Abstract:
This study tested if a high-resolution, multi-modal, multi-scale retinal imaging instrument can provide novel information about structural abnormalities in vivo. The study examined 11 patients with very mild to moderate non-proliferative diabetic retinopathy (NPDR) and 10 healthy subjects using fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), adaptive optics scanning laser ophthalmoscopy (AO-SLO), adaptive optics OCT and OCTA (AO-OCT(A)). Of 21 eyes of 11 patients, 11 had very mild NPDR, 8 had mild NPDR, 2 had moderate NPDR, and 1 had no retinopathy. Using AO-SLO, capillary looping, inflections and dilations were detected in 8 patients with very mild or mild NPDR, and microaneurysms containing hyperreflective granular elements were visible in 9 patients with mild or moderate NPDR. Most of the abnormalities were seen to be perfused in the corresponding OCTA scans while a few capillary loops appeared to be occluded or perfused at a non-detectable flow rate, possibly because of hypoperfusion. In one patient with moderate NPDR, non-perfused capillaries, also called ghost vessels, were identified by alignment of corresponding en face AO-OCT and AO-OCTA images. The combination of multiple non-invasive imaging methods could identify prominent microscopic abnormalities in diabetic retinopathy earlier and more detailed than conventional fundus imaging devices.
摘要:
这项研究测试了如果高分辨率,多模态,多尺度视网膜成像仪器可以提供体内结构异常的新信息。该研究使用眼底照相检查了11例轻度至中度非增生性糖尿病视网膜病变(NPDR)患者和10例健康受试者,光学相干断层扫描(OCT),OCT血管造影(OCTA),自适应光学扫描激光检眼镜(AO-SLO),自适应光学OCT和OCTA(AO-OCT(A))。在11例患者的21只眼中,11人的NPDR非常温和,8人患有轻度NPDR,2有中等的NPDR,1例没有视网膜病变。使用AO-SLO,毛细管循环,在8例非常轻度或轻度NPDR的患者中检测到拐点和扩张,在9例轻度或中度NPDR患者中可见含有高反射颗粒元素的微动脉瘤。在相应的OCTA扫描中发现大多数异常被灌注,而一些毛细血管回路似乎以不可检测的流速被阻塞或灌注。可能是因为灌注不足.在一名中度NPDR患者中,非灌注毛细血管,也被称为幽灵血管,通过对齐相应的正面AO-OCT和AO-OCTA图像进行识别。多种非侵入性成像方法的组合可以比常规眼底成像设备更早,更详细地识别糖尿病性视网膜病变中突出的微观异常。