Azar Georges, Wolff Benjamin, Mauget-Faÿsse Martine, Rispoli Marco, Savastano Maria-Cristina, Lumbroso Bruno
Eye & Ear Hospital International, Beirut, Lebanon.
Faculty of Medicine, Holy Spirit University of Kaslik (USEK), Kaslik, Lebanon.
Acta Ophthalmol. 2017 Jun;95(4):421-427. doi: 10.1111/aos.13221. Epub 2016 Sep 6.
To describe and interpret the features of pachychoroid neovasculopathy (PNV) using optical coherence tomography angiography (OCTA) technique.
This is an observational case series of patients who presented with PNV. Best-corrected visual acuity (BCVA), anterior segment examination, dilated funduscopic examination, infrared and autofluorescence fundus images and spectral-domain optical coherence tomography (SD-OCT; B-scan, 'en-face' and OCTA) were carried out for all patients. Choroid thickness was measured using enhanced depth imaging (EDI) mode. Colour fundus photographs, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were not performed systematically. Optical coherence tomography angiography (OCTA) features of PNV are described and interpreted.
Five eyes of five patients with a mean age of 62.2 years (range, 53-73 years) presenting with PNV were analysed. They all presented pachychoroid pigment epitheliopathy (PPE) with choroidal thickening and dilated choroidal vessels as seen with EDI-OCT. Fluorescein angiography (FFA) was performed in three patients showing multiple areas of retinal pigment epithelium atrophy and fundus lesions suggestive of chronic central serous chorioretinopathy. Indocyanine green angiography (ICGA) in one patient confirmed the presence of large choroidal veins and choroidal hyperpermeability seen beneath the area of the neovascular tissue. Two eyes had the appearance of polypoidal structures within the neovascular tissue, with the characteristic aspect of the polypoidal lesions on B-scan and 'en-face'. Optical coherence tomography angiography (OCTA) showed the appearance of tangled filamentous vascular network in all eyes.
Optical coherence tomography angiography (OCTA) is a safe, highly sensitive and specific examination for the detection of type 1 neovascularization associated with PPE. Features are characteristic of tangled filamentous vessels overlying a focal area of thickened choroid.
运用光学相干断层扫描血管造影（OCTA）技术描述并阐释厚脉络膜新生血管病变（PNV）的特征。
这是一组针对患有PNV患者的观察性病例系列研究。对所有患者均进行了最佳矫正视力（BCVA）、眼前节检查、散瞳眼底检查、红外及自发荧光眼底图像以及光谱域光学相干断层扫描（SD - OCT；B扫描、“正面”图像及OCTA）。采用增强深度成像（EDI）模式测量脉络膜厚度。未系统进行彩色眼底照片、眼底荧光血管造影（FFA）及吲哚菁绿血管造影（ICGA）检查。描述并阐释了PNV的光学相干断层扫描血管造影（OCTA）特征。
对5例平均年龄62.2岁（范围53 - 73岁）患有PNV的患者的5只眼进行了分析。所有患者均表现为厚脉络膜色素上皮病变（PPE），伴有脉络膜增厚及脉络膜血管扩张，这在EDI - OCT检查中可见。3例患者进行了荧光素血管造影（FFA），显示多个视网膜色素上皮萎缩区域以及提示慢性中心性浆液性脉络膜视网膜病变的眼底病变。1例患者的吲哚菁绿血管造影（ICGA）证实了新生血管组织区域下方存在粗大脉络膜静脉及脉络膜高通透性。2只眼的新生血管组织内可见息肉样结构，在B扫描和“正面”图像上具有息肉样病变的特征表现。光学相干断层扫描血管造影（OCTA）显示所有眼中均出现了缠结的丝状血管网络。
光学相干断层扫描血管造影（OCTA）是一种用于检测与PPE相关的1型新生血管形成的安全、高度敏感且特异的检查方法。其特征为在增厚脉络膜的局部区域上方出现缠结的丝状血管。
