Deep Capillary Geometric Perfusion Deficits on OCT Angiography Detect Clinically Referable Eyes with Diabetic Retinopathy.
Deep Capillary Geometric Perfusion Deficits on OCT Angiography Detect Clinically Referable Eyes with Diabetic Retinopathy.
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DOI：
10.1016/j.oret.2022.05.028
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发表时间：
2022-12
影响因子：
4.5
通讯作者：
Fawzi, Amani A.
中科院分区：
文献类型：
--
作者：
Nesper, Peter L.;Ong, Janice X.;Fawzi, Amani A.
目的评价光学相干断层血管成像(OCTA)参数检测糖尿病视网膜病变(DR)临床参考眼的敏感性(SN)和特异性(SP)。回顾性横断面研究。在3×3 mm OCTA图像上测量了全视网膜、浅层毛细血管丛(SCP)和深层毛细血管丛(DCP)的血管密度、血管长度密度(VLD)和几何灌注量(GPD)。近些年来，GPD被描述为位于距离血管30μm以上的视网膜组织，但不包括中心凹无血管区。我们修改了GPD指标，包括了附加变量(GPDf)的FAZ。临床参考眼定义为中度非增殖性糖尿病视网膜病变(NPDR)或更严重的视网膜病变和/或糖尿病黄斑水肿(DME)。从每个患者中选择一只眼睛进行基于图像质量的分析。我们使用二元Logistic回归模型对协变量进行调整。SN、SP和接收器工作特性曲线下面积(AUC)。临床可参考的糖尿病视网膜病变15例(糖尿病无糖尿病视网膜病变52例，轻度糖尿病视网膜病变27例，中度糖尿病视网膜病变16例，重度糖尿病视网膜病变10例，增殖性糖尿病视网膜病变30例，糖尿病视网膜病变15例15只眼)中，GPDF对SCP中可参考DR的检出优于GPD(P=0.025)，但对DCP或全视网膜DR的检出无统计学意义(P>；0.05)。DCPGPD对临床参考眼的AUC值最大(AUC值=0.965，SN=97.2%，SP=84.8%)，显著大于各层血管密度的AUC值(P均<0.05)，但DCPVLD值无显著差异(P=0.166)。DCPGPD的分界值为2.5%，无需调整协变量(AUC=0.955，SN=97.2%，SP=79.7%)，即可获得高灵敏度的临床参考眼。OCTA中的血管参数，特别是DCP中的血管参数，有可能识别出需要进一步评估的眼睛。与标准血管密度参数相比，GPD可以更好地区分这些具有临床参考价值的DR眼。光学相干断层扫描血管成像显示深部毛细血管丛的几何灌注缺陷具有很高的敏感性，在识别糖尿病视网膜病变眼方面比血管密度更好，值得进一步评估。
To evaluate the sensitivity (SN) and specificity (SP) of optical coherence tomography angiography (OCTA) parameters for detecting clinically referable eyes with diabetic retinopathy (DR) in a cohort of patients with diabetes mellitus (DM). Retrospective, cross-sectional study. Patients with DM with various levels of DR. We measured vessel density, vessel length density (VLD), and geometric perfusion deficits (GPD) in the full retina, superficial (SCP) and deep capillary plexus (DCP) on 3 × 3 mm OCTA images. GPD was recently described as retinal tissue located further than 30 μm from blood vessels, excluding the foveal avascular zone (FAZ). We modified the GPD metric by including the FAZ for an additional variable (GPDf). Clinically referable eyes were defined as moderate nonproliferative DR (NPDR) or worse retinopathy and/or diabetic macular edema (DME). One eye from each patient was selected for the analysis based on image quality. We used a binary logistic regression model to adjust for covariates. SN, SP, and area under the receiver operating characteristic curve (AUC). Seventy-one of the 150 included eyes from 150 patients (52 DM without DR, 27 mild NPDR, 16 moderate NPDR, 10 severe NPDR, 30 proliferative DR, and 15 eyes with DME) had clinically referable DR. GPDf performed better than GPD in detecting referable DR in the SCP (P = 0.025), but not the DCP or full retina (P > 0.05 for both). DCP GPD had the largest AUC for detecting clinically referable eyes (AUC = 0.965, SN = 97.2%, SP = 84.8%), which was significantly larger than the AUC for vessel density of any layer (P < 0.05 for all), but not DCP VLD (P = 0.166). The cut-off value of 2.5% for DCP GPD resulted in a highly sensitive test for detecting clinically referable eyes without adjusting for covariates (AUC = 0.955, SN = 97.2%, SP = 79.7%). Vascular parameters in OCTA, especially in the DCP, have the potential to identify eyes that warrant further evaluation. GPD may better distinguish these clinically referable DR eyes than standard vessel density parameters. Geometric perfusion deficits in the deep capillary plexus on optical coherence tomography angiography had a high sensitivity and performed better than vessel density in identifying diabetic retinopathy eyes that warrant further evaluation.
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影响因子：
3.8
作者：
Jia Y;Tan O;Tokayer J;Potsaid B;Wang Y;Liu JJ;Kraus MF;Subhash H;Fujimoto JG;Hornegger J;Huang D
通讯作者：
Huang D
影响因子：
8
作者：
HUANG, LK;WANG, MJJ
通讯作者：
WANG, MJJ
影响因子：
3.4
作者：
Kubin, Anna-Maria;Wirkkala, Joonas;Hautala, Nina
通讯作者：
Hautala, Nina
糖尿病性视网膜病：靶向血管进度。
影响因子：
7.7
作者：
Hammes HP;Feng Y;Pfister F;Brownlee M
通讯作者：
Brownlee M
影响因子：
4.2
作者：
Chen S;Moult EM;Zangwill LM;Weinreb RN;Fujimoto JG
通讯作者：
Fujimoto JG