应用光学相干断层扫描血管成像评估视网膜血流的可重复性及再现性

Repeatability and reproducibility of quantification of superficial retinal capillaries using optical coherence tomography angiography

目的:应用Cirrus HD-OCT 5000对正常眼黄斑及视盘血流参数进行血管成像测量,评估其可重复性及再现性。方法:纳入40只正常眼进行前瞻性研究。操作者A于一周内3天的同一时段(T1,T2,T3)对正常受试者的同一眼黄斑及视盘进行3次血管成像扫描,扫描过程中均开启FastTracTM图像跟踪功能,操作者B在T2时间点再次对受试者同一眼进行相同程序扫描,使用Angio Plex MetrixTM量化软件(版本10.0)自动测量黄斑和视盘的血管长度密度(vessel length density,VD)和血管灌注密度(vascular perfusion density,PD)。应用单因素方差分析或非参数检验比较3次扫描的VD、PD是否有差异。采用组内相关系数(intraclass correlation coeff icient,ICC)、变异系数(coefficient of variation,CV)评价操作者A的可重复性,采用一致性相关系数(consistent correlation coeff icient,CCC)、重复性系数(repeatabi lit y coeff icient,CR)、CV评价操作者间的再现性。结果:操作者A对黄斑及视盘各区域3次扫描的VD、PD之间差异无统计学意义(P>0.05)。操作者A对黄斑和视盘VD、PD 3次扫描的ICC值分别为0.260~0.517、0.362~0.898,黄斑及视盘各区域VD、PD的CV值均<8.1%。黄斑和视盘VD、PD的操作者间CCC值分别为0.3130~0.5665、0.5149~0.7801;黄斑VD和PD的CR值分别为3.2212~4.6399、0.0574~0.0832;视盘VD和PD的CR值分别为2.0675~4.0630、0.0447~0.0730。黄斑CV值均<9.0%,视盘CV值均<6.9%。结论:非同日的同一时段视盘浅层血流参数具有较好的重复性及再现性,黄斑浅层血流参数的重复性及再现性相对较差。

Objective:To evaluate the repeatability and reproducibility of quantification of macular and peri-papillary superficial capillaries in normal eyes using Cirrus HD-OCT 5000 angiography.Methods:Forty normal eyes were included in this prospective study.Angiography 3 mm × 3 mm scan protocol centered on the disc or macula of the same eye was repeated 3 times by operator A in the same period on 3 days (T1,T2,T3) within 1 week,and the FastTracTM image tracking function was turned on during the scan.Operator B repeated the same scan independently at T2 after operator A.Angio Plex MetrixTM quantification software (version 10.0) was used to automatically measure the vessel length density (VD) and vascular perfusion density (PD) of macular and peri-papillary superficial capillaries.One-way analysis of variance or nonparametric test was used to compare the VD and PD measurements of the 3 scans.The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated to evaluate the intra-operator repeatability.Consistent correlation coefficient (CCC),repeatability coefficient (CR),and CV were calculated to evaluate the inter-operator reproducibility.Results:There was no statistically significant difference in the measurements of VD and PD between the 3 scans of the macular and peri-papillary superficial capillaries by operator A (P>0.05).The ICC values for the 3 scans of VD and PD of the macular and peri-papillary superficial capillaries by operator A were 0.260–0.517 and 0.362~0.898,respectively.The CV values of the VD and PD of the macular and peri-papillary superficial capillaries were all <8.1%.The inter-operator CCC values of the macular and peri-papillary superficial capillaries were 0.3130–0.5665 and 0.5149~0.7801,respectively;the CR values of the VD and PD of macula were 3.2212–4.6399 and 0.0574–0.0832,respectively;the CR values of the VD and PD of optic disc were 2.0675–4.0630 and 0.0447–0.0730,respectively.The CV values of macular were all <9.0%,and the CV values of optic disc were all <6.9%.Conclusion:The macular and peri-papillary superficial capillaries parameters in the same period on different days have a good repeatability and reproducibility,while the superficial macular blood flow parameters have relatively poor repeatability and reproducibility.