扩展场OCT血管学生物标志物用于预测非增殖性糖尿病视网膜病变的临床显著结果
Xinyi Ding1, Francesco Romano1, Itika Garg2
1From the Harvard Retinal Imaging Lab (X.D., F.R., I.G., J.G., F.V., M.D.G., K.M.O., Y.C., Y.Z., C.F.B., I.S., M.S., M.J.F., J.B.M.), Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA; Retina Service (X.D., F.R., D.G.V., D.H., N.A.P., L.A.K., J.B.M.), Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
American journal of ophthalmology
|November 3, 2024
概括
非增殖性糖尿病视网膜病变 (NPDR) 眼睛具有不稳定的视网膜内微血管异常 (IRMA) 和更高的基线缺血,具有显著临床结果的风险增加. 扩展场SS-OCTA可以帮助预测高风险患者.
科学领域:
- 眼科医生 眼科 眼科
- 医疗成像医学成像
背景情况:
- 糖尿病视网膜病变 (DR) 是导致视力丧失的主要原因.
- 早期检测和风险分层对于管理DR至关重要.
- 非增殖性糖尿病视网膜病变 (NPDR) 需要监测是否进展到危及视力的并发症.
研究的目的:
- 评估扩展现场扫描源光学一致性断层扫描血管学 (SS-OCTA) 生物标志物的预测价值,以评估NPDR中的显著临床结果.
- 为了识别显示DR进展或并发症风险较高的成像特征.
主要方法:
- 追溯病例对照研究涉及88只眼睛,来自57名参与者的NPDR.
- 连续的SS-OCTA扫描 (12x12mm) 在基线和随访期间分析了内微血管异常 (IRMA) 和非 perfusion 缺血指数 (ISI).
- 显著的临床结果包括DR进展,中心涉及的糖尿病黄斑胀 (CI-DME),以及启动PRP或抗VEGF治疗.
- 混合效应的考克斯回归模型被用于分析.
主要成果:
- 在平均25.1个月的随访期间,19.3%的眼睛出现了显著的临床结果.
- 随访期间不稳定的IRMA (HR=3.88) 和更高的基线ISI (HR=1.05) 与不良结果有显著的关联.
- 这些关联在调整年龄,糖尿病持续时间和先前的抗VEGF治疗后仍然显著.
结论:
- 在NPDR眼中,不稳定的IRMA和较高的基线缺血预测了显著临床结果的更大风险.
- 扩展场SS-OCTA成像为DR分期提供了宝贵的预后信息.
- 这些发现支持使用SS-OCTA来识别需要更密切监测或干预的高风险NPDR患者.
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