Vitreous Retina Macula Consultants of New York, New York, New York 10022, USA.
Retina. 2011 Apr;31(4):717-23. doi: 10.1097/IAE.0b013e318203c1ef.
To compare the spectral-domain optical coherence tomography (SD-OCT) findings of the acute lesions of multifocal choroiditis (MFC) with those of new-onset myopic choroidal neovascularization (CNV).
Observational case series. A retrospective review comparing the SD-OCT findings of the acute lesions of MFC with those of early myopic CNV. Spectral-domain optical coherence tomography findings in two female patients and one male patient presenting with acute inflammatory lesions of MFC were compared with those of new-onset CNV in three patients with myopic macular degeneration. Each patient underwent a comprehensive eye examination, fundus photography, and fluorescein angiography on the initial visit. The patients underwent SD-OCT scanning at baseline and at follow-up visits using image registration and eye tracking.
Spectral-domain optical coherence tomography imaging of the acute lesions of MFC showed drusenlike material between the retinal pigment epithelium and the Bruch membrane, presumed vitreous cells, and localized choroidal hyperreflectivity below the subretinal pigment epithelial material. These SD-OCT findings were not usually present in the eyes with myopic CNV. The subretinal pigment epithelial material corresponded to acute lesions found on color photographs and fluorescein angiography. The subretinal pigment epithelial material and choroidal hyperreflectivity appeared to improve after treatment with antiinflammatory or anti-vascular endothelial growth factor therapy. In contrast, SD-OCT in the patients with myopic CNV showed a very thin choroid, a posterior staphyloma, and a Type 2 (subretinal) neovascular pattern.
The acute lesions of MFC can be difficult to distinguish from myopic CNV based on clinical examination and fluorescein angiography. However, the inflammatory lesions of MFC can demonstrate characteristic SD-OCT findings not seen with myopic CNV. These SD-OCT findings may help to differentiate these two entities that typically require different treatments.
比较多发性脉络膜炎（MFC）急性病变的光谱域光相干断层扫描（SD-OCT）结果与新发性近视脉络膜新生血管（CNV）的结果。
观察性病例系列研究。回顾性比较 MFC 急性病变的 SD-OCT 结果与新发性近视 CNV 的结果。比较两名女性患者和一名男性患者的 MFC 急性炎症病变的 SD-OCT 结果与三名近视性黄斑变性患者的新发性 CNV 的结果。每位患者在初次就诊时均进行全面的眼部检查、眼底照相和荧光素血管造影。患者在基线和随访时使用图像配准和眼球跟踪进行 SD-OCT 扫描。
MFC 急性病变的 SD-OCT 成像显示视网膜色素上皮和布鲁赫膜之间有类沉积物物质、推测为玻璃体细胞，以及在视网膜下色素上皮下物质下方有局部脉络膜高反射性。这些 SD-OCT 发现通常不存在于近视性 CNV 眼中。视网膜下色素上皮下物质与在彩色照片和荧光素血管造影上发现的急性病变相对应。在接受抗炎或抗血管内皮生长因子治疗后，视网膜下色素上皮下物质和脉络膜高反射性似乎有所改善。相比之下，近视性 CNV 患者的 SD-OCT 显示脉络膜非常薄、后葡萄肿和 2 型（视网膜下）新生血管模式。
根据临床检查和荧光素血管造影，MFC 的急性病变可能难以与近视性 CNV 区分。然而，MFC 的炎症病变可以表现出与近视性 CNV 不同的特征性 SD-OCT 发现。这些 SD-OCT 发现可能有助于区分这两种通常需要不同治疗的实体。
