Retinal vessel metric analysis of type 1 diabetes mellitus in OCT angiography.

IF 3.1 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Frontiers in Medicine Pub Date : 2025-06-13 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1562809

Nianfeng Tang, Na Su, Zetian Zhang, Keren Xie, Qiang Chen, Wen Fan, Junjie Shan, Songtao Yuan

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引用次数: 0

Abstract

Purpose: To investigate retinal vascular characteristics in type 1 diabetes mellitus (T1DM) patients at different stages via optical coherence tomography angiography (OCTA).

Design: A retrospective observational study.

Method: 63 T1DM patients (110 eyes) who underwent OCTA (3*3 mm) examination and 40 age-matched healthy individuals (79 eyes) were included. A deep learning model was used to segment the retinal arteries and veins on OCTA images, and the vascular metrics in the macular area, including fractal dimension (FD), vessel diameter index (VDI), vascular length fraction (VLF), vascular tortuosity, and vessel density (VD) in different zones (fovea, superior parafoveal, inferior parafoveal, nasal parafoveal, and temporal parafoveal) were calculated.

Results: In accordance to the diagnostic criteria for diabetic retinopathy (DR), T1DM patients were classified into groups. There were 12 individuals (19 eyes) in the NPDR group, all of whom exhibited non-proliferative DR, and 51 (91 eyes) in the NDR (non-DR) group. The NDR group was divided into 2 subgroups according to the duration of T1DM, with 28 people (49 eyes) having a duration of less than 5 years and 23 people (42 eyes) having a duration of 5 years or more. Built-in metrics of OCTA showed that the VD in each zone of NPDR group was significantly lower than that of control group and NDR group (all p < 0.05). In addition, the VD of the inferior parafoveal vein (P = 0.022) and superior parafoveal artery (P = 0.03) were significantly decreased in the NPDR group. Comparing the VD among NDR subgroups and control group, the VD of the superficial inferior parafovea of T1DM patients of early stage (less than 5 years) was significantly lower than that of normal people (p < 0.05), while the VD of the inferior parafoveal artery increased (P = 0.012).

Conclusion: We employed a deep learning vessel segmentation model to analyze the changes in arterial and venous metrics in OCTA images of T1DM patients. Early damage of NPDR to large vessels occurs in the inferior parafoveal vein and the superior parafoveal artery. In patients without DR, the arterial VD of the inferior parafovea has a compensatory increase.

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1型糖尿病视网膜血管的OCT血管造影分析。

目的：通过光学相干断层扫描血管造影（OCTA）研究不同阶段1型糖尿病（T1DM）患者的视网膜血管特征。设计：回顾性观察性研究。方法：选择行OCTA （3* 3mm）检查的T1DM患者63例（110眼）和年龄匹配的健康人40例（79眼）。采用深度学习模型对OCTA图像上的视网膜动静脉进行分割，计算黄斑区域不同区域（中央凹、上中央凹、下中央凹、鼻中央凹和颞中央凹）的分形维数（FD）、血管直径指数（VDI）、血管长度分数（VLF）、血管弯曲度和血管密度（VD）。结果：按照糖尿病视网膜病变（DR）的诊断标准，对T1DM患者进行分组。NPDR组12例（19只眼）均为非增殖性DR， NDR组51例（91只眼）为非增殖性DR。NDR组根据T1DM持续时间分为2个亚组，28人（49只眼）持续时间小于5年，23人（42只眼）持续时间大于或等于5年。OCTA内建指标显示NPDR组各区VD均显著低于对照组和NDR组（均p < 0.05）。NPDR组下凹旁静脉VD （P = 0.022）和上凹旁动脉VD （P = 0.03）明显降低。NDR亚组与对照组比较，早期（小于5年）T1DM患者浅下凹旁动脉VD明显低于正常人（p < 0.05），而下凹旁动脉VD明显升高（p = 0.012）。结论：我们采用深度学习血管分割模型分析了T1DM患者OCTA图像中动脉和静脉指标的变化。NPDR对大血管的早期损害发生在下凹旁静脉和上凹旁动脉。在没有DR的患者中，下中央凹的动脉VD有代偿性增加。

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

Frontiers in Medicine Medicine-General Medicine

CiteScore

5.10

自引率

5.10%

发文量

3710

审稿时长

12 weeks

期刊介绍： Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world