Invernizzi Alessandro, Agarwal Aniruddha, Cozzi Mariano, Viola Francesco, Nguyen Quan Dong, Staurenghi Giovanni
*Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy; †Ophthalmological Unit, Department of Clinical Sciences and Community Health, IRCCS-Cà Granda Foundation-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; and ‡Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska.
Retina. 2016 Oct;36(10):2013-21. doi: 10.1097/IAE.0000000000001031.
To detect choriocapillaris changes by enhanced depth imaging optical coherence tomography (EDI-OCT) in areas of choriocapillaris hypoperfusion visualized on indocyanine green angiography.
Combined indocyanine green angiography and EDI-OCT from patients diagnosed with inflammatory choriocapillaris hypoperfusion were retrospectively analyzed. The EDI-OCTs were compared with indocyanine green angiography to detect choriocapillaris changes suggestive of choriocapillaris hypoperfusion in both active stage (AS) and inactive stage of the disease. The EDI-OCT was graded by two independent observers for choriocapillaris pattern (normal/altered) and reflectivity (hyper/hypo/isoreflective) changes. Manual measurements of choriocapillaris thickness were obtained. Interobserver agreement was assessed using Cohen's kappa, and differences in groups were assessed using McNemar's test.
Forty-two lesions from 11 eyes (8 patients, 3 males) were analyzed. Three patients (4 eyes, 17 lesions) were diagnosed with serpiginous choroiditis, and 5 patients (7 eyes, 25 lesions) were diagnosed with acute posterior multifocal placoid pigmented epitheliopathy. All the lesions demonstrated choriocapillaris hyporeflectivity on EDI-OCT during AS and isoreflectivity during inactive stage. The characteristic choriocapillaris dotted pattern was absent during AS. Choriocapillaris thickness at the sites of hypoperfusion was significantly higher during AS (63.07 ± 16.47 μm) than in inactive stage (22.92 ± 7.65 μm) (P < 0.001). Disruption of retinal pigment epithelium during AS was strongly associated with choriocapillaris atrophy during follow-up (P < 0.001).
The EDI-OCT shows characteristic choriocapillaris changes suggestive of choriocapillaris hypoperfusion that correlate with ischemia on indocyanine green angiography during both AS and inactive stage of the disease.
通过增强深度成像光学相干断层扫描（EDI-OCT）检测吲哚菁绿血管造影显示的脉络膜毛细血管灌注不足区域的脉络膜毛细血管变化。
对诊断为炎症性脉络膜毛细血管灌注不足患者的吲哚菁绿血管造影和EDI-OCT进行回顾性分析。将EDI-OCT与吲哚菁绿血管造影进行比较，以检测疾病活动期（AS）和非活动期提示脉络膜毛细血管灌注不足的脉络膜毛细血管变化。由两名独立观察者对EDI-OCT的脉络膜毛细血管形态（正常/改变）和反射率（高/低/等反射）变化进行分级。对脉络膜毛细血管厚度进行手动测量。采用Cohen's kappa评估观察者间一致性，采用McNemar检验评估组间差异。
分析了11只眼（8例患者，3例男性）的42个病变。3例患者（4只眼，17个病变）诊断为匐行性脉络膜炎，5例患者（7只眼，25个病变）诊断为急性后极部多灶性鳞状色素上皮病变。所有病变在AS期的EDI-OCT上均显示脉络膜毛细血管低反射，在非活动期显示等反射。AS期缺乏特征性的脉络膜毛细血管点状形态。灌注不足部位的脉络膜毛细血管厚度在AS期（63.07±16.47μm）显著高于非活动期（22.92±7.65μm）（P<0.001）。AS期视网膜色素上皮的破坏与随访期间脉络膜毛细血管萎缩密切相关（P<0.001）。
EDI-OCT显示了提示脉络膜毛细血管灌注不足的特征性脉络膜毛细血管变化，这些变化与疾病AS期和非活动期吲哚菁绿血管造影显示的缺血相关。
