Coscas Florence, Coscas Gabriel, Souied Eric, Tick Sarah, Soubrane Gisele
Creteil University Eye Clinic, University of Paris XII, Creteil, France.
Am J Ophthalmol. 2007 Oct;144(4):592-9. doi: 10.1016/j.ajo.2007.06.014. Epub 2007 Aug 15.
To evaluate and describe the various optical coherence tomography (OCT) features of occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD) at the time of diagnosis.
Prospective, consecutive, observational case series.
One hundred and fifty-three eyes of 130 consecutive patients with subfoveal occult CNV diagnosed on scanning laser ophthalmoscope (SLO) fluorescein angiography (FA) and SLO indocyanine green angiography (ICGA) were evaluated with OCT. The diagnostic criteria for occult CNV on angiography were heterogeneous hyperfluorescence with late leakage in the macular region associated with pigment epithelial detachment (PED), stippled hyperfluorescent dots, and signs of deterioration. OCT findings were evaluated and described.
A PED was observed on OCT in 98% (150 eyes) either as a limited retinal pigment epithelium (RPE) elevation (54 eyes [35.3%]) or a complete detachment (96 eyes [62.7%]). Occult CNV corresponded to zones of hyperreflectivity in contact with the RPE band and was detected in 62.7% of eyes. In fibrovascular PED (63 eyes [65.5%]), the elevated RPE was highlighted posteriorly by a moderately reflective band overlying a hyporeflective cavity. In serous PED, the cavity remained optically empty. The RPE in the detached zone showed changes such as fragmentation (137 eyes [89.5%]). OCT also showed intraretinal (122 eyes [79.7%]) and subretinal (64 eyes [41.8%]) fluid.
Analysis of the various OCT features observed in this study confirms the polymorphic nature of occult CNV in AMD, their exudative reactions, the almost constant presence of PED, and the different changes in the RPE band. OCT examination, therefore, provides valuable data to confirm the features of subepithelial occult CNV.
评估并描述年龄相关性黄斑变性（AMD）患者隐匿性脉络膜新生血管（CNV）在诊断时的各种光学相干断层扫描（OCT）特征。
前瞻性、连续性、观察性病例系列研究。
对130例经扫描激光眼底镜（SLO）荧光素血管造影（FA）和SLO吲哚菁绿血管造影（ICGA）诊断为黄斑下隐匿性CNV的连续患者的153只眼进行OCT评估。血管造影隐匿性CNV的诊断标准为黄斑区异质性高荧光伴晚期渗漏，伴有色素上皮脱离（PED）、点状高荧光点及病变迹象。对OCT检查结果进行评估和描述。
OCT检查发现98%（150只眼）存在PED，表现为局限性视网膜色素上皮（RPE）隆起（54只眼[35.3%]）或完全脱离（96只眼[62.7%]）。隐匿性CNV对应于与RPE带接触的高反射区，62.7%的眼可检测到。在纤维血管性PED（63只眼[65.5%]）中，隆起的RPE后方有一条中等反射带覆盖在低反射腔上。在浆液性PED中，腔保持光学空泡状态。脱离区的RPE出现如碎裂等改变（137只眼[89.5%]）。OCT还显示视网膜内（122只眼[79.7%]）和视网膜下（64只眼[41.8%]）积液。
本研究中观察到的各种OCT特征分析证实了AMD中隐匿性CNV的多态性、其渗出反应、PED几乎恒定存在以及RPE带的不同变化。因此，OCT检查为确认上皮下隐匿性CNV的特征提供了有价值的数据。
