PDF(Pubmed)
Abstract：
Diabetic retinopathy, the most serious ocular complication of diabetes, imposes a serious economic burden on society. Automatic and objective assessment of vessel changes can effectively manage diabetic retinopathy and prevent blindness. Optical coherence tomography angiography (OCTA) metrics have been confirmed to be used to assess vessel changes. The accuracy and reliability of OCTA metrics are restricted by vessel segmentation methods. In this study, a multi-branch retinal vessel segmentation method is proposed, which is comparable to the segmentation results obtained from the manual segmentation, effectively extracting vessels in low contrast areas and improving the integrity of the extracted vessels. OCTA metrics based on the proposed segmentation method were validated to be reliable for further analysis of the relationship between OCTA metrics and diabetes and the severity of diabetic retinopathy. Changes in vessel morphology are influenced by systemic risk factors. However, there is a lack of analysis of the relationship between OCTA metrics and systemic risk factors. We conducted a cross-sectional study that included 362 eyes of 221 diabetic patients and 1,151 eyes of 587 healthy people. Eight systemic risk factors were confirmed to be closely related to diabetes. After controlling these systemic risk factors, significant OCTA metrics (such as vessel complexity index, vessel diameter index, and mean thickness of retinal nerve fiber layer centered in the macular) were found to be related to diabetic retinopathy and severe diabetic retinopathy. This study provides evidence to support the potential value of OCTA metrics as biomarkers of diabetic retinopathy.
摘要：
糖尿病视网膜病变，糖尿病最严重的眼部并发症，给社会带来了严重的经济负担。血管变化的自动和客观评估可以有效地管理糖尿病视网膜病变并防止失明。光学相干断层扫描血管造影（OCTA）指标已被确认用于评估血管变化。OCTA度量的准确性和可靠性受到血管分割方法的限制。在这项研究中,提出了一种多分支视网膜血管分割方法,这与手动分割获得的分割结果相当，在低对比度区域有效提取血管，提高提取血管的完整性。验证了基于所提出的分割方法的OCTA指标对于进一步分析OCTA指标与糖尿病和糖尿病视网膜病变严重程度之间的关系是可靠的。血管形态的变化受系统性危险因素的影响。然而,缺乏对OCTA指标与系统性风险因素之间关系的分析。我们进行了一项横断面研究，包括221名糖尿病患者的362只眼和587名健康人的1,151只眼。八个系统性危险因素被证实与糖尿病密切相关。在控制了这些系统性风险因素后，重要的OCTA指标(如血管复杂性指数，血管直径指数，和黄斑中心的视网膜神经纤维层的平均厚度）被发现与糖尿病性视网膜病变和严重的糖尿病性视网膜病变有关。这项研究提供了支持OCTA指标作为糖尿病视网膜病变生物标志物的潜在价值的证据。
