Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Nonproliferatif Diyabetik Retinopatisi Olan Hastalarda Optik Koherens Tomografi Anjiyografi FAZ Ölçekleme Uygulaması Bulguları
FAZ Assesment Tool Findings in Patients with Non-proliferative Diabetic Retinopathy Via Optic Coherence Tomography Angiography
Yasin Şakir GÖKERa, Hasan KIZILTOPRAKa, Esat YETKİNa, Kemal TEKİNb
aGöz Hastalıkları Kliniği, Ulucanlar Göz Eğitim ve Araştırma Hastanesi, Ankara, TÜRKİYE
bGöz Hastalıkları Kliniği, Van Erciş Devlet Hastanesi, Van, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2019;28(1):43-51
doi: 10.5336/ophthal.2018-61137
Article Language: TR
Full Text
ÖZET
 Amaç: Nonproliferatif diyabetik retinopatisi olan (NPDRP) hastalarda optik koherens tomografi anjiyografi(OKTA) kullanarak foveal avasküler zon (FAZ) alanı, FAZ çevresi, FAZ'ın dairesellik indeksi (Dİ), foveal dansite (FD) ve makuler kapiller pleksusların vasküler yoğunluklarının yaş ve cinsiyet uyumlu normal bireyler ile karşılaştırmak. Gereç ve Yöntemler: Retina kliniğimizde hafif-orta NPDRP olarak izlem altında olan hastalar incelendi. Çalışma kapsamına alınma kriteri, en iyi düzeltilmiş görme keskinliğinin en az 20/20 olması olarak belirlendi. Bireyler OKTA'nın FAZ, non-flow ve dansite ölçekleme uygulaması ile görüntülendi. Düşük görüntü kalitesi olan hastalar ve kistoid maküler değişiklikler nedeni ile segmentasyon hatası ve bozulmuş retinal anatomik özellikleri olanlar çalışma dışında bırakıldı. FAZ parametreleri ve yüzeyel (YKP) ve derin kapiller pleksusların (DKP) vasküler dansite değerleri ölçüldü. Bulgular: 24 olgu NPDRP grubunda ve 26 hasta kontrol grubunda olmak üzere 50 bireyin 50 gözü çalışmaya dâhil edildi. Yüzeyel kapiller pleksusdaki FAZ alanı, tüm retina FAZ alanı, FAZ çevresi ve Dİ NPDRP grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu. Ayrıca, FAZ ölçekleme uygulamasındaki FD NPDRP grubunda kontrol grubuna göre anlamlı olarak düşük bulundu. Sonuç: OKTA FAZ alanı, FAZ çevresi, FAZ'ın dairesellik indeksi, foveal dansite ve makuler kapiller pleksusların damarsal yoğunlukları hakkında niceliksel veriler sağlamaktadır. Foveal dansite NPDRP'si olan hastalarda OKTA'nın dansite ölçekleme uygulaması ile değil FAZ ölçekleme uygulaması ile incelenmelidir.

Anahtar Kelimeler: Diyabetik retinopati; foveal avasküler zon; optik koherens tomografi
ABSTRACT
 Objective: To compare the foveal avascular zone (FAZ) area, FAZ perimeter, acircularity index of FAZ (AI), foveal density (FD) and vessel density of macular capillary plexuses in patients with non-proliferative diabetic retinopathy (NPDRP) using optical coherence tomography angiography (OCTA) with age and sex matched controls. Material and Methods: The patients with mild to moderate NPDRP who were followed at our retina clinic were evaluated. Inclusion criteria was best corrected visual acuity of at least 20/20. The subjects were screened via OCTA FAZ, nonflow and density assesment tool. Patients with poor image quality and presence of cystoid macular changes causing disrupted retinal anatomic features and segmentation errors were excluded. FAZ parameters and vessel density values of both superficial (SCP) and deep capillary plexuses (DCP) were measured. Results: This study included 50 eyes of 50 subjects: 24 subjects in NPDRP group and 26 subjects in control group. The FAZ area in SCP, FAZ area in whole retina, FAZ perimeter and AI were significantly higher in the NPDRP group than in the control group. Additionally, the FD in FAZ assesment tool was significantly lower in the NPDRP group than in the control group. Conclusion: OCTA provides quantitative values about FAZ area, FAZ perimeter, AI of FAZ, FD and vessel density of macular capillary plexuses. Foveal density should be evaluated with the FAZ assessment tool of OCTA, not with the density assessment tool in patients with NPDRP.

Keywords: Diabetic retinopathy; foveal avascular zone; optical coherence tomography
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