Michalewska Zofia, Michalewski Janusz, Nawrocka Zofia, Dulczewska-Cichecka Karolina, Nawrocki Jerzy
*Ophthalmic Clinic "Jasne Blonia," Lodz, Poland; and †III Municipal Hospital K. Jonscher, Ophthalmic Department, Lodz, Poland.
Retina. 2015 Feb;35(2):244-9. doi: 10.1097/IAE.0000000000000281.
To define the morphology of outer choroidal margins in swept-source optical coherence tomography.
This is a prospective observational study of 180 eyes: 20 eyes of healthy volunteers, 20 eyes of myopic patients, and 20 eyes from each of the following groups: macular hole, lamellar macular hole, epiretinal membranes, drusen, dry age-related macular degeneration (AMD), neovascular AMD, and vitreomacular traction. A single 12-mm wide swept-source optical coherence tomography image for each of the examined eyes consisting of 1,024 A-scans has been created. The main outcome measure selected was to estimate the presence of suprachoroidal layer, as well as to estimate the ability to delineate the outer choroidoscleral boundary using the software available (DRI-OCT) and to determine its shape.
Suprachoroidal layer was observed in 5% of healthy emmetropic eyes, in 50% of eyes with full-thickness macular holes, and in 60% of eyes with vitreomacular traction syndrome. It was also present in 50% of eyes with dry AMD and in 20% of eyes with neovascular AMD. The outer margin of the choroid in all eyes of the healthy volunteers and in eyes with macular diseases has been delineated correctly. In all healthy and myopic eyes, we recognized the outer choroidoscleral boundary as having a regular shape following the natural oval contour of the globe. In eyes with epiretinal membranes, macular hole, vitreomacular traction, and AMD, the outer choroidoscleral boundary was irregular; the choroid varied in thickness from point to point.
Swept-source optical coherence tomography enables exact visualization of the outer choroidoscleral boundary. Suprachoroidal layer consisting of two bands has been recognized, the upper of which is hyperreflective and the lower of which is hyporeflective. It may be supposed that the lower hyporeflective band corresponds to suprachoroidal space, which was not earlier visualized in vivo in eyes without choroidal effusion. Suprachoroidal layer in myopic and emmetropic healthy subjects has been rarely observed. We observed it more frequently in different macular diseases.
在扫频源光学相干断层扫描中定义脉络膜外层边缘的形态。
这是一项对180只眼睛的前瞻性观察研究：20只健康志愿者的眼睛、20只近视患者的眼睛，以及以下每组各20只眼睛：黄斑裂孔、板层黄斑裂孔、视网膜前膜、玻璃膜疣、干性年龄相关性黄斑变性（AMD）、新生血管性AMD和玻璃体黄斑牵引。为每只被检查的眼睛创建了一张12毫米宽的扫频源光学相干断层扫描图像，由1024条A扫描线组成。选择的主要观察指标是评估脉络膜上层的存在情况，以及使用可用软件（DRI - OCT）描绘脉络膜巩膜外层边界的能力并确定其形状。
在5%的正视健康眼睛、50%的全层黄斑裂孔眼睛和60%的玻璃体黄斑牵引综合征眼睛中观察到脉络膜上层。在50%的干性AMD眼睛和20%的新生血管性AMD眼睛中也存在脉络膜上层。健康志愿者的所有眼睛以及患有黄斑疾病的眼睛中脉络膜的外层边缘都被正确描绘。在所有健康和近视眼睛中，我们认识到脉络膜巩膜外层边界呈规则形状，遵循眼球的自然椭圆形轮廓。在患有视网膜前膜、黄斑裂孔、玻璃体黄斑牵引和AMD的眼睛中，脉络膜巩膜外层边界不规则；脉络膜厚度逐点变化。
扫频源光学相干断层扫描能够精确显示脉络膜巩膜外层边界。已识别出由两条带组成的脉络膜上层，其上部高反射，下部低反射。可以推测，下部低反射带对应于脉络膜上腔，在没有脉络膜积液的眼睛中，此前尚未在体内观察到该结构。在近视和正视健康受试者中很少观察到脉络膜上层。我们在不同的黄斑疾病中更频繁地观察到它。
