Nomogram model predicts the risk of visual impairment in diabetic retinopathy: a retrospective study

作者全名："Zhao, Yuancheng; Yu, Rentao; Sun, Chao; Fan, Wei; Zou, Huan; Chen, Xiaofan; Huang, Yanming; Yuan, Rongdi"

作者地址："[Zhao, Yuancheng; Sun, Chao; Fan, Wei; Zou, Huan; Chen, Xiaofan; Huang, Yanming; Yuan, Rongdi] Army Med Univ, Dept Ophthalmol, Affiliated Hosp 2, 183 Xinqiaozheng St, Chongqing 400037, Peoples R China; [Yu, Rentao] Chongqing Med Univ, Dept Dermatol, Affiliated Hosp 1, 1 Youyi Rd, Chongqing, Peoples R China"

通信作者："Yuan, RD (通讯作者)，Army Med Univ, Dept Ophthalmol, Affiliated Hosp 2, 183 Xinqiaozheng St, Chongqing 400037, Peoples R China."

来源：BMC OPHTHALMOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000895975500003

JCR分区：Q3

影响因子：2

年份：2022

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Nomogram; Visual impairment; Decision curve analysis; Clinical impact curve; Optical coherence tomography angiography; Diabetic retinopathy

摘要："Background: To develop a model for predicting the risk of visual impairment in diabetic retinopathy (DR) by a nomogram. Methods: Patients with DR who underwent both optical coherence tomography angiography (OCTA) and fundus fluorescein angiography (FFA) were retrospectively enrolled. FFA was conducted for DR staging, swept-source optical coherence tomography (SS-OCT) of the macula and 3*3-mm blood flow imaging by OCTA to observe retinal structure and blood flow parameters. We defined a logarithm of the minimum angle of resolution visual acuity (LogMAR VA) & GE;0.5 as visual impairment, and the characteristics correlated with VA were screened using binary logistic regression. The selected factors were then entered into a multivariate binary stepwise regression, and a nomogram was developed to predict visual impairment risk. Finally, the model was validated using the area under the receiver operating characteristic (ROC) curve (AUC), calibration plots, decision curve analysis (DCA), and clinical impact curve (CIC). Results: A total of 29 parameters were included in the analysis, and 13 characteristics were used to develop a nomogram model. Finally, diabetic macular ischaemia (DMI) grading, disorganization of the retinal inner layers (DRIL), outer layer disruption, and the vessel density of choriocapillaris layer inferior (SubVD) were found to be statistically significant (P < 0.05). The model was found to have good accuracy based on the ROC (AUC = 0.931) and calibration curves (C-index = 0.930). The DCA showed that risk threshold probabilities in the (3-91%) interval models can be used to guide clinical practice, and the proportion of people at risk at each threshold probability is illustrated by the CIC. Conclusion: The nomogram model for predicting visual impairment in DR patients demonstrated good accuracy and utility, and it can be used to guide clinical practice."

基金机构："Department of Ophthalmology, Second Affiliated Hospital of Army Medical University"

基金资助正文："This study was supported by scientific research funds from the Department of Ophthalmology, Second Affiliated Hospital of Army Medical University."