Superficial capillary perfusion on optical coherence tomography angiography differentiates moderate and severe nonproliferative diabetic retinopathy.
Superficial capillary perfusion on optical coherence tomography angiography differentiates moderate and severe nonproliferative diabetic retinopathy.
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DOI：
10.1371/journal.pone.0240064
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Fawzi AA
中科院分区：
文献类型：
--
作者：
Ong JX;Kwan CC;Cicinelli MV;Fawzi AA
确定表征非增殖性糖尿病视网膜病变（NPDR）光谱的客观光学相干断层扫描血管造影（OCTA）参数，特别是区分中度和重度NPDR的参数。入选了60例未经治疗的NPDR患者（轻度：21例，中度：21例，重度：18例）的60只眼，23只眼糖尿病且无视网膜病变，24只眼健康对照眼。将OCTA切片分割为浅表（SCP）、中（MCP）和深毛细血管丛（DCP），并通过基于DCP量化血管长度的新方法进行阈值化。在校正年龄和图像质量后，比较每个严重程度组之间的中心凹无血管区（FAZ）面积、视网膜旁血管密度（VD）和所有三个毛细血管层的校正血流指数（AFI）以及SCP的血管长度密度（VLD）。所有血管密度标志物均随着NPDR严重程度的增加而降低。SCP VD和VLD在无视网膜病变的糖尿病眼睛和轻度NPDR之间（分别为p = 0.001和p < 0.001）以及中度与重度NPDR之间（分别为p = 0.004和p = 0.009）显示出显著差异。中度和重度NPDR之间的MCP VD显着降低（p = 0.01）。随着NPDR严重程度的增加，SCP的AFI显著增加，MCP和DCP呈下降趋势。SCP VD、SCP VLD和MCP VD的变化可以区分重度NPDR和低风险期。SCP变化可能更可靠，因为它们对噪声和投影伪影的敏感性较低。基于DCP标准化血管长度的手持OCTA图像显示，中度和重度NPDR的变异性较小。进一步的研究是必要的，以验证这种新的阈值方法。
To identify objective optical coherence tomography angiography (OCTA) parameters that characterize the spectrum of non-proliferative diabetic retinopathy (NPDR), especially those that distinguish moderate from severe NPDR. Sixty eyes of 60 patients with treatment-naïve NPDR (mild: 21, moderate: 21, severe: 18), 23 eyes with diabetes and no retinopathy, and 24 healthy control eyes were enrolled. OCTA slabs were segmented into superficial (SCP), middle (MCP), and deep capillary plexus (DCP) and thresholded by a new method based on DCP skeletonized vessel length. The foveal avascular zone (FAZ) area, parafoveal vessel density (VD), and adjusted flow index (AFI) from all three capillary layers and the vessel length density (VLD) of the SCP were compared between each severity group, after adjusting for age and image quality. All vessel density markers decreased with increasing severity of NPDR. SCP VD and VLD demonstrated significant differences between eyes with diabetes with no retinopathy and mild NPDR (p = 0.001 and p < 0.001, respectively), as well as between moderate vs. severe NPDR (p = 0.004 and p = 0.009, respectively). MCP VD significantly decreased between moderate and severe NPDR (p = 0.01). AFI significantly increased in the SCP and showed a decreasing trend in the MCP and DCP with increasing NPDR severity. Changes in the SCP VD, SCP VLD, and MCP VD can distinguish severe NPDR from lower-risk stages. SCP changes may be more reliable due to their lower susceptibility to noise and projection artifacts. Thresholding OCTA images based on DCP skeletonized vessel length showed less variability in moderate and severe NPDR. Additional studies are warranted to validate this new thresholding method.
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影响因子：
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作者：
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影响因子：
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影响因子：
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作者：
Hammes HP;Feng Y;Pfister F;Brownlee M
通讯作者：
Brownlee M
影响因子：
8.1
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