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光学相干断层扫描血管造影在葡萄膜炎和炎症性眼病中的应用。

The application of optical coherence tomography angiography in uveitis and inflammatory eye diseases.

机构信息

Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.

Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA; Greater Los Angeles VA Healthcare Center, Los Angeles, CA, USA.

出版信息

Prog Retin Eye Res. 2017 Jul;59:178-201. doi: 10.1016/j.preteyeres.2017.04.005. Epub 2017 Apr 29.

Abstract

Since its introduction in the early 1990s, optical coherence tomography (OCT) has evolved in resolution and technological advances, and in recent years its initial application of assessing the morphology of a tissue has been implemented by the study of its functional blood flow, through optical coherence tomography angiography (OCTA). This novel technique details capillary networks by comparing the amount of light returned from static and moving targets without the need for intravenous dye administration. While this imaging modality has been used for various ocular conditions, the application OCTA to uveitis conditions remains sparse. This review aims to establish the basis of OCTA and its current application to ocular inflammatory disorders, with an emphasis on monitoring progression and response to treatment, as well as predicting visual complications. In particular, this review explores the use of OCTA in iris vessel dilation seen in various forms of iritis, as a predictive factor for further episodes of inflammation. OCTA can also depict ischemia in the deep plexus layers of the retina and identify true choroicapillaris ischemia in cases of placoid diseases or masking of the indocyanine green dye, as in multiple evanescent white dot syndrome. In addition, OCTA can depict neovascularization in granulomatous disease of the retina or choroid not previously depicted with previous imaging methods. While OCTA provides several advancements in the imaging, management and prognosis of uveitis diseases, we emphasize that further studies are required to fully understand its application to these conditions.

摘要

自 20 世纪 90 年代初问世以来,光学相干断层扫描(OCT)在分辨率和技术进步方面不断发展,近年来,通过光学相干断层扫描血管造影(OCTA)对组织形态的初步研究,实现了对其功能血流的研究。这项新技术通过比较静态和移动目标返回的光量来详细描述毛细血管网络,而无需静脉内染料给药。虽然这种成像方式已用于各种眼部疾病,但 OCTA 在葡萄膜炎疾病中的应用仍然很少。本综述旨在介绍 OCTA 的基础及其在眼部炎症性疾病中的当前应用,重点关注监测疾病进展和治疗反应,以及预测视觉并发症。特别是,本综述探讨了 OCTA 在各种虹膜炎形式中所见的虹膜血管扩张中的应用,作为进一步炎症发作的预测因素。OCTA 还可以描绘视网膜深层丛层的缺血,并在盘状疾病或靛氰绿染料掩盖的情况下(如多发性一过性白点综合征)识别真正的脉络膜毛细血管缺血。此外,OCTA 可以描绘以前用其他成像方法无法检测到的视网膜脉络膜肉芽肿病的新生血管。虽然 OCTA 在葡萄膜炎疾病的成像、管理和预后方面提供了多项进展,但我们强调需要进一步研究才能充分了解其在这些疾病中的应用。

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