光学相干断层扫描血管成像技术在糖尿病视网膜病变中的研究进展
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v7i3.14435
Abstract
糖尿病视网膜病变(Diabetic Retinopathy,DR)作为全球成年人失明的主要病因之一,其早期诊断与精准治疗对改善患者预后至关重要。光学相干断层扫描血管成像(Optical Coherence Tomography Angiography,OCTA)凭借无创性、三维血管可视化及量化分析优势,成为DR研究的关键技术。本文系统阐述OCTA的技术原理、核心优势、国内外研究进展、当前局限性及未来发展方向,为DR的临床诊疗与机制研究提供参考。
Keywords
光学相干断层扫描血管成像;糖尿病视网膜病变
Full Text
PDF - Viewed/Downloaded: 0 TimesReferences
[1] 叶清清,龚维坤.宽视野SS-OCTA在糖尿病视网膜病变早期筛查的研究进展[J].现代实用医学,2024,36(12):1677-80.
[2] 张树军.不同分期DR患者视网膜神经纤维层厚度和视网膜厚度及血流密度的变化[J].国际眼科杂志,2025,25(05):714-7.
[3] GAO S S, LIU G J, HUANG D, et al. Optimization of the split-spectrum amplitude-decorrelation angiography algorit hm on a spectral optical coherence tomography system [J].Optics Letters,2015,40(10):2305-8.
[4] AMINI S,SAHEBKAR A, DEHGHANI A,et al.The effect of cur cumin-piperine on cardiometabolic, inflammatory and oxidati ve stress factors and macular vascular density in optical coherence tomography angiography (OCTA) in patients with non-proliferative diabetic retinopathy: Study protocol for a randomized, double-blind controlled trial[J].Avicenna Journ al of Phytomedicine,2023,13(2):153-64.
[5] BELENJE A,RANI P K.Role of wide-angle optical cohere nce tomography angiography in the detection of clinically non-apparent neovascularisation in proliferative diabetic retinopathy[J].Bmj Case Reports,2020,13(9).
[6] FALAVARJANI K G,SARRAF D.Optical coherence tomograp hy angiography of the retina and choroid;current applications and future directions [J]. Journal of Current Ophthalmology,2017,29(1):1-4.
[7] AHMED M A A,ABDELHALEEM A S.Evaluation of Microvasc ular and Visual Acuity Changes in Patients with Early Diabetic Retinopathy: Optical Coherence Tomography Angiography Stu dy[J].Clinical Ophthalmology,2022,16:429-40.
[8] 曾少杰,谢怀林,张昀昀.OCTA评估黄斑中心凹无血管区参数对早期糖尿病视网膜病变的诊断价值[J].国际眼科杂志,2024,24(09):1471-5.
[9] YOON Y S,WOO J E, WOO J M. Optical Coherence Tomography Angiography According to Severity of Diabetic Retinopathy [J].Jo urnal of the Korean Ophthalmological Society,2017,58 (6):653-62.
[10] 纪风涛.基于扫频源光学相干断层血管成像糖尿病脉络膜病变的研究[D].安徽:安徽医科大学,2024.
[11] 郝泽宇,刘杰,韩雪.OCTA检查结果在不同分期糖尿病视网膜病变患者中的差异性分析[J].医师在线,2024,14(11):3-5.
[12] BIDWAI P,GITE S,PRADHAN B,et al.Harnessing deep lear ning for detection of diabetic retinopathy in geriatric group using optical coherence tomography angiography-OCTA: A pro mising approach[J].Methodsx,2024,13.
[13] 郭楚云.广域扫频源OCTA对糖尿病视网膜病变无灌注区识别的对比及预测研究[J].眼科新进展,2025,45(03):211-5.
[14] DHURANDHAR D,RANI P K. Optical coherence tomography angiography of foveal neovascularisation in proliferative diabetic retinopathy[J].Bmj Case Reports,2019,12(8).
[15] WRIGHT P H,KHALID H,KEANE P A.The utility of wide-field optical coherence tomography angiography in diagnosis and monitoring of proliferative diabetic retinopathy in pregnancy[J].American journal of ophthalmology case reports, 2022,25:101280.
[16] 李朗,张福燕,贾旭.基于OCTA观察糖尿病视神经病变的研究进展[J].医学研究杂志,2025,54(01):163-6+80.
[17] PRAMIL V,LEVINE E S,WAHEED N K.Macular Vessel Density in Diabetic Retinopathy Patients: How Can We Accurately Measure and What Can It Tell Us?[J].Clinical Ophthalmology, 2021,15:1517-27.
[18] 李雁杰,杨子爱.光学相干断层扫描血管成像在诊断早期眼部疾病中的应用[J].实用医技杂志,2025,32(04):245-9.
[19] 黄玉苗.OCTA在早期糖尿病视网膜病变诊断中的应用及特异度、灵敏度分析[J].糖尿病新世界,2024,27(09):173-5.
[20] DO MONTE AGRA C L,CAVALCANTI LIRA R P, PINHEIRO F G,et al.Optical coherence tomography angiography:microvascular alterations in diabetic eyes without diabetic retinopathy [J].Arquivos Brasileiros De Oftalmologia,2021,84(2):149-57.
[21] SHI F, ZHU W, LIU M, et al. Retinal optical coherence tomography(OCT)image lesion multi-label classification syst em useful for retinal OCT image pathological change and elec tronic device, has classifying module that classifies various diseases of retina OCT image according to output result, CN11 6503639-A;CN116503639-B[P/OL].://DIIDW:202382447U.
[22] PARRAVANO M, FRAGIOTTA S, QUERQUES G. Prognostic rel evance of optical coherence tomography angiography biomarke rs in diabetic macular edema[J].Expert Review of Ophthalmo logy,2022,17(3):161-3.
[23] 董楠楠.增生型糖尿病视网膜病变患者PRP治疗前后视网膜结构和功能变化[J].国际眼科杂志,2025,25(05):718-24.
[24] 王曦.糖尿病视网膜病变患者视网膜及脉络膜超广角SS-OCTA特征分析[D].重庆:重庆医科大学,2024.
[25] MIRSHAHI A, GHASSEMI F, FADAKAR K, et al. Effects of panretinal photocoagulation on retinal vasculature and foveal avascular zone in diabetic retinopathy using optical cohere nce tomography angiography: A pilot study [J]. Journal of Current Ophthalmology,2019,31(3):287-91.
[26] FUMI D, RUGGERI F, FASCIOLO D, et al.Paracentral Acute Middle Maculopathy (PAMM) in Ocular Vascular Diseases-What We Know and Future Perspectives[J].Vision,2025,9(1).
[27] 崔腾,谢驰,蔡亚珍.糖尿病性视网膜病变患者视盘周围微循环变化和神经纤维层厚度相关性分析[J].齐齐哈尔医学院学报,2025,46(02):112-7.
[28] 蔡亚珍.广域SS-OCTA下早期糖尿病性视网膜病黄斑区的改变[J].安徽理工大学学报(自然科学版),2024,44(04):89-98.
[29] 杨硕.糖尿病性视网膜病变视网膜微血管变化特点分析:基于OCTA的定量分析[D].吉林:吉林大学,2024.
[30] SEO J-S, CHO Y-W, SEO S-W, et al. Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickn ess in Type 2 Diabetes[J].Journal of the Korean Ophthalmolog ical Society,2021,62(6):769-76.
[31] LIM A, TSAI W-S, THOTTARATH S, et al. Characterizing the Preferred Retinal Locus and Fixation Stability in Diabetic Macular Ischemia: A One-Year Study[J].Vision,2025,9(1).
[32] SAIF P S,SALMAN A E-R G,OMRAN N A H, et al. Assessment of Diabetic Retinopathy Vascular Density Maps[J].Clinical Oph thalmology,2020,14:3941-53.
[33] RYU G, LEE K, PARK D, et al. A deep learning model for identifying diabetic retinopathy using optical coherence tomography angiography [J]. Scientific Reports, 2021,11(1).
[34] ONISHI A C, FAWZI A A.An overview of optical coherence tomography angiography and the posterior pole[J].Therapeut ic Advances in Ophthalmology,2019,11.
[35] 韦丁杨,陈丽,毛明珠.高速扫频源光学相干断层血流成像不同扫描宽度对糖尿病视网膜病变病灶检测率的影响[J].实用医院临床杂志,2024,21(06):124-8.
[36] 周言,郑政,王曦.应用OCT和OCTA技术测量视网膜定量参数在糖尿病性视网膜病变诊治中的研究进展[J].中国现代医生,2024,62(32):122-6.
[37] FOULSHAM W,CHIEN J,LENIS T L, et al. Optical Coherence Tomography Angiography: Clinical Utility and Future Directions [J].Journal of Vitreoretinal Diseases,2022,6(3):229-42.
[38] MAO X,NIU Y,LIU Y,et al.Applications of optical cohere nce tomography angiography in diabetic retinopathy[J].Chine se Journal of Diabetes Mellitus,2022,14(1):80-3.
[2] 张树军.不同分期DR患者视网膜神经纤维层厚度和视网膜厚度及血流密度的变化[J].国际眼科杂志,2025,25(05):714-7.
[3] GAO S S, LIU G J, HUANG D, et al. Optimization of the split-spectrum amplitude-decorrelation angiography algorit hm on a spectral optical coherence tomography system [J].Optics Letters,2015,40(10):2305-8.
[4] AMINI S,SAHEBKAR A, DEHGHANI A,et al.The effect of cur cumin-piperine on cardiometabolic, inflammatory and oxidati ve stress factors and macular vascular density in optical coherence tomography angiography (OCTA) in patients with non-proliferative diabetic retinopathy: Study protocol for a randomized, double-blind controlled trial[J].Avicenna Journ al of Phytomedicine,2023,13(2):153-64.
[5] BELENJE A,RANI P K.Role of wide-angle optical cohere nce tomography angiography in the detection of clinically non-apparent neovascularisation in proliferative diabetic retinopathy[J].Bmj Case Reports,2020,13(9).
[6] FALAVARJANI K G,SARRAF D.Optical coherence tomograp hy angiography of the retina and choroid;current applications and future directions [J]. Journal of Current Ophthalmology,2017,29(1):1-4.
[7] AHMED M A A,ABDELHALEEM A S.Evaluation of Microvasc ular and Visual Acuity Changes in Patients with Early Diabetic Retinopathy: Optical Coherence Tomography Angiography Stu dy[J].Clinical Ophthalmology,2022,16:429-40.
[8] 曾少杰,谢怀林,张昀昀.OCTA评估黄斑中心凹无血管区参数对早期糖尿病视网膜病变的诊断价值[J].国际眼科杂志,2024,24(09):1471-5.
[9] YOON Y S,WOO J E, WOO J M. Optical Coherence Tomography Angiography According to Severity of Diabetic Retinopathy [J].Jo urnal of the Korean Ophthalmological Society,2017,58 (6):653-62.
[10] 纪风涛.基于扫频源光学相干断层血管成像糖尿病脉络膜病变的研究[D].安徽:安徽医科大学,2024.
[11] 郝泽宇,刘杰,韩雪.OCTA检查结果在不同分期糖尿病视网膜病变患者中的差异性分析[J].医师在线,2024,14(11):3-5.
[12] BIDWAI P,GITE S,PRADHAN B,et al.Harnessing deep lear ning for detection of diabetic retinopathy in geriatric group using optical coherence tomography angiography-OCTA: A pro mising approach[J].Methodsx,2024,13.
[13] 郭楚云.广域扫频源OCTA对糖尿病视网膜病变无灌注区识别的对比及预测研究[J].眼科新进展,2025,45(03):211-5.
[14] DHURANDHAR D,RANI P K. Optical coherence tomography angiography of foveal neovascularisation in proliferative diabetic retinopathy[J].Bmj Case Reports,2019,12(8).
[15] WRIGHT P H,KHALID H,KEANE P A.The utility of wide-field optical coherence tomography angiography in diagnosis and monitoring of proliferative diabetic retinopathy in pregnancy[J].American journal of ophthalmology case reports, 2022,25:101280.
[16] 李朗,张福燕,贾旭.基于OCTA观察糖尿病视神经病变的研究进展[J].医学研究杂志,2025,54(01):163-6+80.
[17] PRAMIL V,LEVINE E S,WAHEED N K.Macular Vessel Density in Diabetic Retinopathy Patients: How Can We Accurately Measure and What Can It Tell Us?[J].Clinical Ophthalmology, 2021,15:1517-27.
[18] 李雁杰,杨子爱.光学相干断层扫描血管成像在诊断早期眼部疾病中的应用[J].实用医技杂志,2025,32(04):245-9.
[19] 黄玉苗.OCTA在早期糖尿病视网膜病变诊断中的应用及特异度、灵敏度分析[J].糖尿病新世界,2024,27(09):173-5.
[20] DO MONTE AGRA C L,CAVALCANTI LIRA R P, PINHEIRO F G,et al.Optical coherence tomography angiography:microvascular alterations in diabetic eyes without diabetic retinopathy [J].Arquivos Brasileiros De Oftalmologia,2021,84(2):149-57.
[21] SHI F, ZHU W, LIU M, et al. Retinal optical coherence tomography(OCT)image lesion multi-label classification syst em useful for retinal OCT image pathological change and elec tronic device, has classifying module that classifies various diseases of retina OCT image according to output result, CN11 6503639-A;CN116503639-B[P/OL].
[22] PARRAVANO M, FRAGIOTTA S, QUERQUES G. Prognostic rel evance of optical coherence tomography angiography biomarke rs in diabetic macular edema[J].Expert Review of Ophthalmo logy,2022,17(3):161-3.
[23] 董楠楠.增生型糖尿病视网膜病变患者PRP治疗前后视网膜结构和功能变化[J].国际眼科杂志,2025,25(05):718-24.
[24] 王曦.糖尿病视网膜病变患者视网膜及脉络膜超广角SS-OCTA特征分析[D].重庆:重庆医科大学,2024.
[25] MIRSHAHI A, GHASSEMI F, FADAKAR K, et al. Effects of panretinal photocoagulation on retinal vasculature and foveal avascular zone in diabetic retinopathy using optical cohere nce tomography angiography: A pilot study [J]. Journal of Current Ophthalmology,2019,31(3):287-91.
[26] FUMI D, RUGGERI F, FASCIOLO D, et al.Paracentral Acute Middle Maculopathy (PAMM) in Ocular Vascular Diseases-What We Know and Future Perspectives[J].Vision,2025,9(1).
[27] 崔腾,谢驰,蔡亚珍.糖尿病性视网膜病变患者视盘周围微循环变化和神经纤维层厚度相关性分析[J].齐齐哈尔医学院学报,2025,46(02):112-7.
[28] 蔡亚珍.广域SS-OCTA下早期糖尿病性视网膜病黄斑区的改变[J].安徽理工大学学报(自然科学版),2024,44(04):89-98.
[29] 杨硕.糖尿病性视网膜病变视网膜微血管变化特点分析:基于OCTA的定量分析[D].吉林:吉林大学,2024.
[30] SEO J-S, CHO Y-W, SEO S-W, et al. Microvasculature and Nerve Fiber Layer-Ganglion Cell Inner Plexiform Layer Thickn ess in Type 2 Diabetes[J].Journal of the Korean Ophthalmolog ical Society,2021,62(6):769-76.
[31] LIM A, TSAI W-S, THOTTARATH S, et al. Characterizing the Preferred Retinal Locus and Fixation Stability in Diabetic Macular Ischemia: A One-Year Study[J].Vision,2025,9(1).
[32] SAIF P S,SALMAN A E-R G,OMRAN N A H, et al. Assessment of Diabetic Retinopathy Vascular Density Maps[J].Clinical Oph thalmology,2020,14:3941-53.
[33] RYU G, LEE K, PARK D, et al. A deep learning model for identifying diabetic retinopathy using optical coherence tomography angiography [J]. Scientific Reports, 2021,11(1).
[34] ONISHI A C, FAWZI A A.An overview of optical coherence tomography angiography and the posterior pole[J].Therapeut ic Advances in Ophthalmology,2019,11.
[35] 韦丁杨,陈丽,毛明珠.高速扫频源光学相干断层血流成像不同扫描宽度对糖尿病视网膜病变病灶检测率的影响[J].实用医院临床杂志,2024,21(06):124-8.
[36] 周言,郑政,王曦.应用OCT和OCTA技术测量视网膜定量参数在糖尿病性视网膜病变诊治中的研究进展[J].中国现代医生,2024,62(32):122-6.
[37] FOULSHAM W,CHIEN J,LENIS T L, et al. Optical Coherence Tomography Angiography: Clinical Utility and Future Directions [J].Journal of Vitreoretinal Diseases,2022,6(3):229-42.
[38] MAO X,NIU Y,LIU Y,et al.Applications of optical cohere nce tomography angiography in diabetic retinopathy[J].Chine se Journal of Diabetes Mellitus,2022,14(1):80-3.
Copyright © 2025 董愿鹏, 余萍
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
