Современные подходы к выявлению доклинических признаков диабетической ретинопатии с помощью ОКТ-ангиографии

 Изобретение оптической когерентной томографии с функцией ангиографии (ОКТА) позволило по-новому  взглянуть на ранние стадии диабетической ретинопатии (ДР). Результаты последних исследований демонстрируют значимые изменения фовеальной аваскулярной зоны (ФАЗ) — ее площади, индекса ациркулярности, соотношения осей и угла ФАЗ до возникновения офтальмоскопических проявлений. Большое количество работ посвящено оценке сосудистой плотности на уровне отдельных сосудистых  сплетений, причем зачастую авторы используют разные  методы обработки изображений, разные количественные и качественные параметры. Не менее важным признаком доклинической ДР является формирование  неперфузируемых зон. ОКТА позволяет детектировать их на разных уровнях и вычислять их площадь. Изменение  извитости ретинальных сосудов, описанное ранее при анализе изображений глазного дна, может быть  зарегистрировано и количественно подсчитано на ОКТА- сканах. Кроме того, в отдельных исследованиях у пациентов без офтальмоскопических признаков ДР выявляются  микроаневризмы. В обзоре представлен анализ современных подходов к оценке ранних ангиографических  изменений сетчатки, а также дана оценка перспектив  использования ОКТА для совершенствования  диагностических алгоритмов ДР.

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