Flow and ischemic changes in retina and choroid across diabetic retinopathy spectrum: a SS-OCTA study.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Eye Pub Date : 2025-02-27 DOI:10.1038/s41433-025-03639-y

Qianhui Yang, Kelvin Y C Teo, Yueheng Hong, Bingyao Tan, Leopold Schmetterer, Chui Ming Gemmy Cheung, Tien Yin Wong, Gavin Tan Siew Wei

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引用次数: 0

Abstract

Purpose: To examine changes in retinal and choroidal vasculature in diabetes mellitus across the range of diabetic retinopathy (DR) severities using optical coherence tomography angiography (OCTA) and compare the patterns of vascular changes.

Methods: We conducted a cross-sectional study enrolling 296 patients (498 eyes) with diabetes mellitus. Swept-Source OCT Angiography variables in both retina and choroid, including perfusion density (PD), vessel density (VD), large vessel density (LVD) in both superficial and deep layer of retina and CC flow voids (FD) density of the choroid were quantified. Correlations between OCTA parameters and DR severity, visual acuity and studied factors were performed.

Results: Totally 498 eyes including 176 had no DR, 160 had mild NPDR, 98 had moderate NPDR, 11 had severe NPDR, 41 had PDR with PRP, and 12 had PDR without PRP. Choriocapillaris (CC) flow voids density increased with increasing DR severity (17.06% vs 17.41% vs 17.60% vs 17.62% vs 18.05% vs 18.41%, p-trend = 0.0004), FAZ area increased with DR severity in both superficial and deep layer (superficial layer p trend=0.0027; deep layer p trend=0.0022). Visual acuity correlated negatively with CC flow voids (Pearson's ρ = 0.09, p = 0.04) and superficial FAZ area (Pearson's ρ = 0.22, p < 0.001), while inversely correlated with SCP PD (Pearson's ρ = -0.15, p < 0.001) and VD (Pearson's ρ = -0.15, p < 0.001), as well as DCP PD (Pearson's ρ = -0.21, p < 0.001) and VD (Pearson's ρ = -0.19, p < 0.001).

Conclusion: Choriocapillaris ischemia increased, FAZ area enlarged, and total retina perfusion density decreased with increasing DR severity. The deep layer and large vessels may change in early stage before DR progresses to PDR. More ischemia and vessel tortuosity are correlated with worse visual acuity and higher HbA1c level. OCTA can be utilized to detect both large and small vascular changes in both the retina and choroid in DR patients.

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糖尿病视网膜病变频谱视网膜和脉络膜血流和缺血改变：SS-OCTA研究。

目的：利用光学相干断层扫描血管造影（OCTA）检查糖尿病视网膜病变（DR）严重程度的视网膜和脉络膜血管的变化，并比较血管变化的模式。方法：我们进行了一项横断面研究，纳入296例糖尿病患者（498只眼）。对视网膜和脉络膜扫源OCT血管造影变量，包括视网膜浅层和深层灌注密度（PD）、血管密度（VD）、大血管密度（LVD）和脉络膜CC流空洞（FD）密度进行量化。观察OCTA参数与DR严重程度、视敏度及研究因素的相关性。结果：共498只眼，无DR 176只，轻度NPDR 160只，中度NPDR 98只，重度NPDR 11只，PDR合并PRP 41只，PDR不合并PRP 12只。绒毛毛层（CC）流动空隙密度随DR严重程度的增加而增加（17.06% vs 17.41% vs 17.60% vs 17.62% vs 18.05% vs 18.41%， p趋势= 0.0004），FAZ面积随DR严重程度的增加而增加(浅层p趋势=0.0027；深层p趋势=0.0022)。视力与CC血流空洞（Pearson’s ρ = 0.09, p = 0.04）和浅表FAZ面积（Pearson’s ρ = 0.22, p）呈负相关。结论：随着DR严重程度的增加，绒毛膜毛细血管缺血加重，FAZ面积增大，视网膜总灌注密度降低。在DR发展为PDR之前，早期深层血管和大血管可能发生改变。缺血和血管弯曲程度越严重，视力越差，HbA1c水平越高。OCTA可用于检测DR患者视网膜和脉络膜的大小血管变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eye 医学-眼科学

CiteScore

6.40

自引率

5.10%

发文量

481

审稿时长

3-6 weeks

期刊介绍： Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists. Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.