| Part ? COMPARISON OF SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY FOR INTRA-RETINAL LAYERS THICKNESS MEASUREMENTS IN HEALTHY AND DIABETIC EYES OF ADULT CHINESE PERSONSPURPOSE: To compare the intra-retinal layers thickness between eyes with no or mild diabetic retinopathy(DR)and age-matched controls by spectral domain optical coherence tomography(SD-OCT).METHODS: Cross-sectional observative analysis study.High-resolution macular volume scans(30° × 25°)were obtained in 133 type 2 diabetes mellitus(T2DM)with NDR,42 T2 DM with mild DR and 115 healthy controls.Mean thickness was measured in all 9 Early Treatment Diabetic Retinopathy Study(ETDRS)sectors for 8 separate layers,inner retinal layer(IRL),outer retinal layer(ORL)and total retinal(TR)after automated segmentation.An ETDRS grid consists of three concentric circles of 1-,3-,and 6-mm diameter.The superior,inferior,temporal,and nasal sector of the 3-,and 6-mm circle was designated for S3,I3,T3,N3,S6,I6,T6,and N6.Linear regression analyses were conducted to evaluate the associations between intra-retinal layer thicknesses,age,diabetes duration,fast blood glucose and Hb A1 c.RESULTS: Mean age and duration of T2 DM were 61.1 and 13.7 years,respectively;Although no significant differences in the average volume of total retina and outer retinal layer among groups were observed,Significant differences were found in the volume and sectorial thicknesses of inner plexiform layer(IPL),outer plexiform layer(OPL)and inner retinal layer(IRL)among groups.The thicknesses of IPL(S3,T3,S6,I6 and T6 sectors sectors),and the IRL(S6 sectors)were decreased in NDR compared with controls(P < 0.05).The thicknesses of OPL(S3,N3,S6and N6)were thinner in NDR than mild DR(P < 0.05).The average IPL thickness was significantly negative correlated with age and the duration of diabetes.CONCLUSION: The assessment of the intra-retinal layers thickness showed a significantly decreased in IPL and inner retinal thickness in Chinese adults with T2 DM,even without visible microvascular signs of DR.Part ? THE INTERCHANGEABILITY AND REPEATABILITY OF MACULAR PERFUSION PARAMETERS IN EARLY DIABETIC RETINOPATHY USING OCT ANGIOGRAPHYPURPOSE: To investigate the Interchangeability and repeatability of macular perfusion parameters in early diabetic retinopathy using OCT angiographyMETHODS:46 patients(46 eyes)diagnosed with mild NPDR were included from April 2017 to June 2017.There were 24 males and 22 females,with 20 left eyes and 26 right eyes.The mean age was 59.16 + 10.32(57-76).Two macular scan sizes: 3×3mm and 6×6mm were performed by the same operator,and the same test was performed by another operator.The superficial retinal layer(SRL)and deep retinal layer(DRL)in the foveal avascular zone(FAZ)(mm)and vessel density VD(%)were quantified.The Interchangeability of the two scan sizes and the repeatability of the same scan size are also evaluated.RESULTS: A total of 40 eyes in 28 subjects were included(16 men and 12 women,mean age 61.2 ± 10.3 years).The mean intraclass correlation coeffcient(ICC)between 3×3mm and 6×6mm scan size are as followed:0.910(0.826-0.937)and 0.821(0.731-0.933)for FAZ in SRL and DRL,0.823(0.699-0.907)and 0.812(0.680-0.908)for VD% SRL and DRL.The mean ICC between two measurements from the inter-rater of 3×3mm FAZ area and VD% in SRL and DRL were 0.866(0.793-0.939),0.832(0.736-0.917),0.790(0.560-0.906)and 0.736(0.515-0.878),respectively.CONCLUSIONS: The use of OCTA in two scanning sizes to measure foveal avascular zone(FAZ)and foveal vascular flow area density(VD)of early diabetic retinopathy has good Interchangeability and repeatability.Part ? RELATIONSHIP AMONG FOVEAL AVASCULAR ZONE AREA,VESSEL DENSITY,FOVEAL GANGLION CELL LAYER THICKNESS AND VISUAL ACUITY IN DIABETIC RETINOPATHYPURPOSE: To evaluate the correlations in the foveal avascular zone area(FAZ),vessel density(VD),foveal ganglion cell layer(GCC)thickness with visual acuity(VA)using optical coherence tomography angiography(OCTA).METHODS: Observational case series study.A total of 60 eyes from 60 patients with diabetic mellitus(DM),including 28 eyes with DR(DR group)and 32 eyes without DR(NDR group).Additionally,20 age-marched normal people were included as the control group.OCTA was performed using an NIDEK RS-3000 Advance device.Retinal capillary VD,FAZ area and GCC thickness were measured in the foveal regions(3×3mm).RESULTS: The mean FAZ area(mm2)of superficial layer in the control group,NDR group and DR group was enlarged : 0.30 ± 0.05,0.38 ± 0.11 and 0.43 ± 0.11,P<0.001.Compared with the control group,the average FAZ area in the DRL layer of NDR group and DR group was also significantly greater,but Avg GCC thickness and the mean VD in both the superficial and deep layer was lower than that of the control group(P<0.05).In all eyes,the logarithm of the minimum angle of resolution(Log MAR)visual acuity was significantly positive correlation with mean FAZ area in both the superficial(r= 0.59;P < 0.01)and deep(r= 0.46;P < 0.001).A negative correlation was found between log MAR VA and Avg GCC(r=-0.42,P < 0.001),VD% in both the superficial(r=-0.42,P<0.001)and deep(r=-0.44,P<0.001)layers.There was a statistically significant negative correlation between the Avg GCC thickness and FAZ area in the superficial(r =-0.37,P<0.001)and deep(r =-0.49,P<0.001)layers.CONCLUSIONS: The FAZ area,mean VD% and GCC thickness in DR patients were differed compared with healthy controls.The log MAR VA was correlated with FAZ area,VD% and Avg GCC thickness.Part ? CLINICAL APPLICATION OF MULTICOLOUR SCANNING LASER IMAGING IN DIABETIC RETINOPATHYPURPOSE: To compare the visualization of the lesions of diabetic retinopathy(DR)using Multicolour scanning laser imaging(MSLI)and conventional colour fundus photography(CFP).METHODS: The paired images of diabetic patients who underwent same-day MSLI and CFP examinations were reviewed.Combined multicolour(MC)images were acquired simultaneously using three laser wavelengths: blue reflectance(BR,?= 488 nm),green reflectance(GR,?= 515 nm)and infrared reflectance(IR,?=820 nm).The number of positive DR lesions was calculated using fundus fluorescein angiography as the reference standard.The visibility of the microaneurysms(Mas)was graded using a scale,and the number of Mas for each method was counted by two masked readers.RESULTS: Eighty eyes of 42 diabetic patients were included.The number of positive Mas,diabetic macular oedema(DME)and epiretinal membranes(EMRs)were significantly higher with MC than CFP(P<0.05),while the numbers of cotton wool spots,haemorrhages,hard exudates,venous beading and abnormal new vessels were not significantly different(P>0.05).Mas and EMR were most effectively detected on GR images,and an elevated greenish shift was clearly visualized in patients with DME on the MC images.The average grading score for Mas visualization was significantly higher with MC(1.50±0.71)and GR(1.55±0.69)than with CFP(0.95±0.81).The average number of Mas was also significantly higher with MC(11.41 ± 14.02)and GR(11.93 ± 13.43)than with CFP(6.43 ±9.39).CONCLUSIONS: MSLI can effectively visualize Mas and other pathological lesions of DR compared with CFP.MSLI with superior resolution may be a useful complement for DME and EMR detection. |
PDF Full Text Request