Koustenis Andrew, Harris Alon, Gross Josh, Januleviciene Ingrida, Shah Aaditya, Siesky Brent
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Eye Clinic of Lithuanian University of Health Sciences, Kaunas, Lithuania.
Br J Ophthalmol. 2017 Jan;101(1):16-20. doi: 10.1136/bjophthalmol-2016-309389. Epub 2016 Oct 4.
In recent years, ophthalmology has experienced significant developments with respect to imaging modalities. Optical coherence tomography angiography is one such technology that seeks to improve diagnostics for retinal diseases. Using standard structural ocular coherence tomography hardware, optical coherence tomography angiography demonstrates the ability to non-invasively visualise the vasculature in the retina and the choroid with high resolution, allowing greater insight into retinal vascular pathologies. In addition, retinal and choroidal vessel density and blood flow can be quantified, offering potential to assist in the diagnosis of a variety of retinal diseases. To date, numerous retinal diseases, such as open-angle glaucoma, have been found to possess a vascular component. Specifically, ischaemia of the optic nerve head and lamina cribrosa has been theorised as a causative factor in ganglion cell death; however, confirmation of this mechanism has been prohibited by the limitations of currently existing imaging modalities. Optical coherence tomography angiography provides clear imaging of these regions and the possibility to elucidate further understanding of vascular factors that contribute to glaucoma development and progression. Furthermore, this imaging modality may provide insight to neural pathologies with vascular components such as Alzheimer's disease. Herein, the authors discuss the theory of operation for optical coherence tomography angiography and the current findings from pilot studies with a focus on open-angle glaucoma. In addition, speculation is offered for future applications of the technology to study other diseases with microvascular contributions.
近年来，眼科在成像技术方面取得了重大进展。光学相干断层扫描血管造影术就是这样一种旨在改善视网膜疾病诊断的技术。利用标准的眼部结构相干断层扫描硬件，光学相干断层扫描血管造影术能够以高分辨率无创地可视化视网膜和脉络膜中的血管系统，从而更深入地了解视网膜血管病变。此外，还可以对视网膜和脉络膜血管密度及血流进行量化，为协助诊断多种视网膜疾病提供了可能。迄今为止，已发现许多视网膜疾病，如开角型青光眼，都存在血管成分。具体而言，视神经乳头和筛板的缺血被认为是神经节细胞死亡的一个致病因素；然而，目前现有成像技术的局限性阻碍了对这一机制的证实。光学相干断层扫描血管造影术能够清晰地成像这些区域，并有可能进一步阐明导致青光眼发生和发展的血管因素。此外，这种成像技术可能有助于深入了解具有血管成分的神经病变，如阿尔茨海默病。在此，作者讨论了光学相干断层扫描血管造影术的工作原理以及初步研究的当前发现，重点是开角型青光眼。此外，还对该技术未来在研究其他具有微血管影响的疾病方面的应用进行了推测。
