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Short-term natural history of non-perfusion areas in treatment-naive diabetic retinopathy patients using swept-source OCT angiography
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DOI：10.1007/s00417-026-07186-4.png)
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Abstract
En 中文
Purpose To investigate the longitudinal progression of non-perfusion areas (NPA) in treatment-na & iuml;ve patients with diabetic retinopathy (DR) using swept-source OCT angiography (SS-OCTA), and to identify clinical and imaging predictors. . Methods Retrospective longitudinal study. At each visit, 6 & times; 6-mm and 12 & times; 12-mm SS-OCTA (PLEX (R) Elite 9000) macular scans were performed. NPA was measured using ImageJ. The ischemic index (ISI) was calculated as NPA divided by total scan area. ISI progression rate was quantified by the change from baseline to the last visit, normalized by time. Additional OCTA metrics, including vessel density and skeletonized vessel density, were calculated using the ARI Network. Results A total of 101 eyes from 70 DR patients were included, with a median age of 59 [52-68] years. During follow-up (median duration: 15.5 [6.0-27.0] months), ISI progression rate per year in the proliferative DR group (0.01 [-0.01-0,06]) is significantly faster than both mild non-proliferative DR (0.00 [0.00-0.00]) and moderate-severe non-proliferative DR (0.00 [0.00-0.02]) groups (all P < 0.05). Mixed-effects linear regression identified DR severity and baseline ISI as the only factors significantly associated with ISI progression rate, with beta values of 0.33 (95% CI: 0.04-0.63, P = 0.03) for DR severity and 3.75 (95% CI: 0.03-7.47, P < 0.05) for baseline ISI. Conclusion This study is the first to characterize progression rate of SS-OCTA-derived ISI in treatment-na & iuml;ve DR eyes, showing a strong linear correlation with baseline DR severity and ISI, but not with other OCTA metrics. These findings support ISI as a robust OCTA biomarker for monitoring DR progression.
Keywords:
non-perfusion areas
progression
diabetic retinopathy
swept-source OCTA
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