Unified deep learning model for predicting fundus fluorescein angiography image from fundus structure image

The prediction of fundus fluorescein angiography(FFA)images from fundus structural images is a cutting-edge research topic in ophthalmological image processing.Prediction comprises estimating FFA from fundus camera imaging,single-phase FFA from scanning laser ophthalmoscopy(SLO),and three-phase FFA also from SLO.Although many deep learning models are available,a single model can only perform one or two of these prediction tasks.To accomplish three prediction tasks using a unified method,we propose a unified deep learning model for predicting FFA images from fundus structure images using a supervised generative adversarial network.The three prediction tasks are processed as follows:data preparation,network training under FFA supervision,and FFA image prediction from fundus structure images on a test set.By comparing the FFA images predicted by our model,pix2pix,and CycleGAN,we demonstrate the remarkable progress achieved by our proposal.The high performance of our model is validated in terms of the peak signal-to-noise ratio,structural similarity index,and mean squared error.

Fundus photography,fluorescein angiography,optical coherence tomography and electroretinography of preclinical animal models of ocular diseases

The eye is an immune-privileged and sensory organ in humans and animals.Anatomical,physiological,and pathobiological features share significant similarities across divergent species(1).Each compartment of the eye has a unique structure and function.The anterior and posterior compartments of the eye contain endothelium(cornea),epithelium(cornea,ciliary body,iris),muscle(ciliary body),vitreous and neuronal(retina)tissues,which make the eye suitable to evaluate efficacy and safety of tissue specific drugs(2).

Fundus photography,fundus fluorescein angiography,and optical coherence tomography of healthy cynomolgus monkey,New Zealand rabbit,Sprague Dawley rat,and BALB/c mouse retinas

Background:A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis.The choice of animal model is based on the measurability of specific parameters or structures,the applicability of clinical measurement technologies,and the similarity to human eye function.Studies of eye pathology usually compare optical parameters between a healthy and altered state,so accurate baseline assessments are critical,but few reports have comprehensively examined the normal anatomical structures and physiological functions in these models.Methods:Three cynomolgus monkeys,six New Zealand rabbits,ten Sprague Dawley(SD)rats,and BALB/c mice were examined by fundus photography(FP),fundus fluorescein angiography(FFA),and optical coherence tomography(OCT).Results:Most retinal structures of cynomolgus monkey were anatomically similar to the corresponding human structures as revealed by FP,FFA,and OCT.New Zealand rabbits have large eyeballs,but they have large optic disc and myelinated retinal nerve fibers in their retinas,and the growth pattern of retinal vessels were also different to the human retinas.Unlike monkeys and rabbits,the retinal vessels of SD rats and BALB/c mice were widely distributed and clear.The OCT performance of them were similar with human beings except the macular.Conclusions:Monkey is a good model to study changes in retinal structure associated with fundus disease,rabbits are not suitable for studies on retinal vessel diseases and optic nerve diseases,and rats and mice are good models for retinal vascular diseases.These measures will help guide the choice of model and measurement technology and reduce the number of experimental animals required.

Changes of Indocyanine Green and Fluorescein Angiography in Multiple Evanescent White-dot Syndrome: A Case Report

Purpose: To study the clinicopathological change on "Multiple Evanescent White-dot Syndrome (MEWDS)"through fundus angiogrphy analyses.Methods:Examing the case with fluorescein angiography (FFA) and indocyanine green angiography(ICGA), visual field and following up for 15 months.Results :There exist multiple white dots in the fundus photo and angiography. The changes on ICGA maintain longer than fundus photo and FFA. Papille may be edematous and macula could present with special hypofluorescent flecks.Conclusions:MEWDS has specific angiographic features. Its pathological changes involve deep retinal pigment epithelium(RPE) as well as choroidal capillaries. The prognosis of the visual acuity for MEWDS is very good.

Don’t forget emergency surgery! Lessons to learn from elective indocyanine green-guided gastrointestinal interventions

Fluorescence-based imaging has found application in several fields of elective surgery,but there is still a lack of evidence in the literature about its use in the emergency setting.Clinical trials have consistently shown that indocyanine green(ICG)-guided surgery can dramatically reduce the risk of postoperative complic-ations,length of in-hospital stay and total healthcare costs in the elective setting.It is well-known that emergency surgery has a higher complication rate than its elective counterpart,therefore an impelling need for research studies to explore,validate and develop this issue has been highlighted.The present editorial aims to provide a critical overview of currently available applications and pitfalls of ICG fluorescence in abdominal emergencies.Furthermore,we evidenced how the experience of ICG-fluorescence in elective surgery might be of great help in implementing its use in acute situations.In the first paragraph we analyzed the tips and tricks of ICG-guided cancer surgery that might be exploited in acute cases.We then deepened the two most described topics in ICG-guided emergency surgery:Acute cholecystitis and intestinal ischemia,focusing on both the advantages and limitations of green-fluorescence application in these two fields.In emergency situations,ICG fluorescence demonstrates a promising role in preventing undue intestinal resections or their entity,facilitating the detection of intestinal ischemic zones,identifying biliary tree anatomy,reducing post-operative complications,and mitigating high mortality rates.The need to improve its application still exists,therefore we strongly believe that the elective and routinary use of the dye is the best way to acquire the necessary skills for emer-gency procedures.

Fundus autofluorescence in central serous chorioretinopathy: association with spectral-domain optical coherence tomography and fluorescein angiography

and FA for identifying pathological abnormalities in CSC. The characteristics of IA AF in CSC were attributable to the modification of melanin in the RPE. IR- AIM: To evaluate the correlation among changes in fundus autofluorescence (AF) measured using infrared fundus AF (IR -AF) and short-wave length fundus AF (SW -AF) with changes in spectral -domain optical coherence tomography (SD -OCT) and fluorescein angiography (FA) in central serous chorioretinopathy (CSC). METHODS: Two hundred and twenty consecutive patients with CSC were included. In addition to AF, patients were assessed by means of SD -OCT and FA. Abnormalities in images of IA -AF, SW -AF, FA were analyzed and correlated with the corresponding outer retinal alterations in SD-OCT findings. RESULTS: Eyes with abnormalities on either IR-AF or SW-AF were found in 256 eyes (58.18%), among them 256 eyes (100%) showed abnormal IR -AF, but SW-AF abnormalities were present only in 213 eyes (83.20%). The hypo-IR-AF corresponded to accumulation of subretinal liquid, collapse of retinal pigment epithelium (APE) or detachment of APE with or without RPE leakage point in the corresponding area. The hyper -IR -AF corresponded to the area with loss of the ellipsoid portion of the inner segments and sub -sensory retinal deposits or focal melanogenesis under sensory retina. The hypo-SW-AF corresponded to accumulation of subretinal liquid or atrophy of RPE. The hyper -SW -AF associated with sub -sensory retinal deposits, detachment of RPE and focal melanogenesis. CONCLUSION: IR-AF was more sensitive than SW-AF AF should be used as a common diagnostic tool for identifying pathological lesion in CSC.

Comparison of fundus fluorescein angiography and fundus photography grading criteria for early diabetic retinopathy

AIM:To compare the assessment outcomes of the characteristics of mild to moderate non-proliferative diabetic retinopathy(NPDR) established by fundus photography and fundus fluorescein angiography(FFA).METHODS:The fundus photos and FFA results of 260 patients with diabetes mellitus were reviewed.Diabetic retinopathy(DR) severity was graded based on the international classification standard.The microaneurysms,hemorrhages,and intraretinal microvascular abnormalities(IRMA) in FFA images of patients with mild to moderate NPDR were observed.The differences between the fundus photos and the FFA results were summarized,analyzed,and compared.RESULTS:The counting of intraretinal hemorrhages identified by FFA revealed that only 9 eyes(1.9%) had more than 20 intraretinal hemorrhages in all four quadrants;15 eyes(3.1%) had more than 20 intraretinal hemorrhages in three quadrants;26 eyes(5.4%) had over 20 intraretinal hemorrhages in two quadrants;and 37 eyes(7.7%) had more than 20 intraretinal hemorrhages in only one quadrant.Furthermore,the number of IRMAs appeared ≥4 in 17 eyes,3 in 35 eyes,2 in 69 eyes,and 1 in 93 eyes.CONCLUSION:FFA has higher detection accuracy of retinal angiopathy than fundus photography.FFA grading results are helpful for timely detection and proper treatment of lesions easily missed by fundus photography.

Can Fundus Fluorescein Angiography be Performed for Diabetic Patients on Oral Metformin

Metformin is a kind of biguanide hypoglycemic agent that has been widely used in patients with diabetes mellitus. In clinical practice, whether metformin should be stopped before Fundus fluorescein angiography （FFA） remains largely unclear. Some endocrinologists suggest stop metformin before FFA. However, ophthalmologists do not always adopt this opinion in their practice. This situation may lead to disputes between physicians and patients. This article analyzed contrast-induced nephropathy（CIN） and the related contrast agent, as well as the adverse reactions of fluorescein angiography. It pointed out that the discrepancy may be caused by misunderstanding of contrast agents used in FFA. For angiography using iodine contrast agent, metformin must be stopped because of the increased possibility of CIN, while for FFA using fluorescein sodium, no CIN has been reported yet. Therefore, the authors believe FFA is safe for diabetic patients with oral metformin and it is unnecessary to stop metformin before the examination.

Risk factors for adverse reactions of fundus fluorescein angiography

Background:To explore the difference between the outcomes of correlations between a series of variables and adverse reactions(ARs)to fluorescein from univariate and multivariate analysis and to evaluate the nausea effects in different age groups.Methods:A retrospective study of patients undergoing consecutive fluorescein angiography between March2010 and February 2012 was conducted.No patients were excluded on the ground of age,presence of atopy,allergy history,previous procedures without severe allergic ARs,asymptomatic hypertension and kidney failure with serum creatinine levels lower than 250μmol/L or with renal dialysis.Results:A total of 829 patients were enrolled and 22.2%of them had ARs.The majority of reactions were nausea(12.1%)which occurred less when age became old(P<0.0001).When the correlations between a series of variables and ARs were assessed separately,age(P<0.0001),prior reactions(P<0.0001)and motion sickness(P=0.0062)were highly and cardio/cerebrovascular disease(P=0.0015),diabetes(P=0.0001)and renal disease(P=0.0219)were lowly related to ARs.However,when the correlations were assessed simultaneously,only age[odd ratio(OR)0.974;95%confidence interval(CI),0.962–0.986],prior reactions(OR 5.596;95%CI,2.083–15.029)and motion sickness(OR 4.849;95%CI,1.583–14.856)were statistically correlated with ARs.Conclusions:Fluorescein angiography is a safe procedure for patients who are relatively healthy but with a history of any systemic disease.Young age,prior reactions and motion sickness which are highly related to emetic events should be considered in the evaluation of ARs to fluorescein.

Indocyanine Green Angiographic and Multifocal Electroretinographic Features in the Diffuse and Regional From of Bietti's Cystalline Retinopathy

Prpose: To observe different features of indocyanine green angiography(ICGA) andtifocal electroretinography (ERG) in the diffuse and regional type of Bieti′sc stalline retinopathy (BCR). Thods: ICGA and the multifocal ERG were performed in two cases of the diffuse andregional type of BCR respectively. These data were compared with fluoresceinangiography (FA), standard Ganzfeld ERG, and visual field testing. Results: In the regional case, ICGA revealed reduced perfusion of the choroidalcirculation in the early phase and multiple hypofluorescent spots in the posterior pole in the late phase, due to choriocapillaris filling defect; the extent of choroiocapillaris losswas shown in early phase of ICGA and there were multifocal hyperfluorescent dotssurrounding hypofluorescent spots in late phase in the diffuse case. The multifocal ERGshowed that the central responses were markedly depressed, corresponding to the visualfield defects, while the findings of Ganzfeld ERG were normal in the regional BCR;however, both the multifocal ERG and Ganzfeld ERG were severely subnormal in thediffuse case.Conclusions: The features of ICGA and multifocal ERG are different between the diffuseand regional BCR. In the meantime, the two tools are also useful to differentiate the typeand assess the extentof evolution in BCR.

Application of non-mydriatic fundus photography-assisted telemedicine in diabetic retinopathy screening

BACKGROUND Early screening and accurate staging of diabetic retinopathy(DR)can reduce blindness risk in type 2 diabetes patients.DR’s complex pathogenesis involves many factors,making ophthalmologist screening alone insufficient for prevention and treatment.Often,endocrinologists are the first to see diabetic patients and thus should screen for retinopathy for early intervention.AIM To explore the efficacy of non-mydriatic fundus photography(NMFP)-enhanced telemedicine in assessing DR and its various stages.METHODS This retrospective study incorporated findings from an analysis of 93 diabetic patients,examining both NMFP-assisted telemedicine and fundus fluorescein angiography(FFA).It focused on assessing the concordance in DR detection between these two methodologies.Additionally,receiver operating characteristic(ROC)curves were generated to determine the optimal sensitivity and specificity of NMFP-assisted telemedicine,using FFA outcomes as the standard benchmark.RESULTS In the context of DR diagnosis and staging,the kappa coefficients for NMFPassisted telemedicine and FFA were recorded at 0.775 and 0.689 respectively,indicating substantial intermethod agreement.Moreover,the NMFP-assisted telemedicine’s predictive accuracy for positive FFA outcomes,as denoted by the area under the ROC curve,was remarkably high at 0.955,within a confidence interval of 0.914 to 0.995 and a statistically significant P-value of less than 0.001.This predictive model exhibited a specificity of 100%,a sensitivity of 90.9%,and a Youden index of 0.909.CONCLUSION NMFP-assisted telemedicine represents a pragmatic,objective,and precise modality for fundus examination,particularly applicable in the context of endocrinology inpatient care and primary healthcare settings for diabetic patients.Its implementation in these scenarios is of paramount significance,enhancing the clinical accuracy in the diagnosis and therapeutic management of DR.This methodology not only streamlines patient evaluation but also contributes substantially to the optimization of clinical outcomes in DR management.

Indocyanine green fluorescence in gastrointestinal surgery:Appraisal of current evidence

Applying indocyanine green(ICG)fluorescence in surgery has created a new dimension of navigation surgery to advance in various disciplines.The research in this field is nascent and fragmented,necessitating academic efforts to gain a comprehensive understanding.The present review aims to integrate diverse perspectives and recent advances in its application in gastrointestinal surgery.The relevant articles were selected by using the appropriate keyword search in PubMed.The angiography and cholangiography property of ICG fluorescence is helpful in various hepatobiliary disorders.In gastroesophageal and colorectal surgery,the lymphangiography and angiography property of ICG is applied to evaluate bowel vascularity and guide lymphadenectomy.The lack of objective parameters to assess ICG fluorescence has been the primary limitation when ICG is used to evaluate bowel perfusion.The optimum dose and timing of ICG administration need to be standardized in some new application areas in gastrointestinal surgery.Binding tumor-specific ligands with fluorophores can potentially widen the fluorescence application to detect primary and metastatic gastrointestinal tumors.The narrative review outlines prior contributions,limitations,and research opportunities for future studies across gastrointestinal sub-specialty.The findings of the present review would be helpful for scholars and practitioners to explore and progress in this exciting domain of gastrointestinal surgery.

Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

Background:Modern surgical medicine strives to manage trauma while improving outcomes using functional imaging.Identification of viable tissues is crucial for the surgical management of polytrauma and burn patients presenting with soft tissue and hollow viscus injuries.Bowel anastomosis after traumarelated resection is associated with a high rate of leakage.The ability of the surgeon’s bare eye to determine bowel viability remains limited,and the need for a more standardized objective assessment has not yet been fulfilled.Hence,there is a need for more precise diagnostic tools to enhance surgical evaluation and visualization to aid early diagnosis and timely management to minimize traumaassociated complications.Indocyanine green(ICG)coupled with fluorescence angiography is a potential solution for this problem.ICG is a fluorescent dye that responds to near-infrared irradiation.Methods:We conducted a narrative review to address the utility of ICG in the surgical management of patients with trauma as well as elective surgery.Discussion:ICG has many applications in different medical fields and has recently become an important clinical indicator for surgical guidance.However,there is a paucity of information regarding the use of this technology to treat traumas.Recently,angiography with ICG has been introduced in clinical practice to visualize and quantify organ perfusion under several conditions,leading to fewer cases of anastomotic insufficiency.This has great potential to bridge this gap and enhance the clinical outcomes of surgery and patient safety.However,there is no consensus on the ideal dose,time,and manner of administration nor the indications that ICG provides a genuine advantage through greater safety in trauma surgical settings.Conclusions:There is a scarcity of publications describing the use of ICG in trauma patients as a potentially useful strategy to facilitate intraoperative decisions and to limit the extent of surgical resection.This review will improve our understanding of the utility of intraoperative ICG fluorescence in guiding and assisting trauma surgeons to deal with the intraoperative challenges and thus improve the patients’operative care and safety in the field of trauma surgery.

Angiographic leakage of polypoidal choroidal vasculopathy on indocyanine angiography

Background There is no detailed report about the angiographic leakage of polypoidal choroidal vasculopathy （PGV） lesions on indocyanine green （ICG） angiography. This study aimed to investigate the angiographic leakage of polypoidal lesions in PCV on ICG angiography. Methods One hundred and forty-four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, fluorescein angiography, and ICG angiography were performed. Leakage of polypoidal lesions and clinical features were recorded according to the angiograms. Results In all 144 eyes, 110 eyes showed angiographic leakage （leakage group） on ICG angiography and three subtypes of leakage group were noted, which were polypoidal dilations leakage （47 eyes, 42.7%）, branching vascular networks leakage （14 eyes, 12.7%） and leakage of both （49 eyes, 44.5%）. The other 34 eyes showed regression of polypoidal lesions （regression group）. In leakage group, the rates of pigment epithelial detachment （PED）, best corrected visual acuity （BCVA） 〈0.1 and old subretinal hemorrhages were 56.4% （62 eyes）, 19.1% （21 eyes）, and 4.6% （5 eyes） respectively, compared with 8.8% （3 eyes）, 50% （17 eyes） and 38.2% （13 eyes） of regression group （P 〈0.001）. The history of regression group was significantly longer （P 〈0.001）. Conclusions Angiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect that the former is active or in the early course while the later is resting or in the late phase of PCV.

A case of scalp avulsion with prolonged ischemic time:indocyanine green angiography can aid in predicting replant survival

Background:Microsurgical replantation has become the most favorable treatment option for scalp avulsion.However,the accurate prediction of postoperative replant viability remains challenging.Case presentation:In this article,we showed that(indocyanine green angiography,ICGA)can provide a much more precise prediction of replant necrosis than conventional clinical assessment in a rare case of complete scalp avulsion with prolonged ischemia time.Conclusion:Clinical assessment of replant survival may be misleading in cases of complex tissue injuries and prolonged ischemic stress.This case provides insight into the promising utility of ICGA as an important adjuvant tool to better assess tissue perfusion and viability in scalp avulsion and possibly other types of replantation.

Usefulness of intraoperative Indocyanine green video angiography to select the recipient artery for bypass surgery in arteriosclerotic occlusion of the middle cerebral artery: a technical case report

Background: In superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass surgery, indocyanine green video angiography (ICG-VA) is usually used to verify bypass patency. Less-commonly reported is the ability to use this technique to evaluate candidate recipient vessels based on either collateral flow or identification of the distal branch of interest. Case presentation: An 82-year-old man presented with progressive cerebral infarction due to infarction of the M2 inferior trunk of the right middle cerebral artery. He underwent superficial temporal artery-middle cerebral artery bypass to prevent further ischemia 1 week after the initial stroke. In the surgery, M4 cortical arteries fed by the inferior trunk could not be identified as recipient arteries. Intraoperative ICG-VA showed delayed luminescence of some M4 arteries. Because the M4 arteries fed by the inferior trunk showed delayed retrograde flows from the anterior cerebral artery on preoperative digital subtraction angiography, the M4 arteries with delayed luminescence on ICG-VA were considered to be M4 arteries fed by the inferior trunk and selected as the recipient arteries. Conclusions: ICG-VA shows differences in flow speed as delayed luminescence. This finding may be useful for detecting target vessels.

Daytona超广角激光扫描眼底成像与FFA在老年白内障病人糖尿病性视网膜病变筛查中的一致性分析

目的探讨Daytona超广角激光扫描眼底成像与荧光素眼底血管造影(fundus fluorescein angiography,FFA)筛查老年白内障病人糖尿病性视网膜病变(diabetic retinopathy,DR)的一致性。方法采用横断面研究方法,选取2021年4月至2023年8月在大庆油田总医院眼科门诊就诊的年龄≥60岁合并糖尿病的老年白内障病人172例(323眼),所有病人均接受Daytona超广角激光扫描眼底成像以及FFA检查,分别记录2种检查方法诊断DR以及DR分期情况。采用卡方检验、加权Kappa一致性检验、Spearman偏回归分析对2种检查结果的相关性进行分析。结果2种检查方法的可阅片率差异无统计学意义(93.8%比94.1%,P=0.869)。Daytona超广角系统检查时间较FFA检查时间明显缩短(Z=16.85,P<0.001)。排除未得到眼底图像25眼,最终153例298眼纳入一致性研究。Daytona超广角系统与FFA检测DR分期完全一致278只眼(93.29%),Kappa值为0.925,95%CI:0.892~0.958。以FFA为金标准,Daytona超广角系统检测增生型DR的敏感度和特异度分别为90.00%、100.00%,Kappa值为0.926;检测非增生型DR的敏感度、特异度分别为94.47%、90.91%,Kappa值为0.900。Daytona超广角系统与FFA检测DR分期结果呈高度正相关(r=0.921)。结论Daytona超广角激光扫描眼底成像对合并糖尿病的老年白内障病人DR筛查效果及分期与FFA有很好的一致性。

光学相干断层扫描血管成像参数诊断非增殖性糖尿病视网膜病变的价值分析

目的:分析光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)诊断非增殖性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)的价值。方法:连续纳入2021年1月至2023年6月期间在我科门诊收治的122例有2型糖尿病病史(包括伴或不伴有视网膜病变)的患者,均接受眼底荧光血管造影(fundus fluorescein angiography,FFA)检查和OCTA定量检查。以FFA结果为金标准,并将患者根据FFA结果分为对照组(无NPDR)、轻度NPDR组、中度NPDR组和重度NPDR组。OCTA观察指标包括,视网膜黄斑区中央视网膜厚度(central macular thickness,CMT)、血管线性密度(vascular density,VD)、血流灌注密度(perfusion density,PD)、黄斑中心凹无血管区面积(foveal avascular zone area,FAZ-A)、黄斑中心凹无血管区周长(foveal avascular zone perimeter,FAZ-P)、圆形指数(foveal avascular zone circularity index,FAZ-CI)。用单因素方差或非参数方法分析比较各组间定量指标的差异,取其中存在显著组间差异的指标纳入多因素Logistic回归模型,分析反映NPDR患病和严重程度的指标,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析单独或联合指标对于NPDR的诊断价值。结果:VD在各NPDR组中较对照组均显著下降,重度NPDR组较轻度、中度NPDR组均显著下降(P<0.05);PD在中度和重度NPDR组较对照组均显著下降(P<0.05),在重度NPDR组较轻度和中度NPDR组均显著下降(P<0.05);FAZ-A在各NPDR组中较对照组均显著下降(P<0.05),但在各NPDR组间均无统计学差异;FAZ-P在各NPDR组中较对照组均显著下降(P<0.05),但在各NPDR组间均无统计学差异;FAZ-CI在各组间均无统计学差异。多因素Logistic回归分析结果显示,CMT升高、VD和FAZ-P下降与NPDR患病相关(P=0.03,<0.001和0.001);CMT上升和VD下降与NPDR严重程度相关(P=0.01,<0.001)。ROC曲线分析显示,CMT(>260.00μm)、VD(<16.55/mm2)和FAZ-P(<2.15 mm)对NPDR均具有单独诊断价值(AUC分别为0.63、0.78和0.70),其中VD的诊断效能显著高于CMT(P=0.02),CMT与VD或FAZ-P的诊断效能之间则无统计学差异(P均>0.05)。CMT、VD和FAZ-P指标联合诊断NPDR的诊断效能(AUC=0.86)显著高于任一单项指标的诊断效能(P均<0.05)。结论:OCTA检查参数CMT、VD和FAZ-P均独立具备对NPDR的诊断价值,将三者联合使用则能进一步提高其诊断效能。OCTA血流参数联合黄斑形态参数可有效提高NPDR的临床诊断。

息肉样脉络膜血管病变患者光学相干断层扫描血管成像与吲哚菁绿血管造影图像特征的比较

目的总结对照息肉样脉络膜血管病变患者光学相干断层扫描血管成像(OCTA)与吲哚菁绿血管造影(ICGA)的图像特征。方法通过便利抽样法,选取2021年4月至2022年4月在南昌大学附属眼科医院接受治疗的50例息肉样脉络膜血管病变患者作为研究对象。所有患者在治疗前均接受OCTA与ICGA检查,以ICGA检查结果作为金标准,对OCTA与ICGA检查结果进行对照分析。结果50例患者中,ICGA检查可见特征性息肉样病灶17例,异常分支血管网21例,异常分支血管网合并特征性息肉样病灶10例,因出血遮挡无异常表现2例,检出率为96.00%(48/50)。OCTA检查可见特征性息肉样病灶16例,异常分支血管网19例,异常分支血管网合并特征性息肉样病灶11例,无异常表现4例,检出率为92.00%(46/50);两种检查方式检出率比较,差异无统计学意义(χ^(2)=0.709,P=0.400)。Kappa一致性检验分析结果显示,ICGA与OCTA诊断息肉样脉络膜血管病变具有较高一致性(Kappa=0.816,P<0.001)。以ICGA检查结果作为金标准,OCTA诊断息肉样脉络膜血管病变的敏感度、特异度、准确度分别为97.83%(45/46)、75.00%(3/4)和92.00%(46/50)。结论ICGA与OCTA诊断息肉样脉络膜血管病变的病变一致性较高,ICGA检查表现为异常分支血管网者,OCTA检查可见相似表现;ICGA检查表现为特征性息肉样病灶者,OCTA检查可见明显强信号亮点;ICGA与OCTA检查显示病灶形态及位置具有一定相似性。

OCTA在早期糖尿病视网膜病变诊断中的应用及特异度、灵敏度分析

目的分析光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)对早期糖尿病视网膜病变(diabetic retinopathy,DR)诊断中的价值。方法选取晋江市医院眼科于2023年1月—2024年1月收治的94例(176眼)疑似DR患者为研究对象,均开展OCTA检查和眼底荧光素血管造影(fundus fluorescein angiography,FFA)。将FFA结果作为金标准,评价OCTA对早期DR的诊断价值,通过kappa一致性检验分析OCTA诊断DR与FFA结果的一致性。结果FFA共检出122眼DR,54眼无DR;OCTA共检出119眼DR,57眼无DR。OCTA诊断早期DR的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为94.26%、92.59%、93.75%、96.64%、87.72%。kappa检验结果可知,OCTA诊断DR与FFA结果的一致性较强(kappa=0.792)。结论OCTA诊断DR与FFA结果的一致性较强,有助于诊断早期DR,具有较高灵敏度、特异度。