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糖尿病脉络膜病变:扫频光学相干断层扫描糖尿病视网膜病变的脉络膜血管密度和体积

Wang, J.C., Laíns, I., Providência, J., et al.

期刊名称:American journal of ophthalmology

卷期:2017年第184卷

摘要

摘要:目的:旨在使用en面扫频光学相干断层扫描(SS-OCT)比较糖尿病眼和对照脉络膜血管密度(CVD)和体积(CVV)。设计:前瞻性横断面研究。方法:多中心研究。患者人群:无糖尿病视网膜病变(DR143例,无增殖性DRNPDR47例,NPDR 51例,糖尿病性黄斑水肿(DME143例,增殖性DRPDR18例,64例年龄相匹配的非糖尿病对照眼。观察过程:完整的眼科检查和SS-OCT成像。主要观察指标:CVD,以中央黄斑区(以中央凹为中心的直径6mm的圆)和整个后极(12×9mm)中的脉络膜血管占据的百分比面积计算。通过将平均CVD乘以黄斑面积和脉络膜厚度(使用SS-OCT自动化软件获得)来计算中心黄斑CVV。结果:与对照组(0.31±0.07)相比,NPDR + DME组中央型黄斑病变组显着下降9%(0.28±0.06; = -0.03P = 0.02 PDR组为15%(0.26±0.05; = -0.04P = 0.01)。与对照组(0.025±0.01mm3)相比,PDR眼中央黄斑CVV显着降低19%(0.020±0.005mm3= -0.01P = 0.01)。结论:更晚期糖尿病视网膜病变的脉络膜血管密度和体积显着降低。新的成像模式应该能够进一步探索脉络膜血管疾病对糖尿病眼病发病机制,预后和治疗反应的贡献。

PURPOSE:To compare choroidal vascular density (CVD) and volume (CVV) in diabetic eyes and controls, using en face swept-source optical coherence tomography (SS-OCT).DESIGN:Prospective cross-sectional study.METHODS:Setting: Multicenter.PATIENT POPULATION:Total of 143 diabetic eyes-27 with no diabetic retinopathy (DR), 47 with nonproliferative DR (NPDR), 51 with NPDR and diabetic macular edema (DME), and 18 with proliferative DR (PDR)-and 64 age-matched nondiabetic control eyes.OBSERVATION PROCEDURES:Complete ophthalmologic examination and SS-OCT imaging. En face SS-OCT images of the choroidal vasculature were binarized.MAIN OUTCOME MEASURES:CVD, calculated as the percent area occupied by choroidal vessels in the central macular region (6-mm-diameter circle centered on the fovea), and throughout the posterior pole (12× 9mm). The central macular CVV was calculated by multiplying the average CVD by macular area and choroidal thickness (obtained with SS-OCT automated software). Multilevel mixed linear models were performed for analyses.RESULTS:Compared to controls (0.31 ± 0.07), central macular CVD was significantly decreased by 9% in eyes with NPDR+ DME (0.28 ± 0.06; =-0.03, P=.02) and by 15% in PDR (0.26 ± 0.05; =-0.04, P= .01). The central macular CVV was significantly decreased by 19% in eyes with PDR (0.020 ± 0.005mm3, =-0.01, P= .01) compared to controls (0.025 ± 0.01mm3).CONCLUSIONS:Choroidal vascular density and volume are significantly reduced in more advanced stages of diabetic retinopathy. New imaging modalities should allow further exploration of the contributions of choroidal vessel disease to diabetic eye disease pathogenesis, prognosis, and treatment response.


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