AbstractBackgroundRetinal microaneurysms (MAs) are among the earliest signs of diabetic retinopathy (DR) and can be classified in several subtypes by non-invasive multimodal retinal imaging. The main aim of the present study is to characterize retinal MAs perfusion properties and their blood flow network connectivity by means of Dense Automatic-RealTime (DART) OCTA technology, checking the relationship with the multimodal retinal imaging classification and testing the clinical impact of DART.MethodsA cross-sectional, observational study setting was chosen.

摘要背景视网膜微动脉瘤（MAs）是糖尿病视网膜病变（DR）的最早体征之一，可通过非侵入性多模式视网膜成像分为几种亚型。本研究的主要目的是通过密集自动实时（DART）OCTA技术表征视网膜MAs灌注特性及其血流网络连通性，检查与多模式视网膜成像分类的关系并测试DART的临床影响。方法选择横断面观察性研究环境。

Multimodal retinal imaging included confocal multicolour, OCT, OCTA and DART OCTA. We classified retinal MAs accordingly with the recently proposed multimodal retinal imaging classification and we tested the role of DART OCTA for detecting retinal MAs blood flow network connectivity. We also tested the relationship with clinical parameters.ResultsWe included 206 retinal MAs of 36 DR eyes.

多模式视网膜成像包括共焦多色，OCT，OCTA和DART OCTA。我们使用最近提出的多模式视网膜成像分类对视网膜MAs进行了相应的分类，并测试了DART OCTA在检测视网膜MAs血流网络连通性中的作用。我们还测试了与临床参数的关系。结果我们纳入了36只眼的206个视网膜MAs。

We categorized retinal MAs as red (70; 34%), mixed (106; 51%) and green (30; 15%), corresponding to precise characteristics on structural OCT and both (regular) enface and DART OCTA images. The agreement between en-face and DART OCTA techniques for detecting MAs perfusion was very high (overall ICC 0.98; p < 0.01).

我们将视网膜MAs分类为红色（70；34%），混合（106；51%）和绿色（30；15%），对应于结构OCT以及（常规）正面和DART OCTA图像的精确特征。en face和DART OCTA技术检测MAs灌注的一致性非常高（总体ICC 0.98；p<0.01）。

However, DART OCTA provided clearer visualization than enface OCTA for detecting the blood flow network connectivity of retinal MAs, especially looking at the afferent and efferent MAs capillaries. Multimodal retinal imaging classification of retinal MAs provided significant correlations with DR duration, DR stage, and macular capillary non-perfusion.ConclusionsDART OCTA provided several new insights on retinal MAs characteristics and their blood flow network connectivity..

然而，DART OCTA比enface OCTA提供了更清晰的可视化，用于检测视网膜MAs的血流网络连通性，特别是观察传入和传出的MAs毛细血管。视网膜MAs的多模式视网膜成像分类与DR持续时间，DR分期和黄斑毛细血管非灌注有显着相关性。结论SDART OCTA为视网膜MAs特征及其血流网络连通性提供了一些新的见解。。

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Fig. 1: Multimodal retinal imaging characteristics of red MAs.Fig. 2: Multimodal retinal imaging characteristics of mixed MAs.Fig. 3: Multimodal retinal imaging characteristics of green MAs.

图1:red MAs的多模式视网膜成像特征。图2：混合MAs的多模式视网膜成像特征。图3：绿色MAs的多模式视网膜成像特征。

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Download referencesFundingFrancesco Bandello consultant for: Alcon (Fort Worth, Texas, USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch And Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La-Roche (Basel, Switzerland), NovagaliPharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee, Belgium), Zeiss (Dublin, USA).

下载参考资料FundingFrancesco Bandello顾问：爱尔康（美国德克萨斯州沃思堡），Alimera Sciences（美国佐治亚州阿尔法雷塔），Allergan Inc（美国加利福尼亚州欧文），Farmila Thea（法国克莱蒙费朗），拜耳谢灵制药（德国柏林），博士伦（美国纽约州罗切斯特），Genentech（美国加利福尼亚州旧金山），霍夫曼-罗氏（瑞士巴塞尔），NovagaliPharma（法国埃弗里），诺华（瑞士巴塞尔），赛诺菲-安万特（法国巴黎），血栓形成（比利时海弗利），泽西ISS（美国都柏林）。

Michel Teussink is employee of Heidelberg Engineering GmbH. All other authors have no disclosures to declare.Author informationAuthors and AffiliationsDepartment of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, ItalyAlessandro Arrigo, Emanuela Aragona, Maurizio Battaglia Parodi & Francesco BandelloEye Repair Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, ItalyAlessandro ArrigoHeidelberg Engineering GmbH, Heidelberg, GermanyMichel TeussinkAuthorsAlessandro ArrigoView author publicationsYou can also search for this author in.

Michel Teussink是海德堡工程有限公司的员工。所有其他作者都没有披露。作者信息作者和附属机构IRCCS圣拉斐尔科学研究所眼科，米兰，ItalyAlessandro Arrigo，Emanuela Aragona，Maurizio Battaglia Parodi＆Francesco BandelloEye修复单位，IRCCS圣拉斐尔科学研究所神经科学部，米兰，ItalyAlessandro ArrigoHeidelberg Engineering GmbH，海德堡，德国Michel Teussink作者Alessandro ArrigoView作者出版物您也可以在中搜索这位作者。

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PubMed Google ScholarContributionsAlessandro Arrigo and Emanuela Aragona: study design, data collection, data analysis, data interpretation, manuscript drafting. Michel Teussink and Maurizio Battaglia Parodi: data collection, data analysis, data interpretation, manuscript revision.

PubMed谷歌学术贡献SalesSandro Arrigo和Emanuela Aragona：研究设计，数据收集，数据分析，数据解释，手稿起草。Michel Teussink和Maurizio Battaglia Parodi：数据收集，数据分析，数据解释，稿件修订。

Francesco Bandello: guarantee of the integrity of the research, data analysis, data interpretation, manuscript revision.Corresponding authorCorrespondence to.

Francesco Bandello：保证研究，数据分析，数据解释，稿件修订的完整性。对应作者对应。

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协会或其他合作伙伴）根据与作者或其他权利持有人的出版协议对本文拥有专有权；本文接受稿件版本的作者自行存档仅受此类出版协议和适用法律的条款管辖。转载和许可本文引用本文Arrigo，A.，Aragona，E.，Teussink，M。

et al. Digital histology of retinal microaneurysms as provided by dense B-scan (DART) OCTA: characteristics and clinical relevance in diabetic retinopathy..

等。致密B扫描（DART）OCTA提供的视网膜微动脉瘤的数字组织学：糖尿病视网膜病变的特征和临床相关性。。

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