PDF(Pubmed)
Abstract：
UNASSIGNED: To longitudinally investigate the changes in intraretinal microvascular abnormalities (IRMAs) over time, employing swept-source optical coherence tomography angiography in eyes with diabetic retinopathy.
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.
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.
摘要：
■为了纵向研究随着时间的推移，视网膜内微血管异常（IRMA）的变化，在糖尿病性视网膜病变的眼中采用扫频源光学相干断层扫描血管造影。
■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。
■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。
