Volumetric Measures of Capillary Nonperfusion on Optical Coherence Tomography Angiography Detect Early Ischemia in Diabetes Without Retinopathy.

IF 5 2区 医学 Q1 OPHTHALMOLOGY
Janice X Ong, Hunter J Lee, Nicole L Decker, Daniela Castellanos-Canales, Hisashi Fukuyama, Amani A Fawzi
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Abstract

Purpose: The purpose of this study was to compare volumetric 3-dimensional (3D) against standard 2-dimensional (2D) measurements of ischemia for distinguishing early stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).

Methods: This cross-sectional study considered 82 eyes of 82 patients (aged 51.0 ± 11.9 years) including 27 healthy controls, 31 patients with diabetes mellitus (DM) without DR, and 24 patients with mild nonproliferative DR (NPDR). Using OCTA, we obtained 2D scans and 3D volumes of the superficial capillary plexus (SCP), middle capillary plexus (MCP), and deep capillary plexus (DCP). We calculated geometric perfusion deficits (GPDs), which define ischemic regions as those located farther than a specified threshold distance from the nearest blood vessel. For the GPD parameter, we compared the performance of a 20 µm versus 30 µm cutoff.

Results: On 2D scans, eyes with mild NPDR had significantly higher GPDs in all 3 retinal capillary layers, indicating worse ischemia, compared with both healthy controls and patients with DM without DR, using either threshold (20 µm or 30 µm) to define GPD (all P < 0.05). DM without DR showed no significant difference from healthy eyes in 2D images. Interestingly, however, using 3D volumes, DM without DR eyes had significantly greater DCP GPDs than healthy eyes using a GPD threshold of 20 µm (P = 0.012), but not with 30 µm (P = 0.057).

Conclusions: Using a stringent threshold (20 µm), volumetric OCTA imaging detects significant DCP perfusion defects in diabetic eyes even before DR onset, whereas traditional 2D OCTA does not. Volumetric scans may therefore be more sensitive to early ischemia in diabetes.

光学相干断层扫描血管造影检测无视网膜病变糖尿病早期缺血的毛细血管非灌注体积测量。
目的:本研究的目的是比较体积三维(3D)和标准二维(2D)的缺血测量,以区分早期糖尿病视网膜病变(DR)的光学相干断层扫描血管造影(OCTA)。方法:对82例患者82只眼(年龄51.0±11.9岁)进行横断面研究,其中健康对照27例,非糖尿病(DM)患者31例,轻度非增生性糖尿病(NPDR)患者24例。使用OCTA,我们获得了浅毛细血管丛(SCP)、中毛细血管丛(MCP)和深毛细血管丛(DCP)的二维扫描和三维体积。我们计算了几何灌注缺陷(gpd),它将缺血区域定义为距离最近的血管超过指定阈值距离的区域。对于GPD参数,我们比较了20µm和30µm截止的性能。结果:在2D扫描中,与健康对照组和无DR的DM患者相比,轻度NPDR的眼睛所有3个视网膜毛细血管层的GPD均显著升高,表明缺血更严重,使用阈值(20µm或30µm)定义GPD(均P < 0.05)。无DR的DM与健康眼在2D图像上无显著差异。然而,有趣的是,使用3D体积,当GPD阈值为20µm时,无DR的DM眼睛的DCP GPD显著高于健康眼睛(P = 0.012),而当GPD阈值为30µm时则没有(P = 0.057)。结论:容积OCTA成像使用严格的阈值(20µm),甚至在DR发病之前就能检测到糖尿病眼睛中显著的DCP灌注缺陷,而传统的2D OCTA则不能。因此,体积扫描可能对糖尿病早期缺血更敏感。
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
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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