2型特发性黄斑毛细血管扩张症的多模态成像

Multimodal imaging in type 2 idiopathic macular telangiectasia.

作者信息

Sallo Ferenc B, Leung Irene, Clemons Traci E, Peto Tunde, Bird Alan C, Pauleikhoff Daniel

机构信息

*Department of Research and Development, Moorfields Eye Hospital, London, United Kingdom; †UCL Institute of Ophthalmology, London, United Kingdom; ‡The EMMES Corporation, Rockville, Maryland; §NIHR Biomedical Research Center for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; ¶Inherited Eye Disease, Moorfields Eye Hospital, London, United Kingdom; **Department of Ophthalmology, St. Franziskus Hospital, Münster, Germany.

出版信息

Retina. 2015 Apr;35(4):742-9. doi: 10.1097/IAE.0000000000000365.

DOI:10.1097/IAE.0000000000000365

PMID:25412037

Abstract

BACKGROUND

Macular telangiectasia Type 2 is a bilateral, progressive potentially blinding retinal disease characterized by both vascular and neurodegenerative signs that have been documented using different imaging techniques. The correlation between macular telangiectasia Type 2 signs from various imaging modalities is unknown. Our aim was to investigate the relationship of various macular telangiectasia Type 2 signs using fundus fluorescein angiography, optical coherence tomography and dual-wavelength autofluorescence images.

METHODS

Participants were selected from the macular telangiectasia Type 2 Natural History Observation Study, based on a confirmed diagnosis and the availability of images. Signs in fundus fluorescein angiography, dual-wavelength autofluorescence, and optical coherence tomography images were graded according to standardized categories, and agreement among the multimodel imaging was assessed statistically.

RESULTS

One hundred and ninety-one eyes of 96 patients were examined. Significant correlations were found between early and late fundus fluorescein angiography (ρ = 0.82, P < 0.0001), luteal pigment loss and early/late fundus fluorescein angiography signs (ρ = 0.52, P < 0.0001 and ρ = 0.62, P < 0.0001, respectively), inner and outer segment break length and pigment loss (Class 1 vs. 2/3, P < 0.0001; Class 2 vs. 3, P = 0.04). Correlation between pigment loss and retinal spaces/atrophic retinal restructuring was fair (κ = 0.25-0.33). Bilateral symmetry was slight to substantial (κ = 0.18-0.62).

CONCLUSION

Our data demonstrate the relative extent of neurodegenerative and vascular signs; it may be useful for designing systems for staging disease severity using multimodal imaging and may also provide clues to the pathogenesis of the disease.

摘要

背景

2型黄斑毛细血管扩张症是一种双侧性、进行性、有潜在致盲风险的视网膜疾病，其特征为血管和神经退行性病变体征，这些体征已通过不同的成像技术得到记录。不同成像方式下2型黄斑毛细血管扩张症体征之间的相关性尚不清楚。我们的目的是利用眼底荧光血管造影、光学相干断层扫描和双波长自发荧光图像，研究2型黄斑毛细血管扩张症各种体征之间的关系。

方法

从2型黄斑毛细血管扩张症自然病史观察研究中选取参与者，入选标准为确诊且有可用图像。眼底荧光血管造影、双波长自发荧光和光学相干断层扫描图像中的体征按照标准化类别进行分级，并对多模式成像之间的一致性进行统计学评估。

结果

对96例患者的191只眼进行了检查。发现早期和晚期眼底荧光血管造影之间存在显著相关性（ρ = 0.82，P < 0.0001），黄斑色素缺失与早期/晚期眼底荧光血管造影体征之间存在显著相关性（分别为ρ = 0.52，P < 0.0001和ρ = 0.62，P < 0.0001），内、外节段断裂长度与色素缺失之间存在显著相关性（1级与2/3级相比，P < 0.0001；2级与3级相比，P = 0.04）。色素缺失与视网膜间隙/萎缩性视网膜重构之间的相关性一般（κ = 0.25 - 0.33）。双侧对称性为轻度至重度（κ = 0.18 - 0.62）。