National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital National Health Service (NHS) Foundation Trust, London, UK.
JAMA Ophthalmol. 2013 Mar;131(3):341-50. doi: 10.1001/jamaophthalmol.2013.1724.
To combine "extramacular" and "enhanced depth" optical coherence tomographic (OCT) scanning protocols to facilitate enhanced characterization of patients with birdshot chorioretinopathy.
Spectral-domain OCT images were prospectively collected from 24 eyes of 12 patients with birdshot chorioretinopathy. The images were acquired both from the macula and from 4 peripheral locations: superior and inferior to the temporal vascular arcades, nasal to the optic disc, and temporal to the macula. All images were obtained using enhanced depth scanning protocols. Qualitative and quantitative assessments were performed and compared with those from healthy, age-matched controls.
Generalized loss of the photoreceptor inner segment/outer segment junction was seen more frequently on extramacular OCT image sets. Focal loss of the inner segment/outer segment junction was seen most commonly on inferior extramacular images. Generalized thinning and loss of retinal architecture, accompanied by outer retinal hyperreflective foci, were also commonly seen on extramacular scans. Assessment of choroidal morphology included thinning/absence of the Sattler layer, generalized thinning, discrete hyperreflective foci, focal depigmentation, and the presence of suprachoroidal hyporeflective space. The mean (SD) foveal choroidal thickness was significantly less for patients with birdshot chorioretinopathy (276 [101] μm) than for controls (337 [74] μm) (P = .04).
The OCT images obtained outside the macula often show significant retinal and choroidal changes in cases for which conventional OCT scans appear unremarkable. Use of extramacular scanning may thus allow improved phenotyping of uveitic disorders such as birdshot chorioretinopathy. Evaluation of the photoreceptor inner segment/outer segment junction, using this approach, may be of value for monitoring disease activity in clinical practice and as a surrogate end point in clinical trials.
结合“周边部”和“增强深度”光学相干断层扫描（OCT）扫描方案，以促进对鸟枪弹样脉络膜视网膜病变患者的增强特征描述。
对 12 例鸟枪弹样脉络膜视网膜病变患者的 24 只眼前瞻性地采集了光谱域 OCT 图像。从黄斑和 4 个周边部位采集图像：颞血管弓的上方和下方、视神经盘的鼻侧和黄斑的颞侧。所有图像均使用增强深度扫描方案获得。进行定性和定量评估，并与健康、年龄匹配的对照组进行比较。
在周边 OCT 图像组中更频繁地观察到光感受器内节/外节连接的广泛丢失。在下方周边图像中最常见的是内节/外节连接的局灶性丢失。在外周扫描中还经常观察到视网膜结构的普遍变薄和丢失，伴有外视网膜高反射焦点。脉络膜形态的评估包括 Sattler 层变薄/缺失、普遍变薄、离散高反射焦点、局灶性色素减退和脉络膜下低反射空间的存在。鸟枪弹样脉络膜视网膜病变患者的平均（标准差）黄斑中心凹脉络膜厚度明显小于对照组（276[101]μm 比 337[74]μm）（P=0.04）。
在外周部获得的 OCT 图像通常在常规 OCT 扫描似乎正常的情况下显示出明显的视网膜和脉络膜变化。因此，使用周边部扫描可能允许对鸟枪弹样脉络膜视网膜病变等葡萄膜炎性疾病进行更好的表型分析。使用这种方法评估光感受器内节/外节连接可能有助于在临床实践中监测疾病活动，并作为临床试验中的替代终点。
