■使用平均OCT血管造影(OCTA)定位没有临床糖尿病性视网膜病变(DR)的糖尿病(DM)患者的早期毛细血管灌注缺陷。
■回顾性横断面研究。
■无DR的DM患者和健康对照。
■我们测量了全视网膜的灌注缺陷,浅表毛细血管丛(SCP),和深毛细血管丛(DCP)在平均3×3毫米OCTA图像上。灌注缺陷定义为距血管>30μm的视网膜组织的百分比,不包括中央凹无血管区(FAZ)。根据图像质量选择每个患者的一只眼睛。我们测量了旁凹区域的赤字,围绕FAZ的300μm,和围绕FAZ的300至1000μm。如果没有DR的DM与对照组相比,其中一个区域内的毛细血管层明显不同,我们进一步将灌注不足的位置描述为小动脉周围,静脉周围,或这两个区域之间的毛细血管。
■与对照组相比,无DR的DM患者灌注缺陷增加的位置。
■将16例健康对照者的16只眼与16例无DR的DM患者的16只眼进行了比较(年龄分别为45.1±10.7和47.4±15.2岁,P=0.64)。整个副凹和FAZ周围300至1000μm环中的中央凹无血管区面积和灌注缺陷在各组之间没有显着差异(均P>0.05)。在全视网膜厚度无DR的DM患者中,FAZ周围300μm的灌注缺陷显着增加,SCP,和DCP(均P<0.05)。在分析静脉周围时,小动脉周围,和毛细管区,仅静脉周围DCP灌注缺陷显著增加(无DR的DM为5.03±2.92%,对照组为2.73±1.97%,P=0.014)。
■无DR的DM患者的黄斑灌注缺陷在最接近FAZ的区域显著增加,主要在静脉周围深毛细血管。对这些早期变化的进一步研究可能会提高我们对糖尿病期间最容易受到血管损伤和破坏的毛细血管的理解。
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UNASSIGNED: To localize early capillary perfusion deficits in patients with diabetes mellitus (DM) without clinical diabetic retinopathy (DR) using averaged OCT angiography (OCTA).
UNASSIGNED: Retrospective cross-sectional study.
UNASSIGNED: Patients with DM without DR and healthy controls.
UNASSIGNED: We measured perfusion deficits in the full retina, superficial capillary plexus (SCP), and deep capillary plexus (DCP) on averaged 3 × 3-mm OCTA images. Perfusion deficits were defined as the percentage of retinal tissue located >30 μm from blood vessels, excluding the foveal avascular zone (FAZ). One eye from each patient was selected based on image quality. We measured deficits in the parafoveal region, the 300 μm surrounding the FAZ, and 300 to 1000 μm surrounding the FAZ. If a capillary layer within one of these regions was significantly different in DM without DR compared with controls, we further characterized the location of perfusion deficit as periarteriolar, perivenular, or the capillaries between these 2 zones.
UNASSIGNED: Location of increased perfusion deficits in patients with DM without DR compared with controls.
UNASSIGNED: Sixteen eyes from 16 healthy controls were compared with 16 eyes from 16 patients with DM without DR (age 45.1 ± 10.7 and 47.4 ± 15.2 years respectively, P = 0.64). Foveal avascular zone area and perfusion deficits in the entire parafovea and the 300 to 1000-μm ring around the FAZ were not significantly different between groups (P > 0.05 for all). Perfusion deficits in 300 μm around the FAZ were significantly increased in patients with DM without DR in full retinal thickness, SCP, and DCP (P < 0.05 for all). When analyzing the perivenular, periarteriolar, and capillary zones, only the perivenular DCP perfusion deficits were significantly increased (5.03 ± 2.92% in DM without DR and 2.73 ± 1.97% in controls, P = 0.014).
UNASSIGNED: Macular perfusion deficits in patients with DM without DR were significantly increased in the region nearest the FAZ, mainly at the perivenular deep capillaries. Further research on these early changes may improve our understanding of the capillaries most susceptible to vascular injury and disruption during diabetes.
UNASSIGNED: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.