Macular and Peripapillary Optical Coherence Tomography Angiography Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data
Macular and Peripapillary Optical Coherence Tomography Angiography Metrics Predict Progression in Diabetic Retinopathy: A Sub-analysis of TIME-2b Study Data
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DOI：
10.1016/j.ajo.2020.06.009
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发表时间：
2020-11-01
影响因子：
4.2
通讯作者：
Waheed, Nadia K.
中科院分区：
文献类型：
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作者：
Greig, Eugenia Custo;Brigell, Mitchell;Waheed, Nadia K.
目的：确定光学相干断层扫描血管造影（OCTA）衍生的黄斑和视神经头（ONH）血管指标，预测糖尿病视网膜病变（DR）疾病进展。设计：对临床试验数据进行二次分析。方法：这是对参加TIME-2b研究（Aerpio制药公司）的73名受试者前瞻性收集数据的亚分析，TIME-2b研究是一项多中心临床试验，用于接受AKB-9778治疗的中重度DR患者，随访时间超过12个月。每3个月对符合条件的受试者进行彩色眼底摄影、光谱域OCT和裂隙灯生物显微镜检查。黄斑和ONH的OCTA是在参与部位的一部分患者中获得的。在面部，分析以黄斑为中心的全深度视网膜投影的多个指标，包括中央凹无血管区（FAZ）面积和周长、非灌注面积、血管密度（VD）和视网膜内微血管异常（IRMA）的存在。在视盘周围的4个象限评估径向乳头周围毛细血管的VD。进展定义为DR严重程度评分>= 2级升高或糖尿病性黄斑水肿的发生。结果：在12个月的随访期间，73名受试者中有15名（20.5%）进展。在预处理基线时，较大的FAZ面积、IRMA的存在以及颞上和颞下区域乳头周围VD的减少与进展的几率增加显著相关。结论：FAZ面积和颞部乳头周围VD是DR进展的预测因子。与单独确定的危险因素相比，OCTA指标可以改善DR的进展风险评估。(C) 2020由爱思唯尔公司出版。
PURPOSE: To identify optical coherence tomography angiography (OCTA)-derived vessel metrics of the macula and optic nerve head (ONH) that predict diabetic retinopathy (DR) disease progression.DESIGN: Secondary analysis of clinical trial data.METHODS: This was a sub-analysis of prospectively collected data from 73 subjects that participated in the TIME-2b study (Aerpio Pharmaceuticals), a multicenter clinical trial for patients with moderate-to-severe DR treated with AKB-9778 and followed over a 12-month period. Eligible subjects were tested every 3 months with color fundus photography, spectral-domain OCT, and slit-lamp biomicroscopy. OCTA of the macula and ONH was obtained for a subset of patients enrolled at participating sites. En face, full-depth retinal projections centered at the macula were analyzed for multiple metrics including foveal avascular zone (FAZ) area and perimeter, nonperfusion area, vessel density (VD), and presence of intraretinal microvascular abnormalities (IRMA). VD of the radial peripapillary capillaries was evaluated in 4 quadrants surrounding the optic disc for ONH images. Progression was defined as a >= 2-step increase in DR severity scale score or development of diabetic macular edema.RESULTS: Over a follow-up period of 12 months, 15 of 73 (20.5%) subjects progressed. At pretreatment baseline, larger FAZ area, presence of IRMA, and reduced peripapillary VD in the superior temporal and inferior temporal regions were significantly associated with increased odds of progression.CONCLUSIONS: FAZ area and temporal peripapillary VD are predictors of DR progression. OCTA metrics may improve progression risk assessment in DR when compared to established risk factors alone. (C) 2020 Published by Elsevier Inc.