视网膜血管床面积在糖尿病视网膜病变中的应用研究进展

Research progress on the application of retinal vascular bed area in diabetic retinopathy

视网膜血管床面积(RVBA)是在超广角荧光素血管造影(UWFA)图像中分割出的视网膜血管的面积总和,是一个以平方毫米为单位的绝对值,客观性较强。RVBA主要受视网膜血管直径和长度的影响,其增加或减少取决于局部缺血和血管生成之间的“竞争”,可以提示视网膜血管形态上的细微改变。作为研究视网膜血管性疾病的新指标,与既往常用的缺血指数(ISI)、无灌注区面积(NPA)等相比,RVBA可能具有更高的稳定性和准确性。目前,RVBA主要被用于评估糖尿病视网膜病变(DR)的病程进展和疗效预后。与正常眼相比,DR眼的视网膜总RVBA更大;在抗血管内皮生长因子(VEGF)治疗后DR眼的视网膜总RVBA下降。这些发现为研究DR中的微血管病变提供了有利支持。本文就RVBA在DR中的应用作一综述,为RVBA在视网膜静脉阻塞(RVO)等其它视网膜血管性疾病中的临床研究提供参考。

Retinal vascular bed area(RVBA)is the total area of retinal vasculature segmented by ultra-widefield fluorescein angiography(UWFA)images,and is an objective absolute value in square millimeter.RVBA is mainly affected by the diameter and length of retinal vessels,and whether RVBA increases or decreases depends on the“competition”between ischemia and angiogenesis,indicating subtle changes in retinal vascular morphology.As a new indicator for the study of retinal vascular diseases,RVBA may have higher stability and accuracy than the ischemia index(ISI)and non-perfusion area(NPA).RVBA is currently mainly used to evaluate the progression and prognosis of diabetic retinopathy(DR).It was found that retinal total RVBA in DR eyes was greater than the normal eyes and it decreased in DR eyes after anti-vascular endothelial growth factor(VEGF)treatment.These findings provide favorable support for the study of microvascular lesions in DR.In this article,the application of RVBA in DR was reviewed to provide a reference for the clinical study of RVBA in other retinal vascular diseases such as retinal vein occlusion(RVO).