广角光相干断层扫描血管成像对临床前期糖尿病视网膜病变的定量评估

Quantitative evaluation of preclinical diabetic retinopathy using widefield optical coherence tomography angiography

目的:运用广角光相干断层扫描血管成像(OCTA)研究临床前期糖尿病视网膜病变(PCDR)的微血管异常。方法:选取2020年9月—12月北京协和医院眼科收治的PCDR患者为研究对象。对PCDR组和对照组进行常规眼部检查,同时使用12 mm广角OCTA测量视网膜浅层及深层毛细血管丛的血管密度(VD)。结果:研究共纳入50只PCDR患眼和50只健康对照眼。PCDR的旁中心凹、中心凹周围区、环区6-9的颞侧深层VD显著低于对照组(P<0.05)。患眼旁中心凹区域深层的鼻侧、下方和平均VD也均明显降低(P<0.05)。而两组的浅层VD未发现明显区别(P>0.05)。结论:PCDR的视网膜微血管病变可能最早产生于黄斑颞侧的深层血管丛,这种改变可以通过广角OCTA早期检测。

Objective To study microvascular abnormalities in preclinical diabetic retinopathy(PCDR)using widefield optical coherence tomography angiography(WF-OCTA).Methods PCDR patients admitted to the Ophthalmology Department of Peking Union Medical College Hospital from September to December 2020 were selected as the study objects.Routine eye examination was performed in the PCDR group and the control group,and vessel density(VD)in the superficial and deep capillary plexus was measured using 12 mm WF-OCTA.Results A total of 50 PCDR eyes and 50 healthy control eyes were included in the study.The deep temporal VDs in PCDR parafovea,perifovea and annular6-9 regions were significantly lower than in the controls(P<0.05).There were also significant decreases in nasal,inferior and mean VDs in the deep fovea region of the affected eye(P<0.05).There was no significant difference in superficial VD between the two groups(P>0.05).Conclusions Retinal microvascular impairments of PCDR may first occur in the deep capillary plexus of the temporal macula,which can be detected early by WF-OCTA.