目的:在本研究中,在中等年龄相关性黄斑变性的视网膜色素上皮和光感受器(PR)的量化中,采用不同轴向分辨率研究了高分辨率光学相干断层扫描(OCT)设备的视网膜特征可视化差异.
方法:患者使用标准SPECTRALISHRA+OCT和研究性高分辨率OCT设备(均由海德堡工程,海德堡,德国)。玻璃疣,视网膜色素上皮,和PR层使用经过验证的基于人工智能的算法进行分割,然后进行手动校正。计算所有患者的厚度和玻璃疣图。设备之间的损耗和厚度测量进行了比较,玻璃疣与非玻璃疣地区,和早期治疗糖尿病视网膜病变研究子领域使用混合效应模型。
结果:纳入28例中年黄斑变性患者的33只眼。标准OCT的标准化PR完整性损失显著高于4.6%,而高分辨率OCT为2.5%。中央和旁凹PR完整性损失大于中央凹损失(P<0.05)。在高分辨率OCT和非玻璃疣区域,光感受器厚度增加(P<0.001)。标准OCT显示视网膜色素上皮增厚,玻璃疣以上(P<0.01)。
结论:我们的研究表明,高分辨率OCT能够以更高的精度识别中年相关性黄斑变性中所研究层的状况。这种改进的体内成像技术可能会促进我们对年龄相关性黄斑变性的病理生理学和进展的理解。
OBJECTIVE: In this study, differences in retinal feature visualization of high-resolution optical coherence tomography (OCT) devices were investigated with different axial resolutions in quantifications of retinal pigment epithelium and photoreceptors (PRs) in intermediate age-related macular degeneration.
METHODS: Patients were imaged with standard SPECTRALIS HRA + OCT and the investigational High-Res OCT device (both by Heidelberg Engineering, Heidelberg, Germany). Drusen, retinal pigment epithelium, and PR layers were segmented using validated artificial intelligence-based algorithms followed by manual corrections. Thickness and drusen maps were computed for all patients. Loss and thickness measurements were compared between devices, drusen versus nondrusen areas, and early treatment diabetic retinopathy study subfields using mixed-effects models.
RESULTS: Thirty-three eyes from 28 patients with intermediate age-related macular degeneration were included. Normalized PR integrity loss was significantly higher with 4.6% for standard OCT compared with 2.5% for High-Res OCT. The central and parafoveal PR integrity loss was larger than the perifoveal loss (P < 0.05). Photoreceptor thickness was increased on High-Res OCT and in nondrusen regions (P < 0.001). Retinal pigment epithelium appeared thicker on standard OCT and above drusen (P < 0.01).
CONCLUSIONS: Our study shows that High-Res OCT is able to identify the condition of investigated layers in intermediate age-related macular degeneration with higher precision. This improved in vivo imaging technology might promote our understanding of the pathophysiology and progression of age-related macular degeneration.