UNASSIGNED: In this retrospective, longitudinal study, we evaluated 12 × 12-mm swept-source optical coherence tomography angiography centered on the macula at baseline and last available follow-up visit for (1) IRMA changes during follow-up, defined as (a) stable, (b) regressed, (c) obliterated, and (d) progressed; and the (2) development of new neovascularization (NV) and their origins. Competing-risk survival analysis was used to assess the factors associated with these changes.
UNASSIGNED: In total, 195 eyes from 131 participants with diabetic retinopathy were included. Stable, regressed, obliterated, and progressed IRMA were observed in 65.1%, 12.8%, 11.3%, and 19% of eyes with diabetic retinopathy, respectively. Anti-VEGF injections during the follow-up periods and a slower increase of foveal avascular zone were associated with IRMA regression (P < 0.001 and P = 0.039). Obliterated IRMA were correlated with previous panretinal photocoagulation (P < 0.001) and a lower deep capillary plexus vessel density at baseline (P = 0.007), as well as with follow-up anti-VEGF injections (P = 0.025). A higher baseline ischemia index (ISI) and panretinal photocoagulation during the follow-up periods were associated with IRMA progression (P = 0.049 and P < 0.001). A faster increase in ISI predicted the development of NV elsewhere (NVE) from veins (P < 0.001). No significant factors were found to be associated with NVE originating from IRMA.
UNASSIGNED: Changes in IRMA closely correlated with the severity of retinal ischemia and treatment. Notably, our study confirmed the potential, yet relatively rare, development of NVE from IRMA in a large cohort; however, the risk factors associated with this transformation require further exploration.
■在这次回顾中,纵向研究,我们在基线和最后一次可用随访时评估了以黄斑为中心的12×12-mm扫频光源光学相干断层扫描血管造影(1)随访期间的IRMA变化,定义为(A)稳定,(b)回归,(c)抹杀,(d)进展;(2)新血管形成(NV)的发展及其起源。竞争风险生存分析用于评估与这些变化相关的因素。
■总共,纳入131例糖尿病视网膜病变参与者的195只眼。稳定,回归,抹杀,并观察到65.1%的IRMA进展,12.8%,11.3%,19%的眼睛患有糖尿病性视网膜病变,分别。在随访期间注射抗VEGF和缓慢增加的中央凹无血管区与IRMA消退相关(P<0.001和P=0.039)。闭塞的IRMA与先前的全视网膜光凝(P<0.001)和基线时较低的深毛细血管丛血管密度(P=0.007)相关,以及后续抗VEGF注射(P=0.025)。随访期间较高的基线缺血指数(ISI)和全视网膜光凝与IRMA进展相关(P=0.049和P<0.001)。ISI的更快增加预测了从静脉到其他地方的NV(NVE)的发展(P<0.001)。没有发现与源自IRMA的NVE相关的重要因素。
■IRMA的变化与视网膜缺血的严重程度和治疗密切相关。值得注意的是,我们的研究证实了这种潜力,然而相对罕见,在一个大的队列中从IRMA开发NVE;然而,与这种转变相关的风险因素需要进一步探索。