Sambhav Kumar, Grover Sandeep, Chalam Kakarla V
Department of Ophthalmology, University of Florida College of Medicine, Jacksonville, Florida.
Retin Cases Brief Rep. 2019 Fall;13(4):308-313. doi: 10.1097/ICB.0000000000000610.
To establish correlation between the structural compromise (capillary loss and hypoperfusion on optical coherence tomography [optical coherence tomography angiography]) with perimacular functional impairment noted on microperimetry.
Retrospective case series. Clinical records and multimodal imaging findings of patients presenting with sickle cell disease were reviewed.
Three eyes of three patients (two men) were included in the study with a visual acuity of 20/20 and no sickle cell retinopathy. Images using optical coherence tomography angiography (AngioVue OCT angiography system; Optovue, Inc, Fremont, CA) were obtained along with spectral domain optical coherence tomography, fluorescein angiography, and microperimetry (MP-1). Spectral domain optical coherence tomography revealed selective loss of inner retinal layers with thinning of the retina. Optical coherence tomography angiography revealed compromise of both superficial and deep capillaries in the area of temporal thinning expressed on spectral domain optical coherence tomography. MP-1 demonstrated focal increase in threshold (decreased sensitivity) correlating with the perfusion defects on optical coherence tomography angiography. Fluorescein angiography did not show any substantial perfusion compromise.
Optical coherence tomography angiography may reflect the extent of functional compromise even before it being evident on fluorescein angiography. The area vascular compromise was larger in the deep plexus compared with the superficial plexus. The area of complete loss of retinal sensitivity corresponds to loss of vasculature in both the superficial and deep plexuses, whereas the area of decreased sensitivities corresponds to compromise only in the deep plexus.
建立光学相干断层扫描血管造影（光学相干断层扫描血管造影）显示的结构损伤（毛细血管丢失和灌注不足）与微视野检查发现的黄斑周围功能损害之间的相关性。
回顾性病例系列研究。对镰状细胞病患者的临床记录和多模态成像结果进行了回顾。
研究纳入了3例患者（2例男性）的3只眼，视力为20/20，无镰状细胞视网膜病变。使用光学相干断层扫描血管造影（AngioVue OCT血管造影系统；Optovue公司，弗里蒙特，加利福尼亚州）获取图像，同时进行了光谱域光学相干断层扫描、荧光素血管造影和微视野检查（MP-1）。光谱域光学相干断层扫描显示视网膜内层选择性丢失，视网膜变薄。光学相干断层扫描血管造影显示，光谱域光学相干断层扫描显示的颞侧变薄区域的浅层和深层毛细血管均有损伤。MP-1显示阈值局部升高（敏感性降低），与光学相干断层扫描血管造影上的灌注缺陷相关。荧光素血管造影未显示任何实质性的灌注损伤。
光学相干断层扫描血管造影可能在荧光素血管造影显示明显损伤之前就反映出功能损伤的程度。与浅层丛相比，深层丛的血管损伤区域更大。视网膜敏感性完全丧失的区域对应于浅层和深层丛中血管的丢失，而敏感性降低的区域仅对应于深层丛中的损伤。
