دورية أكاديمية
Assessment of Parafoveal Diabetic Macular Ischemia on Optical Coherence Tomography Angiography Images to Predict Diabetic Retinal Disease Progression and Visual Acuity Deterioration.
| العنوان: | Assessment of Parafoveal Diabetic Macular Ischemia on Optical Coherence Tomography Angiography Images to Predict Diabetic Retinal Disease Progression and Visual Acuity Deterioration. |
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| المؤلفون: | Yang D; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China., Tang Z; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China., Ran A; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China., Nguyen TX; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China., Szeto S; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China., Chan J; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China., Wong CYK; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China., Hui V; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China., Tsang K; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China., Chan CKM; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China., Tham CC; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; Hong Kong Eye Hospital, Hong Kong Special Administrative Region, China., Sivaprasad S; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom., Lai TYY; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.; 2010 Eye & Cataract Centre, Hong Kong Special Administrative Region, China., Cheung CY; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. |
| المصدر: | JAMA ophthalmology [JAMA Ophthalmol] 2023 Jul 01; Vol. 141 (7), pp. 641-649. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101589539 Publication Model: Print Cited Medium: Internet ISSN: 2168-6173 (Electronic) Linking ISSN: 21686165 NLM ISO Abbreviation: JAMA Ophthalmol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Chicago, IL : American Medical Association, [2013]- |
| مواضيع طبية MeSH: | Diabetic Retinopathy*/physiopathology , Macular Edema*/physiopathology , Diabetes Mellitus*, Humans ; Female ; Middle Aged ; Male ; Fluorescein Angiography/methods ; Tomography, Optical Coherence/methods ; Cohort Studies ; Artificial Intelligence ; Capillaries/physiopathology ; Retrospective Studies ; Visual Acuity ; Disease Progression ; Ischemia/diagnosis |
| مستخلص: | Importance: The presence of diabetic macular ischemia (DMI) on optical coherence tomography angiography (OCTA) images predicts diabetic retinal disease progression and visual acuity (VA) deterioration, suggesting an OCTA-based DMI evaluation can further enhance diabetic retinopathy (DR) management. Objective: To investigate whether an automated binary DMI algorithm using OCTA images provides prognostic value on DR progression, diabetic macular edema (DME) development, and VA deterioration in a cohort of patients with diabetes. Design, Setting, and Participants: In this cohort study, DMI assessment of superficial capillary plexus and deep capillary plexus OCTA images was performed by a previously developed deep learning algorithm. The presence of DMI was defined as images exhibiting disruption of fovea avascular zone with or without additional areas of capillary loss, while absence of DMI was defined as images presented with intact fovea avascular zone outline and normal distribution of vasculature. Patients with diabetes were recruited starting in July 2015 and were followed up for at least 4 years. Cox proportional hazards models were used to evaluate the association of the presence of DMI with DR progression, DME development, and VA deterioration. Analysis took place between June and December 2022. Main Outcomes and Measures: DR progression, DME development, and VA deterioration. Results: A total of 321 eyes from 178 patients were included for analysis (85 [47.75%] female; mean [SD] age, 63.39 [11.04] years). Over a median (IQR) follow-up of 50.41 (48.16-56.48) months, 105 eyes (32.71%) had DR progression, 33 eyes (10.28%) developed DME, and 68 eyes (21.18%) had VA deterioration. Presence of superficial capillary plexus-DMI (hazard ratio [HR], 2.69; 95% CI, 1.64-4.43; P < .001) and deep capillary plexus-DMI (HR, 3.21; 95% CI, 1.94-5.30; P < .001) at baseline were significantly associated with DR progression, whereas presence of deep capillary plexus-DMI was also associated with DME development (HR, 4.60; 95% CI, 1.15-8.20; P = .003) and VA deterioration (HR, 2.12; 95% CI, 1.01-5.22; P = .04) after adjusting for age, duration of diabetes, fasting glucose, glycated hemoglobin, mean arterial blood pressure, DR severity, ganglion cell-inner plexiform layer thickness, axial length, and smoking at baseline. Conclusions and Relevance: In this study, the presence of DMI on OCTA images demonstrates prognostic value for DR progression, DME development, and VA deterioration. |
| التعليقات: | Comment in: JAMA Ophthalmol. 2023 Jul 1;141(7):649-650. (PMID: 37227709) |
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| تواريخ الأحداث: | Date Created: 20230525 Date Completed: 20230721 Latest Revision: 20240526 |
| رمز التحديث: | 20240526 |
| مُعرف محوري في PubMed: | PMC10214181 |
| DOI: | 10.1001/jamaophthalmol.2023.1821 |
| PMID: | 37227703 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2168-6173 |
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| DOI: | 10.1001/jamaophthalmol.2023.1821 |