超宽视场扫描源OCTA对无临床糖尿病视网膜病变的2型糖尿病患者脉络膜结构改变的横断面研究

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2026-04-01 Epub Date: 2026-01-15 DOI:10.1016/j.pdpdt.2026.105349

Cong Chen , Wen-Jing Zhang , Qin Ding , Shu-Min Shen , Ya Ye , Zhen Huang , Ming Yan , Yan-Ping Song

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引用次数: 0

摘要

目的：本研究旨在利用超宽视场扫描源光学相干断层扫描血管造影（UWF-SS-OCTA）定量检测未出现临床糖尿病视网膜病变（DR）的不同病程的2型糖尿病（T2DM）患者的脉络膜结构改变。方法：本横断面研究纳入200例无DR的T2DM患者（200眼）和78例健康人（78眼）。根据糖尿病病程将患者分为3组：小于5年（DM1, n = 80），5 ~ 10年（DM2, n = 60），10年以上（DM3, n = 60）。UWF- ss - octa量化乳头周围区、以黄斑为中心的UWF中心区（1-12 mm）和周围区（12-21 mm）的脉络膜厚度（CT）、脉络膜血管体积（CVV）和脉络膜血管指数（CVI）。单因素方差分析和事后检验评估组间差异。采用多变量线性回归来评估糖尿病病程与脉络膜参数之间的关系。结果：与健康对照组相比，DM3组患者在所有评估区域的CT和CVV均显著降低，大部分区域的CVI均降低（均p < 0.05）。当对糖尿病亚组进行比较时，与DM1和DM2组相比，DM3组在所有区域的CT和CVV均显著降低（均p < 0.05）。随着糖尿病病程的延长，中枢性CVI逐渐下降，而外周CVI仅在DM3组和DM1组之间存在显著差异。除外周CVI外，所有评估区域的CT、CVV和中枢性CVI均与糖尿病病程呈独立负相关（均p < 0.05）。结论：无DR的T2DM患者早期表现为脉络膜变薄和血管恶化，并随着糖尿病病程的延长而进行性恶化。UWF-SS-OCTA显示无DR的T2DM患者的脉络膜改变广泛存在，但在外周区域最为明显，这突出了宽视场成像对综合评估的重要性。

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Choroidal structural alterations in patients with type 2 diabetes mellitus without clinical diabetic retinopathy using ultra-widefield swept-source OCTA: A cross-sectional study

Objective

This study aimed to quantitatively examine choroidal structural alterations in patients with type 2 diabetes mellitus (T2DM) of varying disease duration who did not present with clinical diabetic retinopathy (DR), using ultra-widefield swept-source optical coherence tomography angiography (UWF-SS-OCTA).

Methods

This cross-sectional study included 200 patients with T2DM without DR (200 eyes) and 78 healthy individuals (78 eyes). Based on diabetes duration, patients were categorized into three groups: <5 years (DM1, n = 80), 5 to 10 years (DM2, n = 60), and >10 years (DM3, n = 60). UWF-SS-OCTA was used to quantify choroidal thickness (CT), choroidal vascular volume (CVV), and choroidal vascularity index (CVI) in the peripapillary region, the macula-centered UWF central area (1–12 mm), and the peripheral area (12–21 mm). One-way analysis of variance with post hoc testing assessed intergroup differences. Multivariable linear regression was performed to evaluate the associations between diabetes duration and choroidal parameters.

Results

Relative to healthy controls, patients in the DM3 group exhibited significant reductions in CT and CVV in all evaluated regions, along with decreases in CVI in most regions (all p < 0.05). When diabetic subgroups were compared, the DM3 group demonstrated significantly lower CT and CVV across all regions compared with the DM1 and DM2 groups (all p < 0.05). Central CVI showed a progressive decline with longer diabetes duration, while peripheral CVI differed significantly only between the DM3 and DM1 groups. Except for peripheral CVI, CT, CVV, and central CVI across all assessed regions were independently and negatively associated with diabetes duration (all p < 0.05).

Conclusion

Patients with T2DM without DR demonstrated early choroidal thinning and vascular deterioration, which progressively worsened with longer diabetes duration. UWF-SS-OCTA revealed that the choroidal alterations in T2DM without DR were widespread but most pronounced in the peripheral regions, highlighting the importance of wide-field imaging for comprehensive assessment.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.