光学相干断层扫描血管造影在慢性中心性浆液性脉络膜视网膜病变中的平坦型不规则色素上皮脱离。

OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF FLAT IRREGULAR PIGMENT EPITHELIUM DETACHMENT IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY.

机构信息

Department of Ophthalmology, Hôpital Hôtel-Dieu Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université Paris 5, Sorbonne Paris Cité, Paris, France.

Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, AP-HP, Université Paris 7, Sorbonne Paris Cité, Paris, France.

出版信息

Retina. 2018 Mar;38(3):629-638. doi: 10.1097/IAE.0000000000001580.

DOI:10.1097/IAE.0000000000001580

PMID:28267114

Abstract

PURPOSE

To assess the rate of choroidal neovascularization (CNV) detected by optical coherence tomography angiography (OCTA) in flat irregular pigment epithelium detachment (PED) in chronic central serous chorioretinopathy.

METHODS

Data on all consecutive patients with chronic central serous chorioretinopathy who underwent OCTA over a 1-year period were reviewed. The presence of flat irregular PED, which was defined as an irregular elevation of the retinal pigment epithelium allowing the visualization of a distinct Bruch's membrane was assessed on high-resolution OCT B-scan. Clinical, multimodal imaging, and OCTA data were reviewed by two graders for the detection of CNV.

RESULTS

Eighty-eight eyes of 61 patients with chronic central serous chorioretinopathy were included. Patient mean age (±SD) was 54.5 ± 12.2 years, and 78.7% were males. Mean subfoveal choroidal thickness (±SD) was 452.6 ± 145.6 μm. Flat irregular PEDs were detected in 59 eyes of 51 patients. OCTA detected the presence of CNV in flat irregular PEDs in 35.6% of cases. Conversely, using the combination of spectral domain optical coherence tomography angiography, fluorescein and indocyanine green angiography, CNV was detected in only 25% of flat irregular PEDs. All hyporeflective flat irregular PEDs on OCT were avascular on OCTA while they were at least partially hyperreflective when associated with CNV.

CONCLUSION

One-third of flat irregular PEDs in chronic central serous chorioretinopathy contained CNV. OCTA detected CNV more frequently than the other imaging modalities. Further longitudinal studies are needed to assess the indication of antivascular endothelial growth factor treatments in such cases.

摘要

目的

评估光学相干断层扫描血管造影（OCTA）在慢性中心性浆液性脉络膜视网膜病变中平坦性不规则色素上皮脱离（PED）中检测脉络膜新生血管（CNV）的发生率。

方法

回顾性分析了 1 年内接受 OCTA 检查的所有连续慢性中心性浆液性脉络膜视网膜病变患者的数据。在高分辨率 OCT B 扫描上评估扁平不规则 PED 的存在，定义为视网膜色素上皮的不规则隆起，可观察到明显的 Bruch 膜。由两名评分者评估临床、多模态成像和 OCTA 数据以检测 CNV。

结果

共纳入 61 例 88 只眼慢性中心性浆液性脉络膜视网膜病变患者。患者平均年龄（±标准差）为 54.5±12.2 岁，78.7%为男性。平均中心凹下脉络膜厚度（±标准差）为 452.6±145.6μm。51 例患者的 59 只眼检测到扁平不规则 PED。OCTA 在 35.6%的病例中检测到扁平不规则 PED 存在 CNV。相反，使用频域光相干断层扫描血管造影、荧光素和吲哚青绿血管造影联合检测，仅在 25%的扁平不规则 PED 中检测到 CNV。OCT 上所有低反射性扁平不规则 PED 在 OCTA 上均无血管，而当它们与 CNV 相关时至少部分高反射。