Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Br J Ophthalmol. 2014 Nov;98(11):1508-13. doi: 10.1136/bjophthalmol-2014-305333. Epub 2014 Jun 17.
To evaluate the efficacy of measuring subfoveal choroidal thickness in monitoring uveitis activity before and after treatment with infliximab in patients with Behçet's disease (BD)-associated uveitis.
Thirteen patients with BD (23 eyes) were selected for this retrospective observational case study. Subfoveal choroidal thickness was measured during active and remission phases of uveitis by enhanced depth imaging-spectral domain optical coherence tomography (EDI-OCT). In five patients (10 eyes), choroidal thickness was assessed at weeks 0, 2, 6 and 14 after the initiation of infliximab treatment.
Accompanied by excessive dye leakage from choroidal vessels on indocyanine green angiography, dilation of choroidal vessels was observed in the active phase of uveitis by EDI-OCT and the choroidal thickness was significantly greater than that in the remission phase. Treatment with infliximab significantly reduced the choroidal thickness from week 2 after the first infusion, and the reduced choroidal thickness was maintained thereafter. No correlation was found between choroidal thickness and best corrected visual acuity converted to logarithm of the minimum angle of resolution, but choroidal thickness correlated significantly with anterior and posterior ocular inflammation scores.
This study indicates that measurement of subfoveal choroidal thickness by EDI-OCT is useful for evaluating the activity of uveitis and the therapeutic efficacy in patients with BD.
评估在接受英夫利昔单抗治疗前后,通过测量黄斑下脉络膜厚度来监测贝赫切特病(BD)相关性葡萄膜炎活动的疗效。
本回顾性观察性病例研究纳入了 13 名(23 只眼)BD 患者。在葡萄膜炎的活动期和缓解期,通过增强深度成像-光谱域光学相干断层扫描(EDI-OCT)来测量黄斑下脉络膜厚度。在 5 名患者(10 只眼)中,在英夫利昔单抗治疗开始后的第 0、2、6 和 14 周评估脉络膜厚度。
在葡萄膜炎的活动期,通过 EDI-OCT 观察到脉络膜血管过度染料渗漏,脉络膜血管扩张,且脉络膜厚度明显大于缓解期。英夫利昔单抗治疗后第 2 周开始,脉络膜厚度显著降低,此后降低的脉络膜厚度得以维持。脉络膜厚度与最佳矫正视力(转换为最小角分辨率对数)之间无相关性,但与眼前段和眼后段炎症评分显著相关。
本研究表明,通过 EDI-OCT 测量黄斑下脉络膜厚度可用于评估 BD 患者葡萄膜炎的活动度和治疗效果。