Three-Dimensional Choroidal Vessels Assessment in Diabetic Retinopathy.

IF 5 2区 医学 Q1 OPHTHALMOLOGY
Elham Sadeghi, Katherine Du, Oluwaseyi Ajayi, Elli Davis, Nicola Valsecchi, Mohammed Nasar Ibrahim, Sandeep Chandra Bollepalli, Kiran Kumar Vupparaboina, Jose Alain Sahel, Jay Chhablani
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Abstract

Purpose: To evaluate choroidal vasculature in eyes with diabetic retinopathy (DR) using a novel three-dimensional algorithm.

Methods: Patients with DR and healthy controls underwent clinical examinations and swept-source optical coherence tomography (PlexElite-9000). The choroidal layer was segmented using the ResUNet model. Phansalkar thresholding was used to binarize the choroidal vasculature. The macular area was divided into 5 sectors by a custom grid, and the 15 largest vessels in each sector were measured for mean choroidal vessel diameter (MChVD). Volumetric choroidal thickness (ChT) and the choroidal vascularity index (CVI) were calculated. A linear mixed model was used for analysis.

Results: This retrospective cross-sectional study analyzed 73 eyes of 45 patients with DR (36 proliferative vs. 37 nonproliferative DR, and 42 with diabetic macular edema [DME] vs. 31 without DME), and 27 eyes of 21 age-match controls. The average MChVD was decreased in DR compared with healthy (200.472 ± 28.246 µm vs. 240.264 ± 22.350 µm; P < 0.001), as well as lower sectoral MChVD (P < 0.001); however, there was no difference in average ChT between the groups (P > 0.05). The global CVI was reduced in DR, especially in temporal and central sectors (P < 0.05). Compared with nonproliferative, proliferative DR exhibited decreased ChT (temporal, P < 0.05; other sectors, P > 0.05), CVI (P > 0.05), and MChVD (P > 0.05). DME eyes demonstrated lower but not statistically significant MChVD (196.449 ± 27.221 µm vs. 205.922 ± 29.134 µm; P > 0.05) and significantly reduced average CVI (0.365 ± 0.032 vs. 0.389 ± 0.040; P = 0.008) compared with non-DME eyes.

Conclusions: DR and DME eyes showed reduced MChVD and CVI, likely owing to microvascular changes leading to ischemia. These findings highlight the need for new choroidal biomarkers to better understand DR's pathogenic mechanisms.

糖尿病视网膜病变的三维脉络膜血管评估。
目的:应用一种新颖的三维算法评价糖尿病视网膜病变(DR)眼脉络膜血管。方法:对DR患者和健康对照者进行临床检查和扫描源光学相干断层扫描(PlexElite-9000)。使用ResUNet模型对脉络膜层进行分割。phansalar阈值法用于脉络膜血管的二值化。用自定义网格将黄斑区域划分为5个扇区,每扇区测量最大的15条血管的平均脉络膜血管直径(MChVD)。计算脉络膜体积厚度(ChT)和脉络膜血管指数(CVI)。采用线性混合模型进行分析。结果:本回顾性横断面研究分析了45例DR患者的73只眼(36例增生性DR对37例非增生性DR, 42例糖尿病性黄斑水肿[DME]对31例无DME),以及21例年龄匹配对照的27只眼。与健康组相比,DR组平均MChVD降低(200.472±28.246µm vs. 240.264±22.350µm;P < 0.001),以及较低的行业MChVD (P < 0.001);各组间平均ChT值差异无统计学意义(P < 0.05)。整体CVI在DR中降低,特别是在颞部和中央扇区(P < 0.05)。与非增生性DR相比,增生性DR的ChT含量明显降低(时间,P < 0.05;其他领域,P >.05), CVI (P >.05)和MChVD (P b>.05)。DME眼的MChVD较低但无统计学意义(196.449±27.221µm vs. 205.922±29.134µm);P < 0.05),平均CVI显著降低(0.365±0.032∶0.389±0.040;P = 0.008)。结论:DR和DME眼的MChVD和CVI降低,可能是由于微血管改变导致缺血。这些发现强调需要新的脉络膜生物标志物来更好地了解DR的致病机制。
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来源期刊
CiteScore
6.90
自引率
4.50%
发文量
339
审稿时长
1 months
期刊介绍: Investigative Ophthalmology & Visual Science (IOVS), published as ready online, is a peer-reviewed academic journal of the Association for Research in Vision and Ophthalmology (ARVO). IOVS features original research, mostly pertaining to clinical and laboratory ophthalmology and vision research in general.
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