研究目的
To evaluate the prevalence of different disease pathways (ischemia, neurodegeneration and edema) in the initial stages of diabetic retinopathy (DR).
研究成果
Eyes in the initial stages of diabetic retinal disease may show neurodegeneration, edema and decreases in vessel density. These changes, however, occur to different degrees in different eyes, indicating that the predominant mechanism of retinal disease may be different in different patients. Retinal thinning is an early finding that appears to occur independently of the presence of edema or capillary dropout. Edema may also be identified at the earliest stages of diabetic retinal disease; but its prevalence does not correlate with severity of the disease. Finally, decreases in vessel density involving both the DRP and SRP appear to be the only feature that shows clear association with increase in retinopathy severity, as identified by ETDRS level.
研究不足
One limitation of this study is the use of automated retinal layer segmentation analyses. These, however, were performed in retinas that remained structurally preserved with no evidence of cystoid changes, and they were reviewed by a masked grader.
1：Experimental Design and Method Selection:
A retrospective cross-sectional study design was used to evaluate the prevalence of different disease pathways in the initial stages of diabetic retinopathy. Eyes were grouped by DR severity using the 7-field ETDRS protocol. Neurodegeneration, edema, and ischemia were identified through specific retinal layer thickness and vessel density metrics.
2：Sample Selection and Data Sources:
142 eyes from 142 patients with diabetes, classified into three groups according to the ETDRS severity level. A control group of 106 eyes from healthy controls was used for comparison.
3：List of Experimental Equipment and Materials:
Cirrus AngioPlex (Carl Zeiss Meditec, Dublin, CA, USA) for SD-OCT and OCTA imaging, and 7-field color fundus photography for classification by ETDRS criteria.
4：Experimental Procedures and Operational Workflow:
Participants underwent a full ophthalmological examination, SD-OCT and OCTA imaging. Segmentation of retinal layers was performed on the SD-OCT data using a segmentation software implemented by AIBILI.
5：Data Analysis Methods:
Statistical analysis was performed with Stata 12.1. Differences from the control population were categorized by ETDRS severity groups and compared using the Chi-square test for categorical outcomes and ANOVA for continuous outcomes.
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