Purpose To use optical coherence tomography angiography (OCTA) parameters from both the retinal and choroidal microvasculature to detect the presence and severity of diabetic retinopathy (DR). Method This is a cross-sectional case–control study. OCTA parameters from retinal vasculature, fovea avascular zone (FAZ) and choriocapillaris were evaluated from 3×3 mm2 fovea-centred scans. Areas under the receiver operating characteristic (ROC) curve were used to compare the discriminative power on the presence of diabetes mellitus (DM), the presence of DR and need for referral: group 1 (no DM vs DM no DR), group 2 (no DR vs any DR) and group 3 (non-proliferative DR (NPDR) vs proliferative DR (PDR)). Results 35 eyes from 27 participants with no DM and 132 eyes from 75 with DM were included. DR severity was classified into three groups: no DR group (62 eyes), NPDR (51 eyes), PDR (19 eyes). All retinal vascular parameters, FAZ parameters and choriocapillaris parameters were strongly altered with DR stages (p<0.01), except for the deep plexus FAZ area (p=0.619). Choriocapillaris parameters allowed to better discriminate between no DM versus DM no DR group compared with retinal parameters (areas under the ROC curve=0.954 vs 0.821, p=0.006). A classification model including retinal and choroidal microvasculature significantly improved the discrimination between DR and no DR compared with each parameter separately (p=0.029). Conclusions Evaluating OCTA parameters from both the retinal and choroidal microvasculature in 3×3 mm scans improves the discrimination of DM and early DR. Data are available upon reasonable request.

中文翻译：

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结合视网膜和脉络膜微血管指标可提高糖尿病视网膜病变的判别能力

目的 使用视网膜和脉络膜微血管系统的光学相干断层扫描血管造影 (OCTA) 参数来检测糖尿病视网膜病变 (DR) 的存在和严重程度。方法 这是一项横断面病例对照研究。通过以中央凹为中心的 3×3 mm2 扫描评估视网膜脉管系统、中央凹无血管区 (FAZ) 和脉络膜毛细血管的 OCTA 参数。受试者工作特征 (ROC) 曲线下面积用于比较对是否存在糖尿病 (DM)、是否存在 DR 以及是否需要转诊的判别力：第 1 组（无 DM 与 DM 无 DR）、第 2 组（无 DR 与任何 DR）和第 3 组（非增殖性 DR (NPDR) 与增殖性 DR (PDR)）。结果 纳入 27 名无糖尿病参与者的 35 只眼睛和 75 名患有糖尿病的参与者的 132 只眼睛。DR严重程度分为三组：无DR组（62只眼）、NPDR组（51只眼）、PDR组（19只眼）。除深丛 FAZ 面积（p=0.619）外，所有视网膜血管参数、FAZ 参数和脉络膜毛细血管参数均随 DR 分期发生强烈改变（p<0.01）。与视网膜参数相比，脉络膜毛细血管参数可以更好地区分无 DM 组和 DM 无 DR 组（ROC 曲线下面积=0.954 vs 0.821，p=0.006）。与单独的每个参数相比，包括视网膜和脉络膜微血管系统的分类模型显着改善了 DR 和无 DR 之间的区分 (p=0.029)。结论 在 3×3 mm 扫描中评估视网膜和脉络膜微血管系统的 OCTA 参数可以提高对 DM 和早期 DR 的区分。数据可根据合理要求提供。