Zhang Jie, Yu Zikui, Liu Lin
*MD Department of Ophthalmology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (all authors).
Optom Vis Sci. 2015 Jan;92(1):e21-6. doi: 10.1097/OPX.0000000000000440.
Report a case of polypoidal choroidal vasculopathy (PCV) and reveal its characteristics in multispectral imaging (MSI), a novel modality that examines individual retinal layers and enhances visualization of deep retinal structures.
A 60-year-old Chinese woman presented with blurred vision in her left eye for over 1 week. Fundus examination revealed massive subretinal hemorrhage in the posterior pole with reddish orange polyp-like structure on the fovea of the left eye. Optical coherence tomography showed classic hyperreflectivity in the choroidal layer, known as the "double-layer" sign, adjacent to a serous retinal pigment epithelial detachment, which was further confirmed in fluorescein angiography of the left eye. Indocyanine green angiography demonstrated the features of PCV, including multiple polyps arising out of inner choroidal vessels in the early phase as hyperfluorescent spots and ringlike silhouette staining of the polyps in the late phase. Multispectral imaging as a new modality was introduced to visualize the polypoidal lesion as a polyp-like cluster of hyperreflectance in the short-wavelength images (green and yellow) with subsequent highly defined ringlike hyperreflectance in the longer-wavelength images (near-infrared and infrared). According to the manifestations above, this patient's final diagnosis was PCV in the left eye.
This is the first report using MSI as a novel imaging modality for the detection of PCV. Multispectral imaging can reveal highly defined hyperreflective polyp-like structures in the longer-wavelength images, which is compatible with the indocyanine green angiography findings, indicating preliminarily the advantages of noninvasiveness, simplicity, and effectiveness of MSI in diagnosing PCV.
报告一例息肉样脉络膜血管病变（PCV）病例，并揭示其在多光谱成像（MSI）中的特征。MSI是一种可检查视网膜各层并增强深层视网膜结构可视化的新型成像方式。
一名60岁中国女性因左眼视力模糊1周余就诊。眼底检查发现后极部大量视网膜下出血，左眼黄斑区可见红橙色息肉样结构。光学相干断层扫描显示脉络膜层有典型的高反射性，即“双层”征，紧邻浆液性视网膜色素上皮脱离，左眼荧光素血管造影进一步证实了这一点。吲哚菁绿血管造影显示了PCV的特征，包括早期从脉络膜内层血管发出的多个息肉表现为高荧光斑点，晚期息肉呈环状轮廓染色。引入多光谱成像这种新的成像方式，在短波长图像（绿色和黄色）中，息肉样病变表现为高反射性的息肉样簇，在长波长图像（近红外和红外）中随后出现高度清晰的环状高反射。根据上述表现，该患者最终诊断为左眼PCV。
这是首次使用MSI作为检测PCV的新型成像方式的报告。多光谱成像可在长波长图像中显示高度清晰的高反射性息肉样结构，这与吲哚菁绿血管造影结果相符，初步表明MSI在诊断PCV方面具有无创、简便和有效的优势。
