目的:评估宽视场光学相干断层扫描血管造影(WF-OCTA)不同同心区的毛细血管非灌注,并将非灌注(RNP)的比率与镰状细胞视网膜病变(SCR)的严重程度相关联。
方法:本回顾性研究,横断面研究包括接受WF-OCTA和超宽视野彩色眼底照相(UWF-CFP)的各种镰状细胞病(SCD)基因型患者的眼睛.眼睛被分组为无SCR,非增殖性SCR或增殖性SCR。在以中央凹为中心的不同视野(FOV)区域的WF-OCTA蒙太奇上评估RNP:0-10度圆,不包括中央凹无血管区,不包括视神经的10-30度圆圈,30-60度的圆,和完整的60度圆圈。
结果:纳入28例患者的42只眼。在每个SCR组内,FOV30-60部门的平均RNP高于所有其他部门(p<0.05)。所有部门的平均RNP在无SCR组和增殖性SCR组之间存在显着差异(p<0.05)。为了区分无SCR和无增殖性SCRFOV30-60具有良好的敏感性和特异性,分别为41.67%和93.33%,分别(截止RNP>22.72%,AUC=0.75,95%CI0.56-0.94,p=0.028)。为了区分非增殖性与增殖性SCR,FOV0-10具有良好的敏感性和特异性,分别为33.33%和91.67%,分别(截止值RNP>18.09,AUC=0.73,95%CI0.53至0.93,p=0.041)。为了辨别无SCR与增殖性SCR,所有部门均具有最佳的敏感性和特异性(p<0.05)。
结论:基于WFOCTA的RNP提供有关SCR的存在和严重程度的非侵入性诊断信息,并与某些FOV部门的疾病阶段相关。
OBJECTIVE: To assess the capillary non-perfusion in different concentric sectors on widefield optical coherence tomography angiography (WF-OCTA) and to correlate the ratio of non-perfusion (RNP) to the severity of sickle cell retinopathy (SCR).
METHODS: This retrospective, cross-sectional study included eyes of patients with various sickle cell disease (SCD) genotypes having undergone WF-OCTA and ultra-widefield color fundus photography (UWF-CFP). Eyes were grouped as no SCR, non-proliferative SCR or proliferative SCR. RNP was assessed on WF-OCTA montage in different field-of-view (FOV) sectors centered on the fovea: 0-10-degrees circle excluding the foveal avascular zone, the 10-30-degrees circle excluding the optic nerve, the 30-60-degrees circle, and the full 60-degrees circle.
RESULTS: Forty-two eyes of twenty-eight patients were included. Within each SCR group, mean RNP of the FOV 30-60 sector was higher than all other sectors (p < 0.05). Mean RNP of all sectors were significatively different between no SCR group and proliferative SCR group (p < 0.05). To distinguish no SCR versus non-proliferative SCR FOV 30-60 had a good sensitivity and specificity of 41.67% and 93.33%, respectively (cutoff RNP > 22.72%, AUC = 0.75, 95% CI 0.56-0.94, p = 0.028). To differentiate non-proliferative versus proliferative SCR, FOV 0-10 had good sensitivity and specificity of 33.33% and 91.67%, respectively (cutoff RNP > 18.09, AUC = 0.73, 95% CI 0.53 to 0.93, p = 0.041). To discern no SCR versus proliferative SCR, all sectors had optimal sensitivity and specificity (p < 0.05).
CONCLUSIONS: WF OCTA-based RNP provides non-invasive diagnostic information regarding the presence and severity of SCR, and correlates with disease stage in certain FOV sectors.