光学相干断层扫描在Vogt-小柳-原田病诊断中的特征
FEATURES OF OPTICAL COHERENCE TOMOGRAPHY FOR THE DIAGNOSIS OF VOGT-KOYANAGI-HARADA DISEASE.
作者信息
Liu Xi Yao, Peng Xiao Yan, Wang Shuang, You Qi Sheng, Li Yi-Bin, Xiao Yuan Yuan, Jonas Jost B
机构信息
*Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China; and †Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
出版信息
Retina. 2016 Nov;36(11):2116-2123. doi: 10.1097/IAE.0000000000001076.
BACKGROUND/PURPOSE: To examine the diagnostic value of optical coherence tomography (OCT) for the detection of acute Vogt-Koyanagi-Harada (VKH) disease.
METHODS
Clinical charts and OCT images were retrospectively reviewed for patients consecutively diagnosed with acute VKH, subacute VKH, multifocal central serous chorioretinopathy (CSCR), and posterior scleritis. All patients underwent OCT, fundus photography, and fluorescein angiography (FA) before treatment. The characteristics of OCT and FA were analyzed and recorded.
RESULTS
The study included 80 eyes with acute VKH, 32 eyes with subacute VKH, 33 eyes with CSCR, and 13 eyes with posterior scleritis. The most common OCT features of VKH disease were hyperreflective dots (70/80; 88%), subretinal membranous structures (64/80; 80%), retinal detachment higher than 450 μm (63/80; 79%), and retinal pigment epithelium (RPE) folds (44/80; 55%). For the detection of VKH disease, sensitivity and specificity were for subretinal membranous structures 80% and 95.6%, respectively, for high retinal detachment 78.8% and 76.1%, respectively, for subretinal hyperreflective dots, 87.5 and 60.9%, respectively, and for RPE folds 55% and 80.4% respectively. Subretinal membranous structures showed the highest positive predictive value (97.3%) and negative predictive value (65.7%) of all OCT assessed features.
CONCLUSION
OCT-related morphological signs have a relatively high predictive value for the diagnosis of acute VKH.
背景/目的：探讨光学相干断层扫描（OCT）对急性Vogt-小柳-原田（VKH）病的诊断价值。
方法
对连续诊断为急性VKH、亚急性VKH、多灶性中心性浆液性脉络膜视网膜病变（CSCR）和后巩膜炎的患者的临床病历和OCT图像进行回顾性分析。所有患者在治疗前均接受了OCT、眼底照相和荧光素血管造影（FA）检查。分析并记录OCT和FA的特征。
结果
该研究纳入了80只急性VKH患眼、32只亚急性VKH患眼、33只CSCR患眼和13只后巩膜炎患眼。VKH病最常见的OCT特征为高反射点（70/80；88%）、视网膜下膜状结构（64/80；80%）、视网膜脱离高于450μm（63/80；79%）和视网膜色素上皮（RPE）皱褶（44/80；55%）。对于VKH病的检测，视网膜下膜状结构的敏感度和特异度分别为80%和95.6%，视网膜高度脱离的敏感度和特异度分别为78.8%和76.1%，视网膜下高反射点的敏感度和特异度分别为87.5%和60.9%，RPE皱褶的敏感度和特异度分别为55%和80.4%。在所有OCT评估特征中，视网膜下膜状结构显示出最高的阳性预测值（97.3%）和阴性预测值（65.7%）。
结论
OCT相关的形态学体征对急性VKH的诊断具有较高的预测价值。
Zotero 插件