高速扫频源光学相干断层血流成像不同扫描宽度对糖尿病视网膜病变病灶检测率的影响

The influence of different scanning widths on the detection rate of lesions in diabetic retinopathy using high-speed swept-source optical coherence tomography angiography

目的探讨高速扫频源光学相干断层扫描血流成像(SS-OCTA)不同扫描宽度对糖尿病视网膜病变(DR)病灶检测率的影响。方法纳入2021年10月至2023年10月于四川省人民医院眼科就诊的糖尿病(DM)患者126例213眼,接受包括24 mm×20 mm高速广域SS-OCTA扫描方案在内的全面眼科检查。从24 mm×20 mm的OCTA图像中提取一个中心区域记为“12 mm×12 mm中心区”,其余区域记为“12~24 mm环区”。记录并比较使用不同扫描区域的DR病灶检测率。结果共纳入126例参与者的213只眼(54只眼糖尿病无DR,53只眼轻度至中度非增殖性糖尿病视网膜病变(NPDR),54只眼重度NPDR,52只眼增殖性糖尿病视网膜病变(PDR))。24 mm×20 mm OCTA图像无灌注区(NP)检测率显著高于12 mm×12 mm中心区(P<0.05);12~24 mm环区的缺血指数(ISI)中位数明显高于12 mm×12 mm中心区(P<0.05);7眼视网膜新生血管(NV),10眼视网膜内微血管异常(IRMA)病变仅存在于12~24 mm环区域。结论高速广域SS-OCTA单次扫描可捕获24 mm×20 mm视网膜血管图像,更宽的扫描范围可以提高视网膜缺血程度检测的准确性和NV、IRMA的检测率。

Objective To investigate the effect of different scanning widths in high-speed swept-source optical coherence tomography angiography(SS-OCTA)on the detection rate of lesions in diabetic retinopathy(DR).Methods A total of 126 patients(213 eyes)with diabetes mellitus(DM)were enrolled at the department of ophthalmology,Sichuan Provincial People's Hospital from October 2021 to October 2023.The patients underwent comprehensive ophthalmological examination including a 24 mm×20 mm highspeed ultra-widefield SS-OCTA scan.A central region was extracted from the OCTA image of 24 mm×20 mm and named as"12 mm×12 mm central area",and the other regions were named as"12~24 mm annulus",The detection rates of DR lesions in different scanning areas were recorded and compared.Results In the 213 eyes,there were 54 eyes without DR,53 with mild to moderate non-proliferative diabetic retinopathy(NPDR),54 with severe NPDR,and 52 with proliferative diabetic retinopathy(PDR).The detection rate of non-perfusion areas(NP)in the 24 mm×20 mm OCTA image was significantly higher than that in the 12 mm×12 mm central area(P<0.05).The median of ischemic index(ISI)of the mm-annulus was significantly higher than that of the 12 mm×12 mm central area(P<0.05).Retinal neovascularization(NV)of 7 eyes,and intraretinal microvascular abnormalities(IRMA)of 10 eyes were only found in the area of 12~24 mm-annulus.Conclusions High-speed ultra-widefield SS-OCTA single scan can capture 24 mm×20 mm retinal vascular images.The wider scanning range can improve the accuracy of detecting the degree of retinal ischemia and the detection rate of NV and IRMA.