■为了回顾成像方式在评估糖尿病视网膜疾病(DRD)的血管成分方面的证据,以通知DRD暂存系统的更新。
■由国际专家工作组对文献进行标准化叙述审查,作为DRD暂存系统更新工作的一部分,玛丽·泰勒·摩尔视觉倡议的一个项目。总的来说,有6个工作组:血管视网膜,神经视网膜,系统健康,基本和细胞机制,视觉功能,和生活质量。
■血管视网膜工作组,包括来自4个国家的16名参与者。
■使用5种方式的标准化证据网格进行文献综述:标准彩色眼底照相(CFP),宽视场彩色摄影(WFCP),标准荧光素血管造影(FA),广域FA(WFFA),和OCT血管造影(OCTA)。在从I(最高)到V(最低)的验证量表上确定证据的汇总水平。举行了五次虚拟讲习班进行讨论和达成共识。
■每种模式的证据级别。
■标准CFP的证据水平,WFCP,标准FA,WFFA,OCTA是我,II,I,I,和II分别。标准CFP的传统血管病变应继续纳入更新的分期系统,但需要更多的研究才能将它们用于治疗后的眼睛。宽场彩色照片可用于标准CFP覆盖区域内的严重程度分级,尽管这些等级可能无法直接互换。可以考虑评估WFCP上的周边视网膜,但分级方法需要澄清和验证。标准FA和WFFA提供独立的预后价值,但是应该考虑染料给药的需要。OCT血管造影术在DRD分期系统中具有巨大的潜力,但是首先需要解决各种障碍。
■本研究为评估DRD血管成分的各种成像方式的实用性提供了基于证据的建议,可以通知DRD分段系统的未来更新。尽管新的成像模式提供了丰富的信息,在实现这一潜力之前,仍然存在重大差距和未满足的研究需求。
■专有或商业披露可在本文末尾的脚注和披露中找到。
UNASSIGNED: To review the evidence for imaging modalities in assessing the vascular component of diabetic retinal disease (DRD), to inform updates to the DRD staging system.
UNASSIGNED: Standardized narrative review of the literature by an international expert workgroup, as part of the DRD Staging System Update Effort, a project of the Mary Tyler Moore Vision Initiative. Overall, there were 6 workgroups: Vascular Retina, Neural Retina, Systemic Health, Basic and Cellular Mechanisms, Visual Function, and Quality of Life.
UNASSIGNED: The Vascular Retina workgroup, including 16 participants from 4 countries.
UNASSIGNED: Literature review was conducted using standardized evidence grids for 5 modalities: standard color fundus photography (CFP), widefield color photography (WFCP), standard fluorescein angiography (FA), widefield FA (WFFA), and OCT angiography (OCTA). Summary levels of evidence were determined on a validated scale from I (highest) to V (lowest). Five virtual workshops were held for discussion and
consensus.
UNASSIGNED: Level of evidence for each modality.
UNASSIGNED: Levels of evidence for standard CFP, WFCP, standard FA, WFFA, and OCTA were I, II, I, I, and II respectively. Traditional vascular lesions on standard CFP should continue to be included in an updated staging system, but more studies are required before they can be used in posttreatment eyes. Widefield color photographs can be used for severity grading within the area covered by standard CFPs, although these gradings may not be directly interchangeable with each other. Evaluation of the peripheral retina on WFCP can be considered, but the method of grading needs to be clarified and validated. Standard FA and WFFA provide independent prognostic value, but the need for dye administration should be considered. OCT angiography has significant potential for inclusion in the DRD staging system, but various barriers need to be addressed first.
UNASSIGNED: This study provides evidence-based recommendations on the utility of various imaging modalities for assessment of the vascular component of DRD, which can inform future updates to the DRD staging system. Although new imaging modalities offer a wealth of information, there are still major gaps and unmet research needs that need to be addressed before this potential can be realized.
UNASSIGNED: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.