三种OCTA仪器测量长期服用羟氯喹患者视网膜黄斑区微血管参数的一致性分析OA

·AIM:To compare the consistency of macular microvascular parameters measured by three devices:frequency-domain optical coherence tomography angiography(FD-OCTA)with split-spectrum amplitude-decorrelation angiography(SSADA),FD-OCTA with optical microangiography(OMAG),and swept-source OCTA(SS-OCTA),in patients with long-term hydroxychloroquine(HCQ)administration for rheumatoid arthritis(RA). ·METHODS:This prospective study enrolled patients treated with HCQ for 5 y due to RA who visited the Department of Ophthalmology of the hospital from January 2022 to November 2025.All subjects underwent a 6 mm x6 mm macular scan with three OCTA devices in random order,with a 5-minute interval between examinations by different devices.Images of the superficial capillary plexus(SCP)and deep capillary plexus(DCP)were acquired.The following microvascular parameters were compared:foveal superficial capillary plexus vessel density(F-SCP VD),parafoveal superficial capillary plexus vessel density(PF-SCP VD),foveal deep capillary plexus vessel density(F-DCP VD),parafoveal deep capillary plexus vessel density(PF-DCP VD),and the area of the foveal avascular zone(FAZ). ·RESULTS:A total of 34 female patients(68 eyes)treated with HCQ for 5 y due to RA were enrolled in this study,aged 38-58 y with a mean age of 49.3±5.05 y.Statistically significant differences were found in F-SCP VD,PF-SCP VD,F-DCP VD,PF-DCP VD,and FAZ area among measurements obtained by SS-OCTA,SSADA-based FD-OCTA,and OMAG-based FD-OCTA(all P＜0.05).No statistically significant differences in all above parameters were observed between SSADA-based FD-OCTA and OMAG-based FD-OCTA(all P＞0.05).FAZ areas measured by the three devices were highly positively correlated(|r|≥0.8,P＜0.01).The F-SCP VD,PF-SCP VD,F-DCP VD,and PF-DCP VD values obtained by SSADA-based FD-OCTA and OMAG-based FD-OCTA were all highly positively correlated(|r|≥0.8,P＜0.01).The PF-SCP VD and PF-DCP VD values measured by SS-OCTA versus SSADA-based FD-OCTA and OMAG-based FD-OCTA showed moderate positive correlations(0.5≤|r|＜0.8,P＜0.01).The F-SCP VD and F-DCP VD values measured by SS-OCTA versus SSADA-based FD-OCTA and OMAG-based FD-OCTA exhibited low positive correlations(0.3 ≤|r|＜0.5,P＜0.05).Bland-Altman plots demonstrated good agreement between SSADA-based FD-OCTA and OMAG-based FD-OCTA for the measurements of F-SCP VD,PF-SCP VD,F-DCP VD and PF-DCP VD.By contrast,poor agreement was observed when comparing SS-OCTA with SSADA-based FD-OCTA or OMAG-based FD-OCTA for measurements of F-SCP VD,PF-SCP VD,F-DCP VD and PF-DCP VD.Satisfactory agreement was found among the three OCTA devices for FAZ area measurements. ·CONCLUSION:SSADA-based FD-OCTA and OMAG-based FD-OCTA show favorable correlation and agreement in measuring macular vessel density of patients receiving HCQ,which allows cautious interchangeable use during clinical follow-up.The vessel density parameters measured by SS-OCTA were markedly different from those obtained by SSADA-based FD-OCTA and OMAG-based FD-OCTA;therefore,these devices cannot be directly interchanged.FAZ area measurements exhibit favorable inter-device agreement among the three systems,and interchangeability should be considered in the context of clinical practice.