The Utility of Optical Coherence Tomography Angiography Biomarkers in Detecting Diabetic Retinopathy.

IF 1.6 4区医学 Q3 OPHTHALMOLOGY

Ophthalmic epidemiology Pub Date : 2026-12-01 Epub Date: 2026-08-20 DOI:10.1080/09286586.2026.2719732

Kieran Kumanan, Abolfazl Hassani, Muhammad Husnain, Elias Papaefstratiou, Jose J Estevez

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引用次数: 0

Abstract

Purpose: To evaluate associations between optical coherence tomography angiography (OCT-A) metrics and diabetic retinopathy (DR) and compare their discrimination against conventional clinical risk factors.

Methods: In this cross-sectional study, 108 adult eyes with diabetes were recruited from tertiary ophthalmology/optometry clinics. DR was clinically graded using ETDRS categories and dichotomised as no DR vs ≥ mild NPDR (primary outcome). Macular 6 × 6 mm OCT-A (Zeiss AngioPlex™) was acquired; scans with signal strength > 7 and without major artefact were included. Quantitative metrics from the superficial capillary plexus included vessel density (VD) and perfusion density (PD) (central/inner/outer/full regions); structural OCT measures and FAZ parameters were secondary. Associations with ≥mild NPDR were assessed using multivariable logistic regression adjusted for age, sex, HbA1c, and diabetes duration. Discrimination was evaluated with ROC curves/AUC (95% CI) and DeLong comparisons of AUCs.

Results: ≥Mild DR was present in 63% of eyes. DR was associated with lower VD (central, inner, outer, full) and lower PD (central, inner, full) (all p ≤ 0.04). After adjustment, central VD (OR 0.82, 95% CI 0.68-0.98) and central PD (OR 0.92, 95% CI 0.86-0.99) remained independently associated with DR. The OCT-A model showed moderate discrimination compared to the clinical model (AUC 0.72 vs 0.65); the combined model yielded AUC 0.75.

Conclusion: Central VD and PD from the superficial plexus are independently associated with DR and show moderate discrimination versus conventional clinical factors alone, supporting OCT-A as an adjunctive biomarker for earlier DR detection.

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光学相干断层扫描血管造影生物标志物在糖尿病视网膜病变检测中的应用。

目的：评价光学相干断层扫描血管造影（OCT-A）指标与糖尿病视网膜病变（DR）之间的关系，并比较其与常规临床危险因素的区别。方法：在本横断面研究中，从三级眼科/验光诊所招募了108只成年糖尿病患者。使用ETDRS分类对DR进行临床分级，并将其分为无DR和≥轻度NPDR（主要结局）。获得黄斑6 × 6 mm OCT-A（蔡司AngioPlex™）；包括信号强度为bb70且无主要伪影的扫描。浅表毛细血管丛的定量指标包括血管密度（VD）和灌注密度（PD）（中央/内/外/全区）；其次是结构OCT测量和FAZ参数。使用年龄、性别、HbA1c和糖尿病病程调整后的多变量logistic回归评估与≥轻度NPDR的相关性。用ROC曲线/AUC （95% CI）和AUC的DeLong比较评价辨别力。结果：63%的眼睛出现≥轻度DR。DR与较低VD（中央、内、外、满）和较低PD（中央、内、满）相关（p均≤0.04）。调整后，中枢性VD （OR 0.82, 95% CI 0.68-0.98）和中枢性PD （OR 0.92, 95% CI 0.86-0.99）仍然与dr独立相关。OCT-A模型与临床模型相比显示出中度区分（AUC 0.72 vs 0.65）；组合模型的AUC为0.75。结论：来自浅神经丛的中枢性VD和PD与DR独立相关，与常规临床因素相比，OCT-A可作为早期DR检测的辅助生物标志物。

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

Ophthalmic epidemiology 医学-眼科学

CiteScore

3.70

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.