.: ORİJİNAL ARAŞTIRMA
Diyabetik Retinopatisi Olan Hastalarda Koryokapillaris Sinyal Boşlukları
Choriocapillaries Signal Voids in Patients with Diabetic Retinopathy
Turkiye Klinikleri J Ophthalmol. 2019;28(4):232-8
doi: 10.5336/ophthal.2018-64428
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Nonproliferatif diyabetik retinopatisi (NPDRP) olan hastalarda optik koherens tomografi anjiyografinin (OKTA) flow değerlendirme aracı kullanılarak koryokapillaris flow alanlarını değerlendirmek ve sağlıklı bireyler ile karşılaştırmaktır. Gereç ve Yöntemler: Bu retrospektif araştırma kapsamında, kliniğimiz retina biriminde Diyabetik Retinopati Erken Tedavi Çalışması'na göre çok hafif, hafif ve orta NPDRP nedeni ile izlem altında olan hastalar ve genel polikliniğe rutin göz muayenesi için başvuranlar değerlendirildi. Hastaların en iyi düzeltilmiş görme keskinlikleri, ön ve arka segment muayeneleri, göz içi basınçları, aksiyel uzunlukları, merkezi kornea kalınlıkları ve refraktif hata ölçümleri kaydedildi. Aynı zamanda, spektral domain optik koherens tomografi (SD-OKT), fluoresein anjiyografi ve OKTA görüntülemeleri yapıldı. Tüm OKTA görüntülemeleri RTVue XR Avanti cihazının AngioVue yazılımı kullanılarak (Opto-Vue, Inc., Fremont, CA, Versiyon 2017.1.0.151) ve 6×6 görüntüler alarak gerçekleştirildi. Cihazın flow değerlendirme aracı ile merkezi foveal avasküler zon olan 1 mm, 2 mm ve 3 mm yarıçaplı sabit daireler içinde kalan bölgelerde koryokapillarisin flow alanı hesaplandı. Bulgular: Otuz (21 kadın, 9 erkek) bireyin 30 gözü çalışma grubu, 30 (20 kadın, 10 erkek) sağlıklı olgunun 30 gözü kontrol grubu olarak incelendi. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 58,82±3,50 ve 57,65±5,84 yıl olarak bulundu. OKTA ölçümlerinde NPDRP'si olan grubun her üç yarıçaplı alan içindeki koryokapillaris flow alanları kontrol grubuna göre istatistiksel anlamlı olarak daha düşük bulunmuştur. (sırasıyla p=0,004, p=0,004 ve p=0,008). Sonuç: Sonuç olarak bu çalışma, görüntüleme metodu olarak OKTA kullanılarak gerçekleştirilmiş ve NPDRP'si olan hastalarda koryokapillaris flow alanının sağlıklı bireylere göre daha düşük olduğunu göstermiştir.
Anahtar Kelimeler: Diyabetik koroidopati; optik koherens tomografi anjiyografi
Amaç: Nonproliferatif diyabetik retinopatisi (NPDRP) olan hastalarda optik koherens tomografi anjiyografinin (OKTA) flow değerlendirme aracı kullanılarak koryokapillaris flow alanlarını değerlendirmek ve sağlıklı bireyler ile karşılaştırmaktır. Gereç ve Yöntemler: Bu retrospektif araştırma kapsamında, kliniğimiz retina biriminde Diyabetik Retinopati Erken Tedavi Çalışması'na göre çok hafif, hafif ve orta NPDRP nedeni ile izlem altında olan hastalar ve genel polikliniğe rutin göz muayenesi için başvuranlar değerlendirildi. Hastaların en iyi düzeltilmiş görme keskinlikleri, ön ve arka segment muayeneleri, göz içi basınçları, aksiyel uzunlukları, merkezi kornea kalınlıkları ve refraktif hata ölçümleri kaydedildi. Aynı zamanda, spektral domain optik koherens tomografi (SD-OKT), fluoresein anjiyografi ve OKTA görüntülemeleri yapıldı. Tüm OKTA görüntülemeleri RTVue XR Avanti cihazının AngioVue yazılımı kullanılarak (Opto-Vue, Inc., Fremont, CA, Versiyon 2017.1.0.151) ve 6×6 görüntüler alarak gerçekleştirildi. Cihazın flow değerlendirme aracı ile merkezi foveal avasküler zon olan 1 mm, 2 mm ve 3 mm yarıçaplı sabit daireler içinde kalan bölgelerde koryokapillarisin flow alanı hesaplandı. Bulgular: Otuz (21 kadın, 9 erkek) bireyin 30 gözü çalışma grubu, 30 (20 kadın, 10 erkek) sağlıklı olgunun 30 gözü kontrol grubu olarak incelendi. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 58,82±3,50 ve 57,65±5,84 yıl olarak bulundu. OKTA ölçümlerinde NPDRP'si olan grubun her üç yarıçaplı alan içindeki koryokapillaris flow alanları kontrol grubuna göre istatistiksel anlamlı olarak daha düşük bulunmuştur. (sırasıyla p=0,004, p=0,004 ve p=0,008). Sonuç: Sonuç olarak bu çalışma, görüntüleme metodu olarak OKTA kullanılarak gerçekleştirilmiş ve NPDRP'si olan hastalarda koryokapillaris flow alanının sağlıklı bireylere göre daha düşük olduğunu göstermiştir.
Anahtar Kelimeler: Diyabetik koroidopati; optik koherens tomografi anjiyografi
ABSTRACT
Objective: To evaluate the choriocapillaris flow areas of patients with non-proliferative diabetic retinopathy (NPDRP) using optical coherence tomography angiography (OCTA) flow assesment tool and to compare the results with those obtained in healthy controls. Material and Methods: In this retrospective study, patients who were followed up as having for very mild, mild and moderate NPDRP according to Early Treatment Diabetic Retinopathy Study in the retina unit of our clinic and patients who applied to general outpatient clinic for routine ophthalmologic examination were evaluated. The best corrected visual acuity values, anterior and posterior segment examinations, intraocular pressure values, axial lengths, central corneal thicknesses and refractive error measurements of patients were recorded. At the same time spectral domain optical coherence tomography (SD-OCT), fluorescein angiography and OCTA imaging were performed. All OCTA images were performed using the AngioVue software of RTVue XR Avanti (Opto-Vue, Inc., Fremont, CA, Version 2017.1.0.151) and 6×6 images were taken. The choriocapillaris flow area was calculated with flow assessment tool of OCTA in the regions of fixed circles with 1 mm, 2 mm and 3 mm radii with center of foveal avascular zone. Results: 30 eyes of 30 (21 females, 9 males) patients were examined as study group and 30 eyes of 30 (20 females 10 males) healthy subjects were examined as control group. The mean age of the study and control groups were 58.82±3.50 and 57.65±5.84 years, respectively. In OCTA measurements, choriocapillaris flow areas in all regions with three radius were found to be statistically lower in NPDRP group than the control group. (p=0.004, p=0.004 and p=0.008, respectively). Conclusion: In conclusion, this study was performed using OCTA as an imaging method and showed that choriocapillaris flow area was lower in patients with NPDRP than healthy subjects.
Keywords: Diabetic choroidopathy; optical coherence tomography angiography
Objective: To evaluate the choriocapillaris flow areas of patients with non-proliferative diabetic retinopathy (NPDRP) using optical coherence tomography angiography (OCTA) flow assesment tool and to compare the results with those obtained in healthy controls. Material and Methods: In this retrospective study, patients who were followed up as having for very mild, mild and moderate NPDRP according to Early Treatment Diabetic Retinopathy Study in the retina unit of our clinic and patients who applied to general outpatient clinic for routine ophthalmologic examination were evaluated. The best corrected visual acuity values, anterior and posterior segment examinations, intraocular pressure values, axial lengths, central corneal thicknesses and refractive error measurements of patients were recorded. At the same time spectral domain optical coherence tomography (SD-OCT), fluorescein angiography and OCTA imaging were performed. All OCTA images were performed using the AngioVue software of RTVue XR Avanti (Opto-Vue, Inc., Fremont, CA, Version 2017.1.0.151) and 6×6 images were taken. The choriocapillaris flow area was calculated with flow assessment tool of OCTA in the regions of fixed circles with 1 mm, 2 mm and 3 mm radii with center of foveal avascular zone. Results: 30 eyes of 30 (21 females, 9 males) patients were examined as study group and 30 eyes of 30 (20 females 10 males) healthy subjects were examined as control group. The mean age of the study and control groups were 58.82±3.50 and 57.65±5.84 years, respectively. In OCTA measurements, choriocapillaris flow areas in all regions with three radius were found to be statistically lower in NPDRP group than the control group. (p=0.004, p=0.004 and p=0.008, respectively). Conclusion: In conclusion, this study was performed using OCTA as an imaging method and showed that choriocapillaris flow area was lower in patients with NPDRP than healthy subjects.
Keywords: Diabetic choroidopathy; optical coherence tomography angiography
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