線粒體TXNRD2和ME3基因風險評分與特定的原發性開角型青光眼表型相關聯

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線粒體TXNRD2和ME3基因風險評分與特定的原發性開角型青光眼表型相關聯

Created
Tags Glaucoma
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 7, July 2023

中文摘要

該研究旨在調查基於TXNRD2和ME3基因變異的遺傳風險評分（genetic risk scores, GRS）是否與原發性開角型青光眼（POAG）的特定臨床特徵相關聯。

研究人員利用全基因組關聯研究（GWAS）數據識別與POAG風險相關的單核苷酸多態性（SNP）在TXNRD2和ME3基因區域中。他們選擇了互相獨立的SNP子集，通過計算每個個體携帶的風險等位基因數目來構建GRS。研究參與者包括POAG患者和對照個體。

作者評估了GRS與POAG相關的各種臨床結果之間的關聯性，例如POAG診斷的概率、最高治療眼內壓（IOP）和副中央視野損失的患病率。他們發現，較高的TXNRD2 GRS與POAG診斷的概率增加相關，而較高的ME3 GRS則與POAG患者中副中央視野損失 (paracentral visual field loss)的患病率增加相關。然而，在診斷年齡或青光眼手術需求等其他臨床指標方面並沒有明顯的相關性。

該研究表明，涉及線粒體功能和氧化應激調節的TXNRD2和ME3基因的遺傳變異可能對POAG的發展和嚴重程度有所貢獻。這些發現突出了遺傳風險評分在個體風險分層和POAG診斷和治療中的個性化應用的潛力。

English Abstract

Title :

Mitochondrial TXNRD2 and ME3 Genetic Risk
Scores Are Associated with Specific Primary
Open-Angle Glaucoma Phenotypes

This study aimed to investigate whether genetic risk scores (GRSs) based on variants in the TXNRD2 and ME3 genes are associated with specific clinical features of primary open-angle glaucoma (POAG).

The researchers used genome-wide association study (GWAS) data to identify single nucleotide polymorphisms (SNPs) associated with POAG risk in the TXNRD2 and ME3 gene regions. They selected a subset of SNPs that were independent of each other and constructed GRSs for each individual by summing the number of risk alleles they carried. The study participants included patients with POAG and control individuals.

The authors assessed the association between GRSs and various clinical outcomes related to POAG, such as the odds of POAG diagnosis, maximum treated intraocular pressure (IOP), and prevalence of paracentral visual field loss. They found that higher GRSs for TXNRD2 and ME3 were associated with increased odds of POAG diagnosis, higher GRSs for TXNRD2 were associated with higher mean maximum treated IOP, while higher GRSs for ME3 were associated with a higher prevalence of paracentral visual field loss in patients with POAG. However, there were no significant associations with other clinical measures, such as age at diagnosis or need for glaucoma surgery.

The study suggests that genetic variants in the TXNRD2 and ME3 genes, which are involved in mitochondrial function and oxidative stress regulation, may contribute to the development and severity of POAG. The findings highlight the potential use of genetic risk scores for individual risk stratification and personalized approaches in the diagnosis and treatment of POAG.

近視控制的功效：低濃度阿托品對近視進展的LAMP研究

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近視控制的功效：低濃度阿托品對近視進展的LAMP研究

Created
Tags CGMHOPHPediatricRefraction
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 7, July 2023

中文摘要

低濃度阿托品對近視進展的LAMP(The Low-Concentration Atropine for Myopia Progression)研究在三年的時間內顯著提升了我們對低濃度阿托品在控制近視方面的理解。在研究的第一年，研究將兒童隨機分配到接受不同濃度阿托品或安慰劑的組別。結果顯示，與安慰劑組相比，接受0.05%、0.025%和0.01%阿托品治療的組別近視進展較慢，軸向伸長也較少。

該研究還研究了停藥對近視進展的影響。在第三年開始時，接受兩年治療的兒童中，有一半被隨機分配繼續治療或進行洗藥。停藥組近視進展和軸向伸長速度更快。在第三年中，相較於接受較低濃度阿托品治療的組別，先前接受較高濃度阿托品治療的組別軸向伸長稍微更大。然而，除了0.05%和0.01%阿托品的比較外，不同濃度阿托品之間的近視進展差異並不具有統計學上的顯著性。

由於研究中的第一年對照組在後續年份轉為治療組，因此無法直接計算低濃度阿托品在第一年以後的長期療效。然而，基於其他研究的荟萃分析(metaanalysis)，估計近視進展平均每年減緩15%。根據這個估計，計算了每個阿托品濃度在三年內的預期軸向伸長累計減少量。

與其他高濃度阿托品和光學療法的數據相比，低濃度阿托品在三年的治療療效，特別是0.05%，是令人滿意的。該研究還強調了低濃度阿托品在長期療效方面相對於光學療法和高濃度阿托品的潛在優勢。需要注意的是，該研究存在一些限制，例如在三年期間群體規模的變化以及無法對估計值計算置信區間。

除了LAMP研究的結果，本文還討論了美國兒童中視護存取和視力損害方面的社會經濟和種族不平等問題。由於醫療保健資源分配的不公平性，導致健康差異，影響了特定人群的結果。該研究利用了全國兒童健康調查(NSCH)來探討兒童的未滿足視護需求和報告的視力損害之間的差異，並考慮了不同年齡組和社經類別。研究強調了需要解決與健康有關的社會決定因素，並回應由此產生的健康不平等，涉及醫療保健的所有領域。

總的來說，LAMP研究為低濃度阿托品在近視控制方面的療效提供了寶貴的洞察，而關於社會經濟和種族不平等的討論則強調了解決兒童視護中的健康不平等的重要性。

English Abstract

Title : Efficacy in Myopia Control: The Low-Concentration Atropine for Myopia Progression (LAMP) Study

The Low-Concentration Atropine for Myopia Progression (LAMP) study, conducted over a period of three years, has significantly advanced our understanding of the effectiveness of low-concentration atropine in controlling myopia. In the first year of the study, children were randomly assigned to receive different concentrations of atropine or a placebo. The results showed that compared to the placebo group, the groups receiving 0.05%, 0.025%, and 0.01% atropine experienced a slower progression of myopia, as indicated by reduced axial elongation.

The study also examined the impact of treatment cessation on myopia progression. At the start of the third year, half of the children who had received two years of treatment were randomized to continue treatment or undergo a washout. Those who discontinued treatment showed faster myopia progression and axial elongation. During the third year, there was a slightly larger axial elongation among those previously treated with higher concentrations of atropine compared to those treated with lower concentrations. However, the differences in myopia progression between the various atropine concentrations were not statistically significant, except for the comparison between 0.05% and 0.01% atropine.

Since the year 1 control group in the study switched to treatment in the subsequent years, the long-term efficacy of low-concentration atropine beyond year 1 could not be directly calculated. However, based on a meta-analysis of other studies, it was estimated that myopia slows down by an average of 15% per year. Applying this estimation, the projected cumulative reduction in axial elongation over three years was calculated for each atropine concentration.

Comparisons with other data on higher atropine concentrations and optical therapies show that the 3-year treatment efficacy of low-concentration atropine, particularly at 0.05%, is favorable. The study also highlighted the potential long-term efficacy of low-concentration atropine compared to optical therapies and higher atropine concentrations. It is important to note that the study had some limitations, such as variations in cohort size over the three-year period and the inability to calculate confidence intervals for the estimates.

In addition to the LAMP study findings, the article also discusses the socioeconomic and racial disparities in vision care access and impairment among children in the United States. Health disparities resulting from inequitable distribution of resources within healthcare contribute to worse outcomes for certain populations. The study utilized the National Survey of Children’s Health to explore differences in unmet vision care needs and reported vision impairment among children, considering age groups and socioeconomic categories. The study emphasizes the need to address relevant social determinants of health and respond to resulting health inequities in all domains of healthcare.

Overall, the LAMP study provides valuable insights into the efficacy of low-concentration atropine for myopia control, while the discussion on socioeconomic and racial disparities underscores the importance of addressing health inequities in vision care among children.

自體培養角膜邊緣上皮細胞片移植治療角膜幹細胞缺陷患者的臨床試驗

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Clinical Trial of Autologous Cultivated Limbal Epithelial Cell Sheet Transplantation for Patients with Limbal Stem Cell Deficiency

Created
Tags Cornea
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 6, June 2023

中文摘要

本研究旨在評估自體培養的角膜上皮細胞片在單側角膜幹細胞缺陷（LSCD）患者中的療效和安全性。該研究納入了十名單側LSCD患者，進行自體細胞片移植後的兩年追蹤。這些細胞片是在符合良好製造規範（GMP）的設施中製備的，並遵循良好臨床實踐準則。主要終點是角膜上皮重建率，該終點在手術後一年進行評估。結果顯示，在移植後一年，60%的眼睛成功進行了角膜上皮重建，這一成功率顯著高於同種角膜移植(allogeneic limbal transplantation)的成功率。包括視力改善和生活質量在內的次要終點也顯示出積極的結果。該研究結論認為自體培養的角膜上皮細胞片是一種安全有效的LSCD治療方法。這些發現支持在眼科再生醫學中應用這種方法。

English Abstract

This study aimed to evaluate the efficacy and safety of autologous cultivated limbal epithelial cell sheets in patients with unilateral limbal stem cell deficiency (LSCD). The study included ten patients with unilateral LSCD who were followed for two years after the transplantation of autologous cell sheets. The cell sheets were fabricated in a Good Manufacturing Practice (GMP)-compliant facility and adhered to Good Clinical Practice guidelines. The primary endpoint was the corneal epithelial reconstruction rate, which was evaluated one year postoperatively. The results showed that corneal epithelial reconstruction was successful in 60% of eyes one year after the transplantation, which was significantly higher than the success rate achieved by allogeneic limbal transplantation. The secondary endpoints, including visual acuity improvement and quality of life, also showed positive outcomes. The study concluded that autologous cultivated limbal epithelial cell sheets are a safe and effective treatment for LSCD. The findings support the use of this approach in ocular regenerative medicine.

同側眼睛白內障手術中假性晶體囊性黃斑水腫的風險

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Risk of Pseudophakic Cystoid Macular Edema in Fellow-Eye Cataract Surgeries

Created
Tags CGMHOPH
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 6, June 2023

中文摘要

本研究旨在確定對側眼白內障手術的pseudophakic cystoid macular edema （pCME）風險，並識別潛在的風險因素，包括先前的第一眼pCME。該研究納入在英國8家國家衛生服務中心進行雙眼非同期白內障手術的患者。排除具有糖尿病性黃斑水腫（DME）、CME 或preoperative or perioperative use of NSAID的患者。計算了pCME的總體風險，並使用Poisson模型識別了對側眼pCME的風險因素。研究發現，對側眼白內障手術的pCME風險約為1%。先前的第一眼pCME的存在是最強獨立的風險因素，使風險增加了8倍以上。該研究強調了對患者進行有關對側眼白內障手術中pCME的潛在風險的諮詢的重要性，特別是如果他們有第一眼pCME的病史。

English Abstract

This study aimed to determine the risk of pseudophakic cystoid macular edema (pCME) in fellow-eye cataract surgery and identify potential risk factors, including prior first-eye pCME. The study included patients undergoing bilateral nonsimultaneous cataract surgeries in 8 UK National Health Service centers. Patients with a history of diabetic macular edema (DME), cystoid macular edema (CME), or perioperative nonsteroidal anti-inflammatory drug (NSAID) use were excluded. The overall risk of pCME was calculated, and a Poisson model was used to identify risk factors for pCME in the fellow eye. The study found that the risk of pCME in fellow-eye cataract surgery was approximately 1%. The presence of prior first-eye pCME was the strongest independent risk factor, increasing the risk more than eightfold. The study highlights the importance of counseling patients about the potential risk of pCME in fellow-eye cataract surgeries, particularly if they have a history of pCME in the first eye.

The risk of fellow-eye pCME among patients without first-eye pCME was 0.9%. However, the risk of fellow-eye pCME among those with first-eye pCME was 10.7%. In the fully adjusted model, we found that the risk factors for the development of fellow-eye pCME were first-eye
pCME (RR, 8.55, 95% confidence interval [CI], 6.19-11.8), epiretinal membrane (ERM) (RR, 4.1, CI,
2.63-6.19), history of retinal vein occlusion (RR, 2.94, CI, 1.75-4.93), diabetes without history of DME (RR, 2.08,CI, 1.73-2.5), advanced cataract (RR, 1.75, CI, 1.16-2.65), prostaglandin analogue use preoperatively (RR, 1.49,CI, 1.13-1.97), and male sex (RR, 1.19, CI, 1.0-1.41)

根據光學相干斷層掃描（OCT）對玻璃體狀態進行分層，同側眼睛視網膜脫離的風險。

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Fellow-Eye Retinal Detachment Risk as Stratified by Hyaloid Status on OCT

Created
Tags Retina
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 6, June 2023

中文摘要

本研究旨在根據OCT影像確定的玻璃體狀態，評估對側眼視網膜脫離的風險。研究人員分析了雙側順序性視網膜脫離（RRD）患者的數據，評估了兩眼的後玻璃體脫離（PVD）的存在或缺失。他們發現在首診時對側眼有附著的玻璃體與RRD發展風險較高有關。該研究表明OCT影像可以成為風險分層和指導患者的隨訪和教育的有用工具。然而，需要進一步研究來了解在這些情況下預防性激光治療的有效性。

English Abstract

This study aimed to assess the risk of retinal detachment in the fellow eye based on the hyaloid status as determined by OCT imaging. The researchers analyzed data from patients with bilateral sequential retinal detachment (RRD) and evaluated the presence or absence of a posterior vitreous detachment (PVD) in both eyes. They found that an attached hyaloid in the fellow eye at presentation was associated with a higher risk of RRD development. The study suggests that OCT imaging can be a useful tool for risk stratification and guiding patient follow-up and education. However, further investigation is needed to understand the usefulness of prophylactic laser therapy in these cases.

Effect of Low-Fat Dietary Modification on Incident Open-Angle Glaucoma

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低脂飲食改善對於初發性開角型青光眼的效果

Created
Tags CGMHOPHNeuro
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 6, June 2023

中文摘要

本研究的目的是檢驗飲食調整（diet modification, DM）是否能夠降低原發性開角型青光眼（POAG）的發病風險。該研究將醫療保險索賠數據與參與婦女健康倡議飲食調整試驗的45,203名女性相關聯。使用Cox比例風險模型分析數據，計算危險比（HR）和置信區間（CI）。結果顯示，DM在降低POAG的發病風險方面沒有總體效益。該研究還探討了飲食因素與POAG風險之間的關係，包括膳食脂肪攝入量和ω-6脂肪酸與ω-3脂肪酸之比例。基線時膳食中總脂肪卡路里百分比較低且ω-6脂肪酸與ω-3脂肪酸比例較低的參與者患POAG的風險增加。研究結果表明，保持健康的飲食，包括足夠的脂肪攝入量，可能對降低POAG的風險至關重要。然而，需要進一步的研究來更好地了解最佳脂肪攝入量及其與POAG風險的關係。該研究存在一些限制，例如使用醫療代碼而非直接檢查來診斷POAG。然而，研究結果為飲食因素在POAG發展中的潛在作用提供了見解，並凸顯了進一步調查和預防青光眼視力損失的干預的需求。

English Abstract

The purpose of this study was to examine whether dietary modification (DM) could reduce the risk of incident primary open-angle glaucoma (POAG). The study linked Medicare claims data to 45,203 women who participated in the Women’s Health Initiative Dietary Modification Trial. Cox proportional hazards models were used to analyze the data and calculate hazard ratios (HRs) and confidence intervals (CIs). The results showed no overall benefit of DM in reducing incident POAG. The study also explored the relationship between dietary factors and POAG risk, including the intake of dietary fats and the ratio of omega 6-to-omega 3 fatty acids. Participants with lower percentage of calories from total fat and lower omega 6-to-omega 3 fatty acid ratio at baseline had an increased risk of developing POAG. The findings suggest that maintaining a healthy diet, including a sufficient percentage of fat intake, may be important in reducing the risk of POAG. However, further research is needed to better understand the optimal fat intake and its relationship to POAG risk. The study had some limitations, such as the use of billing codes instead of direct examination for the diagnosis of POAG. Nevertheless, the results provide insights into the potential role of dietary factors in the development of POAG and highlight the need for further investigation and interventions to prevent glaucomatous vision loss.

Comparison of Optical Coherence Tomography Structural Parameters for Diagnosis of Glaucoma in High Myopia

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Created
Tags Glaucoma
Journal JAMA Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

JAMA Ophthalmology Published online May 18, 2023

中文摘要

這項cross sectional 研究旨在確定在高度近視個體中檢測青光眼最有效的光學相干斷層掃描（OCT）參數。該研究從韓國一家單一醫院招募了高度近視的參與者，包括有和無青光眼的患者。測量了每位參與者的黃斑神經節細胞-內膜層（ganglion cell-inner plexiform layer , GCIPL）厚度、視網膜周圍神經纖維層（retinal nerve fiber layer, RNFL）厚度和視神經盤（optic nerve head, ONH）參數。結果顯示，下側額GCIPL厚度在高度近視患者中區分青光眼眼睛具有最高的診斷效用。該研究建議將temporal raphe sign與單一OCT參數相結合，可以進一步提高在高度近視青光眼診斷的準確性。

English Abstract

This cross-sectional study aimed to determine the most effective optical coherence tomography (OCT) parameters for detecting glaucoma in individuals with high myopia. The study recruited participants with high myopia, both with and without glaucoma, from a single hospital in South Korea. Macular ganglion cell-inner plexiform layer (GCIPL) thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters were measured in each participant. The inferotemporal GCIPL thickness was found to have the highest diagnostic utility for discriminating glaucomatous eyes in patients with high myopia. The study suggests that combining the temporal raphe sign with single OCT parameters may further enhance the diagnostic accuracy for glaucoma in high myopia.

Bibliometric Analysis of Ophthalmic Journals

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Created
Tags CGMHOPH
Journal JAMA Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

JAMA Ophthalmology Published online June 1, 2023

中文摘要

這項研究利用Scopus database識別眼科期刊，共納入335個期刊，發表了471,184篇文章。分析主要關注引用度指標，特別是h-index，它結合了引用次數和出版物數量來衡量每個類別。

眼科期刊文章的h-index確定為494，這表明眼科學領域具有強大的研究基礎。該研究識別了眼科文獻中最高引用的文章、領先的期刊、作者、機構和國家。這些信息可以作為臨床醫生、科學家和機構在該領域中貢獻的指南。

該分析排除了發表在一般醫學期刊和非英語期刊中的眼科學文章。該研究還指出了書目計量分析在捕捉整個眼科學文獻方面的限制，因為一些眼科研究可能發表在非眼科學期刊上。

總的來說，該研究提供了有關眼科研究領域的見解，並突出了各方在推進視覺科學(vision science)和眼科護理(eye care)方面所做出的重要貢獻。

English Abstract

The study utilized the Scopus database to identify ophthalmic journal titles and included 335 journals that had published a total of 471,184 articles. The analysis focused on citation metrics, particularly the h-index, which provides a combined measure of citations and publications for each category.

The h-index for ophthalmic journal articles was determined to be 494, suggesting a strong research base in the field of ophthalmology. The study identified the most highly cited articles ( Quigley and Broman, 2006 , concerning the epidemiology of glaucoma) , leading journals (Ophthalmology), authors (Ronald Klein, MD), institutions(Johns Hopkins University), and countries (USA) in the ophthalmic literature. This information can serve as a guide for clinicians, scientists, and institutions regarding their contributions to the field.

The analysis excluded ophthalmology articles published in general medical journals and non-English language journals. The study also noted the limitations of bibliometric analyses in capturing the entire ophthalmic literature, as some ophthalmic research may be published in nonophthalmic journals.

Overall, the study provides insights into the ophthalmic research landscape and highlights the significant contributions made by various entities in advancing vision science and eye care.

Difficulty in Assessing the Systemic Adverse Effects of Intravitreal Anti–Vascular Endothelial Growth Factor Therapy

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Created
Tags Retina
Journal JAMA Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

JAMA Ophthalmology Published online June 1, 2023

中文摘要

作者提到了Zafar等人進行的一項研究，該研究使用退伍軍人健康管理局數據庫評估接受玻璃體內anti-VEGF治療的2型糖尿病患者的全身不良事件。該研究發現與未接受治療的患者相比，接受anti-VEGF治療的患者在心肌梗塞、腦血管疾病和腎臟疾病等不良事件的風險增加。

作者承認已有文獻記錄了接受系統性anti-VEGF治療的癌症患者出現高血壓、蛋白尿和血栓栓塞等不良效應。然而，關於玻璃體內anti-VEGF治療的潛在全身不良效應的辯論仍在進行中，存在支持和反駁這些效應的證據。

評論討論了評估這些不良效應的研究面臨的挑戰，包括樣本量有限、難以找到適當的活性對照組、可能存在選擇偏差、時間混淆以及需要因果推斷。

作者建議使用時間更新的生存模型(time-updating survival modeling)，確保anti-VEGF劑量與不良效應之間的必要關聯。此外，提出使用糖尿病併發症嚴重程度指數作為評估潛在糖尿病嚴重程度並減少時間混淆的工具。

評論最後強調了使用各種研究設計進行進一步研究以達成對於玻璃體內anti-VEGF治療的全身不良效應的共識的重要性。

English Abstract

The author mentions a study conducted by Zafar and colleagues, which used the Veterans Health Administration database to assess systemic adverse events in patients with type 2 diabetes who received intravitreal anti-VEGF therapy. The study found an increased risk of adverse events, such as acute myocardial infarction, cerebrovascular disease, and kidney disease, in patients who received anti-VEGF therapy compared to unexposed patients.

The author acknowledges that adverse effects, including hypertension, proteinuria, and thromboembolic events, have been documented in patients with cancer who received systemic anti-VEGF therapy. However, the debate regarding the potential systemic adverse effects of intravitreal anti-VEGF therapy is ongoing, and evidence both supporting and contradicting these effects exists.

The commentary discusses the challenges in conducting studies to evaluate these adverse effects, including limited sample sizes, the difficulty in finding suitable active comparators, the potential for indication bias, confounding by time, and the need for causal inference.

The author suggests using time-updating survival modeling to ensure the necessary proximity of the anti-VEGF dose to the adverse effect. Additionally, the Diabetes Complications Severity Index is proposed as a tool to assess underlying diabetes severity and reduce confounding by time.

The commentary concludes by highlighting the importance of conducting further research using various study designs to achieve a consensus on the systemic adverse effects of intravitreal anti-VEGF therapy.

Assessment of Parafoveal Diabetic Macular Ischemia on Optical Coherence Tomography Angiography Images to Predict Diabetic Retinal Disease Progression and Visual Acuity Deterioration

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Created
Tags Retina
Journal JAMA Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

JAMA Ophthalmology Published online May 25, 2023

中文摘要

這項研究旨在研究糖尿病黃斑缺血（diabetic macula ischemia, DMI）在預測糖尿病視網膜病變（DR）進展、糖尿病性黃斑水腫（DME）發展和視力（VA）惡化的價值。研究人員使用基於光學相干斷層掃描血管影像學（OCTA）圖像的自動二值化(automated binary) DMI算法。他們使用深度學習算法分析了表層毛細血管網（superficial capillary plexus, SCP）和深層毛細血管網（deep capillary plexus, DCP）的OCTA圖像。

該研究納入了178名患者的321只眼睛。baseline SCP-DMI和DCP-DMI的存在與DR的進展顯著相關。在調整了各種因素後，DCP-DMI與DME的發展和視力惡化也有關聯。研究人員發現，SCP和DCP中都存在DMI可以改善對DR進展的預測判別能力。

該研究結論是，OCTA圖像中的DMI存在，特別是在DCP中，對於糖尿病患者的DR進展、DME發展和視力惡化具有預測價值

English Abstract

The study aimed to investigate the prognostic value of diabetic macular ischemia (DMI) in diabetic retinopathy (DR) progression, diabetic macular edema (DME) development, and visual acuity (VA) deterioration in patients with diabetes. The researchers used an automated binary DMI algorithm based on optical coherence tomography angiography (OCTA) images. They analyzed OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) using a deep learning algorithm.

The study included a total of 321 eyes from 178 patients. The presence of SCP-DMI and DCP-DMI at baseline was significantly associated with DR progression. DCP-DMI was also associated with DME development and VA deterioration after adjusting for various factors. The researchers found that the presence of DMI in both SCP and DCP improved the predictive discrimination for DR progression.

The study concluded that the presence of DMI on OCTA images, particularly in the DCP, provided prognostic value for DR progression, DME development, and VA deterioration in patients with diabetes.