Mané Valérie, Dupas Bénédicte, Gaudric Alain, Bonnin Sophie, Pedinielli Alexandre, Bousquet Elodie, Erginay Ali, Tadayoni Ramin, Couturier Aude
Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7-Sorbonne Paris Cité, Paris, France.
Retina. 2016 Dec;36 Suppl 1:S102-S110. doi: 10.1097/IAE.0000000000001289.
To study the relationship between the location of cystoid spaces and retinal capillary nonperfusion areas in diabetic cystoid macular edema (DCME).
In this retrospective study, 24 eyes of 21 patients with chronic DCME were followed using optical coherence tomography angiography. The capillary density of the superficial capillary plexus and deep capillary plexus was measured using AngioAnalytics software in all DCME eyes and in 20 healthy controls. Diabetic cystoid macular edema improved spontaneously or after treatment in 11 eyes.
The intraretinal cystoid spaces were surrounded by capillary-flow void areas in the superficial capillary plexus in 71% of cases and in the deep capillary plexus in 96% of cases. The deep capillary plexus had lost its regular pattern in all cases. The capillary density was decreased in both plexus (mean decrease of -23.0% in the superficial capillary plexus and -12.4% in the deep capillary plexus vs. normal). In the 11 cases with DCME resolution, the capillary did not reperfuse in areas of resolved cystoid spaces, and the capillary density did not change significantly.
In chronic DCME, cystoid spaces were located within capillary dropout areas. No reperfusion occurred after DCME resolution. The impact of the severity of this nonperfusion on the risk of recurrence of DCME remains to be clarified.
研究糖尿病性黄斑囊样水肿(DCME)中囊样间隙的位置与视网膜毛细血管无灌注区之间的关系。
在这项回顾性研究中,使用光学相干断层扫描血管造影术对21例慢性DCME患者的24只眼进行随访。使用AngioAnalytics软件测量所有DCME患眼及20名健康对照者的浅表毛细血管丛和深部毛细血管丛的毛细血管密度。11只眼的糖尿病性黄斑囊样水肿自发改善或经治疗后改善。
71%的病例中,视网膜内囊样间隙被浅表毛细血管丛中的毛细血管血流缺失区域包围,96%的病例中被深部毛细血管丛中的该区域包围。所有病例中深部毛细血管丛均失去其正常形态。两个丛中的毛细血管密度均降低(浅表毛细血管丛平均降低-23.0%,深部毛细血管丛平均降低-12.4%,与正常相比)。在11例DCME消退的病例中,消退的囊样间隙区域的毛细血管未再灌注,毛细血管密度无明显变化。
在慢性DCME中,囊样间隙位于毛细血管缺失区域内。DCME消退后未发生再灌注。这种无灌注的严重程度对DCME复发风险的影响仍有待阐明。