A Sohrab Mahsa, A Fawzi Amani
Department of Ophthalmology Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Med Hypothesis Discov Innov Ophthalmol. 2013 Fall;2(3):69-73.
Investigations of choroidal vasculature have been of particular interest given choroidal vascular dysfunction are thought to be related with a number pathologic conditions such as central serous chorioretinopathy and various forms of AMD, including polypoidal choroidal vasculopathy. On the other hand, en face imaging of the choroid allows an exceptional alternative to histopathologic evaluation of the choroid, and can be used to quantify choroidal vascular structures. Our former study verified differences in the macular choroid in AMD and control patients previously noted on histopathologic studies. The use of phase-resolved approaches in larger population longitudinal studies reveal the sequence of RPE and choroidal changes in the pathogenesis of various AMD subtypes, which cannot be done using histopathology. Issues with lateral resolution of the OCT system in measuring choriocapillaris size could be solved by incorporating the axial dimension of the choriocapillaris into choriocapilaris diameter assessment (assuming the choriocapillaris are round in vivo), and by correcting for anisometric pixel resolution. Forthcoming studies are required to determine whether areas of choriocapillaris correlate with areas of RPD lesions.
鉴于脉络膜血管功能障碍被认为与多种病理状况相关，如中心性浆液性脉络膜视网膜病变以及各种形式的年龄相关性黄斑变性，包括息肉样脉络膜血管病变，对脉络膜血管系统的研究一直备受关注。另一方面，脉络膜的正面成像为脉络膜的组织病理学评估提供了一种特殊的替代方法，可用于量化脉络膜血管结构。我们之前的研究证实了年龄相关性黄斑变性患者与对照患者黄斑脉络膜的差异，这在之前的组织病理学研究中已有记载。在更大规模的人群纵向研究中使用相位分辨方法揭示了各种年龄相关性黄斑变性亚型发病机制中视网膜色素上皮（RPE）和脉络膜变化的顺序，而这是组织病理学无法做到的。通过将脉络膜毛细血管的轴向尺寸纳入脉络膜毛细血管直径评估（假设脉络膜毛细血管在体内呈圆形），并校正各向异性像素分辨率，可以解决光学相干断层扫描（OCT）系统在测量脉络膜毛细血管大小时横向分辨率的问题。需要进一步的研究来确定脉络膜毛细血管区域是否与视网膜色素上皮脱离（RPD）病变区域相关。
