Ravera Vittoria, Bottoni Ferdinando, Giani Andrea, Cigada Mario, Staurenghi Giovanni
Eye Clinic, Department of Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy.
Retina. 2016 Dec;36(12):2274-2281. doi: 10.1097/IAE.0000000000001152.
To identify signs occurring more frequently in retinal angiomatous proliferation (RAP) lesions compared with other types of choroidal neovascularization (CNV) in age-related macular degeneration.
In this cross-sectional retrospective study, 30 patients were evaluated. These signs were correlated with the type of CNV: shunting of blood flow to the lesion by fluorescein angiography, late leakage by indocyanine green angiography, intraretinal cysts and retinal pigmented epithelium interruption along the retinal pigmented epithelium detachment with a hyperreflective oval area by spectral domain optical coherence tomography, and presence of reticular pseudodrusen by infrared light.
Shunting of blood flow was found in 56% of RAP, whereas it was absent in 100% of other CNVs. Late leakage in indocyanine green angiography occurred in all RAP cases, while it was found in 7% of other CNVs. Intraretinal cysts were detected in 100% of RAP cases and in 14% of other CNVs. Retinal pigmented epithelium interruption along the retinal pigmented epithelium detachment was evident in 93% of RAP cases and in 15% of other CNVs. Reticular pseudodrusen were present in 87% of RAP cases and in 21% of other CNVs.
All the signs investigated were strongly associated to RAP lesions. A multimodal imaging approach may help differentiating subtypes of neovascularization.
鉴别与年龄相关性黄斑变性中其他类型脉络膜新生血管(CNV)相比,视网膜血管瘤样增殖(RAP)病变中更频繁出现的体征。
在这项横断面回顾性研究中,对30例患者进行了评估。这些体征与CNV类型相关:通过荧光素血管造影显示血流向病变分流,通过吲哚菁绿血管造影显示晚期渗漏,通过光谱域光学相干断层扫描显示视网膜内囊肿以及沿视网膜色素上皮脱离处的视网膜色素上皮中断并伴有高反射椭圆形区域,以及通过红外光显示网状假性玻璃膜疣的存在。
56%的RAP患者存在血流分流,而其他CNV患者中100%无血流分流。吲哚菁绿血管造影中的晚期渗漏在所有RAP病例中均出现,而在其他CNV病例中为7%。100%的RAP病例和14%的其他CNV病例检测到视网膜内囊肿。93%的RAP病例和15%的其他CNV病例中,沿视网膜色素上皮脱离处的视网膜色素上皮中断明显。87%的RAP病例和21%的其他CNV病例存在网状假性玻璃膜疣。
所有研究的体征均与RAP病变密切相关。多模态成像方法可能有助于区分新生血管的亚型。