增生早期糖尿病视网膜病变患者视网膜及视盘新生血管的超广角OCTA与FFA检测结果对比分析

Comparison of the detection of retinal and optic disc neovascularization in patients with early-stage proliferative diabetic retinopathy by ultra-wide optical coherence tomography angiography and fundus fluorescein angiography

目的 对比分析超广角OCT血管成像(OCTA)与荧光素眼底血管造影(FFA)对增生早期糖尿病视网膜病变(DR)患眼视网膜及视盘新生血管的检测结果。方法 选取2021年11月至2022年5月在四川省人民医院眼科经FFA确诊为增生早期DR的患者62例(98眼)为研究对象,所有患者均行FFA和超广角OCTA检查。超广角OCTA检查选择以黄斑为中心的24 mm×20 mm扫描模式进行。所有图像均由同一位技术员采集,图像分析由同一位医师进行。以FFA的检查结果为标准,分析超广角OCTA对增生早期DR患眼视网膜及视盘新生血管的检出率。结果 共93眼(94.9%)FFA显示出视网膜新生血管,超广角OCTA显示出其中82眼,检出率88.2%,遗漏的患眼均是由于超广角OCTA检测范围受限所致;在FFA未显示出视网膜新生血管的5眼中,超广角OCTA显示出1眼存在新生血管,该新生血管在FFA检查中被误诊为视网膜内微血管异常。共17眼(17.3%)FFA显示出视盘新生血管,超广角OCTA显示出全部17眼,检出率100.0%;在余下的81眼中,超广角OCTA更灵敏地显示出10眼存在视盘新生血管。在FFA检查中,因荧光素渗漏掩盖了新生血管的特征,导致漏诊。结论 超广角OCTA对增生早期DR患眼视网膜及视盘新生血管检出率高,且能发现被FFA遗漏的新生血管。

Objective To compare and analyze the detection rates of retinal and optic disc neovascularization in eyes with early-stage proliferative diabetic retinopathy(PDR)by ultra-wide optical coherence tomography angiography(UW-OCTA)and fundus fluorescein angiography(FFA).Methods Totally 62 patients(98 eyes)with early-stage PDR diagnosed in the Department of Ophthalmology of Sichuan Provincial People’s Hospital from November 2021 to May 2022 were selected for the study.All patients underwent FFA and UW-OCTA examinations.The 24 mm×20 mm scanning mode centered on the macula was selected for UW-OCTA.All images were collected by the same technician and read by the same physician.Based on the results of FFA,the detection rate of retinal and optic disc neovascularization in eyes with early-stage PDR by UW-OCTA was calculated.Results The retinal neovascularization was found in 93 eyes(94.9%)by FFA.Among the 93 eyes,the positive number obtained by UW-OCTA was 82 eyes(88.2%).Those not detected by UW-OCTA were beyond the inspection range of UW-OCTA.In the 5 eyes that no retinal neovascularization was seen by FFA,neovascularization was found in 1 eye by UW-OCTA.It was misdiagnosed as intraretinal microvascular abnormality by FFA.The optic disc neovascularization was found in 17 eyes(17.3%)by FFA,and all these 17 eyes(100.0%)were detected by UW-OCTA.In the other 81 eyes that no optic disc neovascularization was detected by FFA,neovascularization was founded in 10 eyes by UW-OCTA.The leakage of fluorescein masked the characteristics of neovascularization,resulting in missed diagnosis by FFA.Conclusion UW-OCTA has a high detection rate in retinal and optic disc neovascularization in patients with early-stage PDR,and it also can find the neovascularization missed by FFA.