Politoa Antonio, Napolitano M C, Bandello Francesco, Chiodini Raffaella Gortana
Department of Ophthalmology, University of Udine, Udine, Italy.
Ann Acad Med Singap. 2006 Jun;35(6):420-4.
The aim of this review was to describe the use of optical coherence tomography (OCT) in the diagnosis and management of retinal angiomatous proliferation (RAP) in patients with age-related macular degeneration (AMD).
We reviewed the tomographic characteristics of the eyes affected by RAP seen at our institution and imaged by OCT. Some eyes with RAP were also studied with OCT prior to and after laser treatment to determine the tomographic changes following laser photocoagulation.
In this preliminary report, OCT showed a typical pattern of structural changes in RAP: increased foveal thickness, cystoid macular oedema (CME) consisting of large central cysts and smaller cystoid spaces located mainly in the outer retinal layers, serous retinal detachment and a highly reflective intraretinal mass overlying a highly or moderately elevated retinal pigment epithelium (RPE). This mass corresponded to the hot spot observed on ICG angiography. After successful laser photocoagulation, significant decrease in foveal thickness, complete resolution of CME and retinal detachment with thinning of the neurosensory retina overlying the treated area could be observed.
OCT appears to be useful in evaluating and documenting RAP in AMD patients both before and after laser photocoagulation. Longitudinal studies are required to determine its exact place and utility in clinical practice.
本综述的目的是描述光学相干断层扫描（OCT）在年龄相关性黄斑变性（AMD）患者视网膜血管瘤样增生（RAP）的诊断和管理中的应用。
我们回顾了在我们机构就诊并通过OCT成像的受RAP影响的眼睛的断层特征。一些患有RAP的眼睛在激光治疗前后也进行了OCT研究，以确定激光光凝后的断层变化。
在这份初步报告中，OCT显示了RAP典型的结构变化模式：黄斑中心凹厚度增加、黄斑囊样水肿（CME），由大的中央囊肿和主要位于视网膜外层的较小囊样间隙组成、浆液性视网膜脱离以及覆盖在高度或中度隆起的视网膜色素上皮（RPE）上的高反射性视网膜内肿物。这个肿物对应于吲哚菁绿血管造影（ICG）上观察到的热点。成功进行激光光凝后，可以观察到黄斑中心凹厚度显著降低、CME和视网膜脱离完全消退，且治疗区域上方的神经感觉视网膜变薄。
OCT似乎有助于评估和记录AMD患者激光光凝前后的RAP情况。需要进行纵向研究以确定其在临床实践中的准确地位和效用。
