Assessment of Diabetic Choroidopathy Using Ultra-Widefield Optical Coherence Tomography.
Assessment of Diabetic Choroidopathy Using Ultra-Widefield Optical Coherence Tomography.
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DOI：
10.1167/tvst.11.3.35
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发表时间：
2022-03-02
影响因子：
3
通讯作者：
Cicinelli MV
中科院分区：
文献类型：
--
作者：
Nicolini N;Tombolini B;Barresi C;Pignatelli F;Lattanzio R;Bandello F;Cicinelli MV
本研究的目的是研究共焦扫描激光检眼镜 (cSLO) 超宽场 (UWF) 扫源光学相干断层扫描 (S-SOCT) 在糖尿病脉络膜病变评估中的应用，并评估与谱域 OCT (SD-OCT) 仪器测量结果的一致性。我们对糖尿病患者进行了一项横断面研究，评估以中央凹为中心的 UWF SS-OCT 扫描的鼻部、颞部和中央黄斑部分的脉络膜血管指数 (CVI)。 UWF 伪彩色眼底图像用于糖尿病视网膜病变 (DR) 严重程度分期。采用线性混合模型比较不同严重程度的DR和不同后极扇区的CVI值。在 SD-OCT 扫描中重复进行中央黄斑 CVI 测量； SS-OCT 和 SD-OCT 之间计算观察者间组内系数 (ICC)。总共包括 85 名患者的 151 只眼睛。 CVI值从非增殖性DR到增殖性DR降低，其中高危增殖性DR的CVI值显着低于中重度非增殖性DR（P = 0.03）。中央黄斑区域受影响最明显；鼻部受影响最小。 SS-OCT 和 SD-OCT 之间的一致性中等（ICC = 0.50）。糖尿病性脉络膜病变随着 DR 向增殖性疾病的恶化而进展；脉络膜耗竭在黄斑处更为突出。建议比较不同设备之间的 CVI 值时务必小心。脉络膜血管分布可了解 DR 的严重程度及其并发症，例如黄斑水肿。在某些情况下，阅读器之间和仪器之间的一致性可能不是最佳的。
The purpose of this study was to investigate a confocal scanning laser ophthalmoscopy (cSLO) ultra-widefield (UWF) swept-source optical coherence tomography (S-SOCT) in assessment of diabetic choroidopathy and to evaluate the agreement of measurements with a spectral-domain OCT (SD-OCT) instrument. We conducted a cross-sectional study of patients with diabetes evaluating the choroidal vascularity index (CVI) in the nasal, temporal, and central macula segments of a UWF SS-OCT scan centered to the fovea. UWF pseudocolored fundus images were used for diabetic retinopathy (DR) severity staging. The CVI values were compared between different degrees of severity of DR and different posterior-pole sectors with linear mixed models. Central macula CVI measurements were repeated on SD-OCT scans; the interobserver intraclass coefficient (ICC) was calculated between SS-OCT and SD-OCT. A total of 151 eyes of 85 patients were included. The CVI values decreased from nonproliferative DR to proliferative DR, with high-risk proliferative DR having significantly lower CVI values than moderate to severe nonproliferative DR (P = 0.03). The central macula region was the most evidently affected; the nasal sector was the least affected. The agreement between SS-OCT and SD-OCT was moderate (ICC = 0.50). Diabetic choroidopathy progresses with worsening of DR toward proliferative disease; choroidal depletion is more prominent in the macula. Caution is recommended in comparing CVI values between different devices. Choroidal vascularity informs about the severity of DR and its complications, such as macular edema. The agreement between readers and between instruments may be suboptimal in certain cases.
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