Vitreous-Retina-Macula Consultants of New York, New York, New York, USA.
Retina. 2011 May;31(5):829-37. doi: 10.1097/IAE.0b013e31820c841e.
To develop a method of imaging the retina using wide-field fluorescein angiography and use this method to investigate the areas of perfusion abnormalities in patients treated with ranibizumab for central retinal vein occlusion.
Cross-sectional analysis of patients recruited to a prospective study. Patients in a prospective study of ranibizumab for central retinal vein occlusion were imaged with wide-field angiography. Fluorescein angiograms taken with the Optos P200 Scanning Laser Ophthalmoscope were obtained of the posterior portion of the eye and of the periphery through ocular steering. Resultant images of the periphery were registered to the posterior image using thin-plate spline warping. A transformation was used to measure the retinal surface area. Perfusion characteristics were compared with injection frequencies and protocol refraction visual acuity measurements.
Of 22 patients imaged, 7 would be classified as nonperfused by the Central Retinal Vein Occlusion Study (CVOS) angiographic criteria. However, all patients showed confluent areas of nonperfusion in the retinal periphery ranging in size from 16 disk areas to 242 disk areas. The areas of peripheral nonperfusion were not significantly different in the Central Retinal Vein Occlusion Study-perfused group versus nonperfused group. The area of peripheral nonperfusion was not correlated with the number of injections (r = -0.13, P = 0.58), but was inversely correlated with visual acuity (r = -0.52, P = 0.013). Blood vessels at the border of the peripheral nonperfusion did not show signs of neovascular growth or profuse leakage.
Angiographic mapping of the retina is possible using image-processing techniques with wide-field images. Eyes with central retinal vein occlusion develop widespread peripheral vascular obliteration in regions that are difficult to image with conventional fundus cameras. These nonperfused areas may have important implications for visual function.
开发一种使用广角荧光素血管造影术对视网膜进行成像的方法，并使用该方法研究接受雷珠单抗治疗的中央性视网膜静脉阻塞患者的灌注异常区域。
对前瞻性研究中招募的患者进行横断面分析。对接受雷珠单抗治疗的中央性视网膜静脉阻塞的前瞻性研究患者进行广角血管造影。使用 Optos P200 扫描激光检眼镜拍摄的眼底荧光素血管造影图像通过眼球转向获取眼后段和周边部图像。使用薄板样条变形对周边部图像进行配准。使用转换来测量视网膜表面积。将灌注特征与注射频率和方案矫正视力测量结果进行比较。
在成像的 22 名患者中，7 名患者将根据中央性视网膜静脉阻塞研究（CVOS）血管造影标准被归类为无灌注。然而，所有患者在视网膜周边均显示出大小不一的融合性无灌注区，范围从 16 个盘区到 242 个盘区。在中央性视网膜静脉阻塞研究的灌注组与无灌注组中，周边无灌注区无显著差异。周边无灌注区的面积与注射次数无关（r = -0.13，P = 0.58），但与视力呈负相关（r = -0.52，P = 0.013）。周边无灌注区边界的血管没有出现新生血管生长或大量渗漏的迹象。
使用图像处理技术对广角图像进行处理，可以对视网膜进行血管造影成像。患有中央性视网膜静脉阻塞的眼睛在常规眼底相机难以成像的区域会发生广泛的周边血管闭塞。这些无灌注区可能对视功能有重要影响。
