Phasukkijwatana Nopasak, Iafe Nicholas, Sarraf David
*Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California; †Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; and ‡Greater Los Angeles VA Healthcare Center, Los Angeles, California.
Retin Cases Brief Rep. 2017;11 Suppl 1:S68-S72. doi: 10.1097/ICB.0000000000000418.
To describe the quantitative optical coherence tomography angiography analysis of the superficial and deep retinal capillary plexus in a case of A29 birdshot chorioretinopathy (BCR) complicated by retinal neovascularization.
Multimodal retinal imaging, including optical coherence tomography angiography with quantitated vessel density analysis of the superficial and deep retinal capillary plexus, was performed in a case of A29 BCR. Capillary density (mm) was defined as the total vessel length (mm) per area (mm).
A 39-year-old healthy white man presented with vitreous hemorrhage and retinal neovascularization at baseline. Clinical presentation was consistent with BCR and human leukocyte antigen testing confirmed A29 positivity. Optical coherence tomography angiography was performed 6 years after the diagnosis and revealed capillary density reduction in the superficial and especially in the deep retinal capillary plexus. Quantitative vessel density analysis was compared with the mean capillary density of 11 age-matched normal eyes and demonstrated 6% and 18% reduction of the superficial plexus in the right and left eyes of our patient, respectively. For the deep plexus, a reduction of 25% and 32% was found in the right and left eyes, respectively.
In this patient with BCR, capillary density reduction was most marked at the deep retinal capillary plexus level and may explain the development of retinal neovascularization in this case. Quantitative optical coherence tomography angiography may be a useful tool to study and to monitor retinal microvascular changes in patients with BCR and should be further explored as a biomarker of therapeutic response.
描述一例A29型鸟枪样脉络膜视网膜病变（BCR）合并视网膜新生血管患者的视网膜浅、深层毛细血管丛的定量光学相干断层扫描血管造影分析。
对一例A29型BCR患者进行了多模态视网膜成像，包括对视网膜浅、深层毛细血管丛进行定量血管密度分析的光学相干断层扫描血管造影。毛细血管密度（mm）定义为每单位面积（mm）的血管总长度（mm）。
一名39岁健康白人男性在基线时出现玻璃体积血和视网膜新生血管。临床表现符合BCR，人类白细胞抗原检测证实A29阳性。诊断6年后进行光学相干断层扫描血管造影，结果显示视网膜浅、深层毛细血管丛的毛细血管密度降低。将定量血管密度分析结果与11只年龄匹配的正常眼睛的平均毛细血管密度进行比较，结果显示该患者右眼和左眼的浅层毛细血管丛分别降低了6%和18%。对于深层毛细血管丛，右眼和左眼分别降低了25%和32%。
在该BCR患者中，视网膜深层毛细血管丛水平的毛细血管密度降低最为明显，这可能解释了该病例中视网膜新生血管的发生。定量光学相干断层扫描血管造影可能是研究和监测BCR患者视网膜微血管变化的有用工具，应进一步探索其作为治疗反应生物标志物的作用。
