深浅层血管密度变化和视网膜高反射点评估糖网黄斑水肿治疗反应的效果

doi:10.3969/j.issn.1006-5725.2025.04.017

Abstract

Abstract:

Objective To evaluate the correlation between the changes of vascular density in deep and shallow layers， retinal hyperreflexia and the therapeutic response of diabetic macular edema （DME）. Methods Retrospectively selected DME patients （45 cases and 59 eyes） who visited the Department of Ophthalmology from April 2020 to November 2023 as the experimental group. Compare the change of deep and superficial blood vessel density and retinal hyperreflective points before and after treatment of the patients. The correlation between each index and poor response to anti-vascular endothelial growth factor （VEGF） treatment with DME was analyzed using the Pearson test. The value of baseline deep retinal capillary plexus （DCP）， central macular retinal thickness （CMT）， number of high-reflective foci （HRF） in the retina， and blood flow density （FD300-VD） in diagnosing poor response to anti-VEGF therapy in DME was analyzed using the subject operating characteristic curve （ROC）. Results Compared with pre-treatment， patients' superficial retinal capillary plexus （SCP）， DCP， FD300-VD， and deep-superficial flow ratio （DSFR） increased and CMT thickness significantly decreased after treatment （P < 0.05）. Pearson's correlation test showed that the outcome of patients with poor response to anti-VEGF therapy was negatively correlated with baseline SCP-VD， DCP-VD， DSFR， and FD300-VD （r = -0.458， -0.433， -0.604， and -0.452， P < 0.05） and positively correlated with CMT （r = 0.427， P < 0.05）. The results of multifactorial logistic regression analysis showed that a rise in SCP， DCP， FD300-VD， and DSFR， and a decrease in CMT were correlates affecting the response to anti-VEGF therapy in DME （OR = 0.285， 0.272， 0.291， 0.268， 2.821， P < 0.05）.The results of ROC curve analysis showed that the AUCs of baseline DCP， CMT， HRF quantity， and FD300-VD were 0.918， 0.934， 0.947， and 0.927， respectively， which were of good value in diagnosing poor response to anti-VEGF therapy in DME. Conclusion Morphologic indicators such as changes in the density of deep and superficial blood vessels and retinal hyperreflective spots have good application value in assessing the response to DME treatment and can assist in clinical treatment.

Key words: diabetic macular edema, deep capillary plexus, retinal hyperreflective foci, correlation

CLC Number:

R587.1

Xia SHENG,Mengwen ZHOU,Jingkai HE,Liangkuo XIE,Xiao. LIU. Correlation between morphological indexes such as changes of vascular density in deep and shallow layers， retinal hyperreflexia and the response to treatment of macular edema with glucose net[J]. The Journal of Practical Medicine, 2025, 41(4): 575-579.

Figures/Tables 6

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References 23

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项目	血管密度变化/%		HRF数量	DSFR	FD300-VD/%	CMT/μm	NPA/mm²	MA
项目	SCP-VD	DCP-VD	HRF数量	DSFR	FD300-VD/%	CMT/μm	NPA/mm²	MA
治疗前	37.9 ± 4.89	41.86 ± 6.01	99.97 ± 62.35	1.51 ± 0.52	44.41 ± 7.21	434.37 ± 87.64	1.57 ± 0.68	55.36 ± 25.32
治疗后	45.69 ± 6.03	45.17 ± 6.22	98.81 ± 71.67	1.93 ± 0.59	55.14 ± 6.93	334.32 ± 88.14	1.55 ± 0.65	54.81 ± 24.59
t值	-4.15	-2.23	-0.08	2.58	7.12	6.03	0.14	0.10
P值	< 0.001	0.04	0.94	0.01	< 0.001	< 0.001	0.89	0.92

项目	糖网黄斑水肿
项目	r值	P值
SCP-VD	-0.458	0.021
DCP-VD	-0.433	0.042
FD300-VD	-0.452	0.025
DSFR	-0.604	0.029
HRF数量	0.207	0.356
CMT	0.427	0.021
NPA	0.491	0.057
MA	0.083	0.160

名称		赋值
因变量
自变量	抗VEGF治疗应答	1=应答；0=未应答
	SCP	原始数值
	DCP	原始数值
	FD300-VD	原始数值
	DSFR	原始数值
	CMT	原始数值

指标	β值	SE值	Wald χ²值	P值	OR值	95%CI
SCP	-1.256	0.439	8.186	0.004	0.285	0.120 ~ 0.673
DCP	-1.301	0.467	7.761	0.006	0.272	0.109 ~ 0.680
FD300-VD	-1.234	0.413	8.928	0.003	0.291	0.130 ~ 0.654
DSFR	-1.315	0.461	8.137	0.005	0.268	0.109 ~ 0.663
CMT	1.037	0.411	6.366	0.012	2.821	1.260 ~ 6.313

指标	AUC	标准误	95%CI	P值	约登指数	灵敏度/%	特异度/%
SCP	0.754	0.051	0.652 ~ 0.839	< 0.001	0.40	84.44	55.56
DCP	0.918	0.029	0.841 ~ 0.965	< 0.001	0.76	86.67	88.89
HRF数量	0.947	0.023	0.879 ~ 0.983	< 0.001	0.80	86.67	93.33
DSFR	0.656	0.060	0.548 ~ 0.753	0.01	0.38	82.22	55.56
FD300-VD	0.927	0.027	0.852 ~ 0.971	< 0.001	0.73	86.67	86.67
CMT	0.934	0.026	0.861 ~ 0.975	< 0.001	0.73	75.56	97.78
NPA	0.778	0.049	0.678 ~ 0.859	< 0.001	0.44	80.00	64.44
MA	0.637	0.059	0.528 ~ 0.735	0.02	0.27	86.67	40.00

Correlation between morphological indexes such as changes of vascular density in deep and shallow layers， retinal hyperreflexia and the response to treatment of macular edema with glucose net

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