Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Invest Ophthalmol Vis Sci. 2014 Jan 7;55(1):134-41. doi: 10.1167/iovs.13-13201.
We studied morphologic changes of the retinal vasculature in eyes with central retinal vein occlusion (CRVO) through the use of optical coherence tomography (OCT).
Major retinal vessels in 35 eyes from 35 consecutive patients with acute CRVO were examined prospectively and longitudinally with sequential thin sectioning and circumpapillary scanning. Anteroposterior venous tortuosity associated with CRVO was quantified on longitudinal OCT images of a randomly selected major temporal vein. On OCT sections of a given vein, we identified the innermost and outermost points of the vessel wall. The degree of anteroposterior venous tortuosity was defined as the difference between the vertical distances from the retinal pigment epithelium to the center of the venous lumen at these two points.
The OCT images revealed that the major retinal veins traveled tortuously through the swollen neurosensory retina from the inner retinal surface to the retinal pigment epithelium. The degree of anteroposterior venous tortuosity was correlated with poor visual acuity (r = 0.457, P = 0.017), increased mean foveal thickness (r = 0.671, P < 0.001), and the height of foveal detachment (r = 0.414, P = 0.032). In 4 (11%) eyes, a localized retinal detachment was detected around the optic disc, which correlated with anteroposterior venous tortuosity. In 14 (40%) eyes, elongated major retinal veins disrupted the boundary between retinal vessels and parenchyma, which resulted in juxtavenous splitting of the neurosensory retina.
In eyes with CRVO, OCT can be used to visualize anteroposterior venous tortuosity and associated structural changes to the retinal parenchyma.
我们通过光学相干断层扫描（OCT）研究了视网膜中央静脉阻塞（CRVO）眼中视网膜血管的形态变化。
对 35 例连续急性 CRVO 患者的 35 只眼的主要视网膜血管进行前瞻性和纵向研究，采用连续薄层切片和环视盘扫描。CRVO 相关的静脉前后弯曲通过对随机选择的主要颞侧静脉的纵向 OCT 图像进行定量。在给定静脉的 OCT 切片上，我们确定了血管壁的最内点和最外点。前后静脉弯曲度定义为这两点视网膜色素上皮到静脉管腔中心的垂直距离之间的差异。
OCT 图像显示，主要视网膜静脉从内视网膜表面蜿蜒穿过肿胀的神经感觉视网膜，到达视网膜色素上皮。前后静脉弯曲度与视力差（r = 0.457，P = 0.017）、平均黄斑中心凹厚度增加（r = 0.671，P <0.001）和黄斑脱离高度（r = 0.414，P = 0.032）相关。在 4 只眼（11%）中，检测到围绕视盘的局部视网膜脱离，与前后静脉弯曲度相关。在 14 只眼（40%）中，伸长的主要视网膜静脉破坏了视网膜血管和实质之间的边界，导致神经感觉视网膜的静脉旁分离。
在 CRVO 眼中，OCT 可用于可视化前后静脉弯曲度和相关的视网膜实质结构变化。
