Sierra K Ha, Xinyi Ding, Francesco Romano, Katherine M Overbey, Filippos Vingopoulos, Itika Garg, Cade F Bennett, Isabella Stettler, Ioanna Ploumi, Grace Baldwin, Matthew J Finn, Peyman Razavi, Demetrios G Vavvas, Deeba Husain, Nimesh A Patel, Leo A Kim, John B Miller
{"title":"糖尿病视网膜病变定量对比敏感度功能与乳突周围光学相干断层血管造影的结构-功能关联。","authors":"Sierra K Ha, Xinyi Ding, Francesco Romano, Katherine M Overbey, Filippos Vingopoulos, Itika Garg, Cade F Bennett, Isabella Stettler, Ioanna Ploumi, Grace Baldwin, Matthew J Finn, Peyman Razavi, Demetrios G Vavvas, Deeba Husain, Nimesh A Patel, Leo A Kim, John B Miller","doi":"10.1167/iovs.66.4.69","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess changes in radial peripapillary capillary (RPC) microvasculature and their impact on visual function, measured by visual acuity (VA) and contrast sensitivity, in diabetic retinopathy (DR).</p><p><strong>Methods: </strong>This was a cross-sectional study in 96 eyes of 67 patients, including controls, diabetes without DR (DMnoDR), nonproliferative DR (NPDR), and proliferative DR (PDR) groups. Participants underwent same-day quantitative contrast sensitivity function (qCSF) and 6 × 6 mm OCT angiography (OCTA) centered on the optic disc. The Peripapillary Nerve Fiber Layer Microvasculature Density algorithm (ARI Network) was used to calculate capillary perfusion density (total area of perfused microvasculature per unit area), capillary flux index (CFI, total weighted area of perfused microvasculature per unit area), and retinal nerve fiber layer (RNFL) thickness surrounding the optic disc. Mixed-effects multivariable regression models, controlling for age, hypertension, and lens status, evaluated associations between RPC OCTA metrics, DR severity, VA, and qCSF.</p><p><strong>Results: </strong>Significant RPC microvascular changes were observed across DR stages. Capillary perfusion density decreased with DR severity and even before retinopathy onset in DMnoDR versus controls (βavg = -0.42, P = 0.021). PDR compared to NPDR showed a significant decrease in CFI (β = -1.02 to -0.92, P < 0.01) and in RNFL (βavg = -0.71, P = 0.033). CFI had significant associations with qCSF at various spatial frequencies (β = 0.20 to 0.34, P = 0.002 to 0.042), but not with VA.</p><p><strong>Conclusions: </strong>Radial peripapillary capillary perfusion density worsens with onset of diabetes and increasing severity of DR while capillary flux index is more significantly affected later in disease. Structure-function associations suggest that DR-induced peripapillary microvascular changes are more strongly associated with contrast sensitivity changes than with visual acuity.</p>","PeriodicalId":14620,"journal":{"name":"Investigative ophthalmology & visual science","volume":"66 4","pages":"69"},"PeriodicalIF":5.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025313/pdf/","citationCount":"0","resultStr":"{\"title\":\"Structure-Function Associations Between Quantitative Contrast Sensitivity Function And Peripapillary Optical Coherence Tomography Angiography in Diabetic Retinopathy.\",\"authors\":\"Sierra K Ha, Xinyi Ding, Francesco Romano, Katherine M Overbey, Filippos Vingopoulos, Itika Garg, Cade F Bennett, Isabella Stettler, Ioanna Ploumi, Grace Baldwin, Matthew J Finn, Peyman Razavi, Demetrios G Vavvas, Deeba Husain, Nimesh A Patel, Leo A Kim, John B Miller\",\"doi\":\"10.1167/iovs.66.4.69\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess changes in radial peripapillary capillary (RPC) microvasculature and their impact on visual function, measured by visual acuity (VA) and contrast sensitivity, in diabetic retinopathy (DR).</p><p><strong>Methods: </strong>This was a cross-sectional study in 96 eyes of 67 patients, including controls, diabetes without DR (DMnoDR), nonproliferative DR (NPDR), and proliferative DR (PDR) groups. Participants underwent same-day quantitative contrast sensitivity function (qCSF) and 6 × 6 mm OCT angiography (OCTA) centered on the optic disc. The Peripapillary Nerve Fiber Layer Microvasculature Density algorithm (ARI Network) was used to calculate capillary perfusion density (total area of perfused microvasculature per unit area), capillary flux index (CFI, total weighted area of perfused microvasculature per unit area), and retinal nerve fiber layer (RNFL) thickness surrounding the optic disc. Mixed-effects multivariable regression models, controlling for age, hypertension, and lens status, evaluated associations between RPC OCTA metrics, DR severity, VA, and qCSF.</p><p><strong>Results: </strong>Significant RPC microvascular changes were observed across DR stages. Capillary perfusion density decreased with DR severity and even before retinopathy onset in DMnoDR versus controls (βavg = -0.42, P = 0.021). PDR compared to NPDR showed a significant decrease in CFI (β = -1.02 to -0.92, P < 0.01) and in RNFL (βavg = -0.71, P = 0.033). CFI had significant associations with qCSF at various spatial frequencies (β = 0.20 to 0.34, P = 0.002 to 0.042), but not with VA.</p><p><strong>Conclusions: </strong>Radial peripapillary capillary perfusion density worsens with onset of diabetes and increasing severity of DR while capillary flux index is more significantly affected later in disease. Structure-function associations suggest that DR-induced peripapillary microvascular changes are more strongly associated with contrast sensitivity changes than with visual acuity.</p>\",\"PeriodicalId\":14620,\"journal\":{\"name\":\"Investigative ophthalmology & visual science\",\"volume\":\"66 4\",\"pages\":\"69\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12025313/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Investigative ophthalmology & visual science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1167/iovs.66.4.69\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Investigative ophthalmology & visual science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1167/iovs.66.4.69","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨糖尿病视网膜病变(DR)患者桡骨乳头周围毛细血管(RPC)的变化及其对视觉功能的影响。方法:对67例患者96只眼进行横断面研究,包括对照组、糖尿病无DR (DMnoDR)组、非增殖性DR (NPDR)组和增殖性DR (PDR)组。参与者当天进行定量对比敏感度功能(qCSF)和以视盘为中心的6 × 6 mm OCT血管造影(OCTA)。采用乳头周围神经纤维层微血管密度算法(ARI Network)计算毛细血管灌注密度(单位面积微血管灌注总面积)、毛细血管通量指数(CFI,单位面积微血管灌注总加权面积)、视盘周围视网膜神经纤维层(RNFL)厚度。混合效应多变量回归模型,控制年龄、高血压和晶状体状态,评估RPC OCTA指标、DR严重程度、VA和qCSF之间的关联。结果:在DR分期中观察到明显的RPC微血管改变。与对照组相比,DMnoDR患者的毛细血管灌注密度随DR严重程度而下降,甚至在视网膜病变发生前也有所下降(βavg = -0.42, P = 0.021)。与NPDR相比,PDR显著降低了CFI (β = -1.02 ~ -0.92, P < 0.01)和RNFL (βavg = -0.71, P = 0.033)。CFI与qCSF在各空间频率上均有显著相关性(β = 0.20 ~ 0.34, P = 0.002 ~ 0.042),但与va无显著相关性。结论:桡动脉乳头周围毛细血管灌注密度随糖尿病发病和DR严重程度的增加而恶化,而毛细血管通量指数在疾病后期受到的影响更为显著。结构-功能关联表明dr诱导的乳头周围微血管变化与对比敏感度变化的相关性比与视力的相关性更强。
Structure-Function Associations Between Quantitative Contrast Sensitivity Function And Peripapillary Optical Coherence Tomography Angiography in Diabetic Retinopathy.
Purpose: To assess changes in radial peripapillary capillary (RPC) microvasculature and their impact on visual function, measured by visual acuity (VA) and contrast sensitivity, in diabetic retinopathy (DR).
Methods: This was a cross-sectional study in 96 eyes of 67 patients, including controls, diabetes without DR (DMnoDR), nonproliferative DR (NPDR), and proliferative DR (PDR) groups. Participants underwent same-day quantitative contrast sensitivity function (qCSF) and 6 × 6 mm OCT angiography (OCTA) centered on the optic disc. The Peripapillary Nerve Fiber Layer Microvasculature Density algorithm (ARI Network) was used to calculate capillary perfusion density (total area of perfused microvasculature per unit area), capillary flux index (CFI, total weighted area of perfused microvasculature per unit area), and retinal nerve fiber layer (RNFL) thickness surrounding the optic disc. Mixed-effects multivariable regression models, controlling for age, hypertension, and lens status, evaluated associations between RPC OCTA metrics, DR severity, VA, and qCSF.
Results: Significant RPC microvascular changes were observed across DR stages. Capillary perfusion density decreased with DR severity and even before retinopathy onset in DMnoDR versus controls (βavg = -0.42, P = 0.021). PDR compared to NPDR showed a significant decrease in CFI (β = -1.02 to -0.92, P < 0.01) and in RNFL (βavg = -0.71, P = 0.033). CFI had significant associations with qCSF at various spatial frequencies (β = 0.20 to 0.34, P = 0.002 to 0.042), but not with VA.
Conclusions: Radial peripapillary capillary perfusion density worsens with onset of diabetes and increasing severity of DR while capillary flux index is more significantly affected later in disease. Structure-function associations suggest that DR-induced peripapillary microvascular changes are more strongly associated with contrast sensitivity changes than with visual acuity.
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.