Amarakoon Sankha, de Jong Jan H, Braaf Boy, Yzer Suzanne, Missotten Tom, van Velthoven Mirjam E J, de Boer Johannes F
Rotterdam Ophthalmic Institute, Rotterdam, Netherlands; Medical Retina Service, Rotterdam Eye Hospital, Rotterdam, Netherlands.
Rotterdam Ophthalmic Institute, Rotterdam, Netherlands.
Am J Ophthalmol. 2015 Nov;160(5):1044-1054.e1. doi: 10.1016/j.ajo.2015.07.026. Epub 2015 Jul 23.
To study patients diagnosed with retinal angiomatous proliferation (RAP) based on conventional imaging techniques with phase-resolved Doppler optical coherence tomography (OCT) to detect and localize blood flow in RAP lesions; and to compare these findings to conventional imaging, which are mostly invasive and give limited information concerning intra- and transretinal blood flow.
Single-center, consecutive observational case series.
Twelve treatment-naïve patients diagnosed with RAP based on fundus examination, fluorescein angiography, and indocyanine green angiography were included. Median age was 79 years (range 65-90). Patients were imaged with an experimental 1040 nm swept-source phase-resolved Doppler OCT instrument. Abnormal flow was defined as intraretinal neovascularization or retinal choroidal anastomosis.
In 11 patients adequate phase-resolved Doppler OCT images were obtained showing abnormal blood flow in the RAP lesion. In 4 patients a retinal choroidal anastomosis was found, 3 patients showed intraretinal neovascularization connected with a pigment epithelial detachment, 2 patients showed only intraretinal neovascularization, and in 2 patients flow was limited to the subretinal or sub-retinal pigment epithelial space.
Phase-resolved Doppler OCT is able to detect and localize abnormal blood flow within RAP lesions. Blood flow was mostly confined to the intraretinal structures with or without a connecting pigment epithelial detachment; in one-third of patients a retinal choroidal anastomosis was detected. The potential of angiography with phase-resolved Doppler OCT to accurately distinguish between normal and pathologic blood flow in addition to structural OCT data without invasive procedures will help to further elucidate both retinal and choroidal vascular pathologies like RAP.
基于传统成像技术，采用相分辨多普勒光学相干断层扫描（OCT）研究诊断为视网膜血管瘤样增殖（RAP）的患者，以检测和定位RAP病变中的血流；并将这些发现与传统成像进行比较，传统成像大多具有侵入性，且提供的视网膜内和视网膜血流信息有限。
单中心、连续观察病例系列。
纳入12例初治患者，这些患者根据眼底检查、荧光素血管造影和吲哚菁绿血管造影诊断为RAP。中位年龄为79岁（范围65 - 90岁）。患者使用实验性1040 nm扫频源相分辨多普勒OCT仪器进行成像。异常血流定义为视网膜内新生血管或视网膜脉络膜吻合。
11例患者获得了足够的相分辨多普勒OCT图像，显示RAP病变中有异常血流。4例患者发现视网膜脉络膜吻合，3例患者显示与色素上皮脱离相关的视网膜内新生血管，2例患者仅显示视网膜内新生血管，2例患者血流仅限于视网膜下或视网膜色素上皮下间隙。
相分辨多普勒OCT能够检测和定位RAP病变内的异常血流。血流大多局限于有或无连接性色素上皮脱离的视网膜内结构；三分之一的患者检测到视网膜脉络膜吻合。相分辨多普勒OCT血管造影除了能提供结构OCT数据外，还能在不进行侵入性操作的情况下准确区分正常和病理性血流，这将有助于进一步阐明视网膜和脉络膜血管病变，如RAP。
