成像如下：SO2在视乳头周围血管进行了评估与双波长血氧饱和度。光学相干断层扫描血管造影术（OCTA）扫描是用原型系统采集的，该原型系统使用具有有效400 kHz A扫描速率和16度视场的扫频源激光器。计算视乳头周围微血管的局部血流指数，称为“通量”。结果：本研究包括16名连续患者（59 ± 10岁，6名女性）的29只眼。各象限之间SO2差异有显著性（P < 0.001），小动脉和小静脉的SO2值从鼻上象限到鼻下象限、颞上象限和颞下象限呈递减趋势。相反，乳头周围流量从鼻侧到颞侧呈增加趋势。视网膜oxygenation.CONCLUSIONS：代谢成像确定的区域差异，在视网膜SO2没有相关的地形变化，在微血管血流动力学在II型糖尿病无DR。未来的研究应集中在机制，造成这种异质性的代谢需求。
PURPOSE: Alterations in retinal oxygen metabolism and retinal microcirculation are signs of impending diabetic retinopathy (DR). However, if specific retinal regions are primarily affected is so far unknown. The purpose of this study was to investigate if retinal oxygen saturation (SO2) and microvascular hemodynamic parameters follow a distinct regional pattern in patients with diabetes but no DR.METHODS: Patients with type II diabetes without clinically apparent DR were imaged as follows: SO2 in peripapillary vessels was assessed with dual-wavelength oximetry. Optical coherence tomography angiography (OCTA) scans were acquired with a prototype system using a swept-source laser with an effective 400 kHz A-scan rate and 16 degrees field of view. Regional flow indices termed "flux" were calculated for the peripapillary microvasculature. Parafoveal capillary density was evaluated with the commercially available AngioVue OCTA.RESULTS: Twenty-nine eyes of 16 consecutive patients (59 +/- 10 years, 6 females) were included in this study. SO2 differed significantly between quadrants (P < 0.001), with a decreasing pattern from the upper nasal through the lower nasal, the upper temporal and the lower temporal quadrant in arterioles and venules. In contrast, peripapillary flux followed an increasing trend from nasally to temporally. Peripapillary and parafoveal microvascular hemodynamic parameters demonstrated no significant regional variability as observed for retinal oxygenation.CONCLUSIONS: Metabolic imaging identified regional differences in retinal SO2 without an associated topographic variance in microvascular hemodynamics in type II diabetes without DR. Future studies should focus on the mechanisms causing this heterogeneity in metabolic demand.