光相干断层扫描血管成像测量早期糖尿病视网膜病变黄斑区灌注参数的一致性及可重复性研究  

The consistency and reproducibility of macular perfusion parameters in early diabetic retinopathy using optical coherence tomography angiography

作　　者：王相宁[1] 赵佳玮 李淑婷[1] 杜新华[1] 吴强[1] Wang Xiangning;Zhao Jiawei;Li Shuting;Du Xinhua;Wu Qiang(Department of Ophthalmology, Shanghai Jiaotong University Affiliated Sixth People＇s Hospital, Shanghai 200233, Chin)

机构地区：[1]上海交通大学附属上海市第六人民医院眼科,200233

出　　处：《中华眼底病杂志》2018年第4期323-327,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：上海市科学技术委员会科研计划项目（16DZ0501100）

摘　　要：目的观察光相干断层扫描血管成像（OCTA）对早期糖尿病视网膜病变（DR）黄斑区灌注参数测量的一致性和可重复性。方法横断面前瞻性临床研究。临床检查确诊的轻度非增生型DR患者46例46只眼纳入研究。其中，男性24例24只眼，女性22例22只眼；平均年龄（59.16±10.32）岁。由同一名检查者采用OCTA黄斑容积3 mm×3 mm、6 mm×6mm扫描程序扫描黄斑区，隔日由另一名检查者完成相同检查。测量视网膜浅层（SRL）、视网膜深层（DRL）黄斑中心凹无血管区面积（FAZ）和黄斑区血管密度（VD）。取两名检查者的平均值作为检查结果。可靠性分析比较两种不同扫描程序测量FAZ、VD的一致性以及同一扫描程序不同检查者测量的可重复性。组内相关系数（ICC）＞0.80，一致性较好；0.4～0.8，中等程度一致性；＜0.40，一致性较差。结果3 mm×3 mm、6 mm×6 mm扫描程序，SRL、DRL的FAZ分别为（0.39±0.13）、（0.74±0.22）mm^2和（0.42±0.15）、（0.89±0.23）mm^2；VD分别为（32.23±2.86）%、（43.73±4.64）%和（31.91±3.01）%、（45.12±5.49）%。一致性分析结果显示，SRL、DRLFAZ的ICC为分别为0.920、0.812，VD的ICC分别为0.833、0.830；一致性均较好。同一扫描程序不同检查者可重复性分析SRL FAZ、VD的一致性均较好。结论OCTA黄斑容积3 mm×3 mm、6 mm×6 mm扫描程序测量早期DR患眼FAZ、VD具有较好的一致性和可重性。ObejctiveTo investigate the consistency and reproducibility of macular perfusion parameters in early diabetic retinopathy （DR） using optical coherence tomography angiography （OCTA）.MethodsA prospective cross-sectional observational study. Forty-six patients （46 eyes） diagnosed with mild nonproliferative DR were included in this study. There were 24 males and 22 females, with the mean age of 59.16±10.32 years. Two macular scan sizes of 3 mm×3 mm and 6 mm×6 mm 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） and vessel density （VD） were quantified. The consistency of the two scan sizes and the reproducibility of the same scan size were also evaluated. The consistency was determined by the intraclass correlation coefficient （ICC）. If the intraclass correlation coefficient （ICC）〉0.80, consistency was good; if 0.4≤ICC〈0.8, consistency was general; if ICC〈0.40, consistency was poor.ResultsIn the 3 mm×3 mm and 6 mm×6 mm scanning sizes, the mean results of the two examiners were calculated. The FAZ of SRL were 0.39±0.13 mm^2 and 0.42±0.15 mm^2, FAZ of DRL were 0.74±0.22 mm^2 and 0.89±0.23 mm^2. The VD of SRL were （32.23±2.86）% and （31.91±3.01）%, VD of DRL were （43.73±4.64）% and （45.12±5.49）%. The consistency analysis showed that the ICC of SRL-FAZ and DRL-FAZ were 0.920 and 0.812, respectively; the ICC of VD were 0.833 and 0.830, respectively. The consistency was good. The reproducibility analysis of different examiners in the same scan size was better in the consistency of SRL FAZ and VD.ConclusionOCTA in two scanning sizes to measure FAZ and VD of early DR has good consistency and reproducibility.

关 键 词：糖尿病视网膜病变 体层摄影术 光学相干 结果可重复性 黄斑区灌注参数 

分 类 号：R774.1[医药卫生—眼科] R587.26[医药卫生—临床医学]