Demirel Sibel, Yanık Özge, Nalcı Hilal, Batıoğlu Figen, Özmert Emin
Department of Ophthalmology, Ankara University Faculty of Medicine, Vehbi Koç Göz Hastanesi, Mamak Caddesi, Dikimevi, Ankara, Turkey.
Graefes Arch Clin Exp Ophthalmol. 2017 Dec;255(12):2317-2324. doi: 10.1007/s00417-017-3793-8. Epub 2017 Sep 11.
The study objective was to compare dye angiography and optical coherence tomography angiography (OCTA) in detecting choroidal neovascuarization (CNV) in patients presenting with pachychoroid features and flat irregular pigment epithelial detachment (PED).
Nineteen eyes of 17 patients, presenting with flat PED and pachychoroid features, and without age-related macular degeneration or any other degenerative change, were analyzed. Fuorescein angiography (FA)/Indocyanine green angiography (ICGA) and OCTA were performed during the same visit. Subfoveal choroidal thickness was measured by enhanced depth imaging using spectral domain optical coherence tomography.
The mean age of the patients was 59.1 years. Mean subfoveal choroidal thickness was 388 μm. FA revealed non-patognomic features including RPE alterations, window defects, leaking points and leakage from an undetermined source. ICGA revealed choroidal vascular plaque in eight eyes (42%) and suspicious plaque in five eyes (26%). Nonneovascular features, such as hyperpermeability or dilated choroidal vessels, were observed in six eyes (32%). OCTA showed choroidal neovascularization in 14 (74%). For all of the eyes, which ICGA was positive for presence of CNV, OCTA also showed CNV, and in one case it also revealed polypoidal characteristics of the neovascular network. OCTA was also able to detect CNV in all of the eyes with suspicious plaque, and in one eye without CNV appearance using ICGA.
OCTA demonstrated greater sensitivity in detecting type 1 CNV than conventional dye angiography in cases with pachychoroid spectrum disease.
本研究的目的是比较染料血管造影和光学相干断层扫描血管造影（OCTA）在检测具有厚脉络膜特征和平坦不规则色素上皮脱离（PED）的患者脉络膜新生血管（CNV）方面的效果。
对17例患者的19只眼睛进行分析，这些患者表现为平坦PED和厚脉络膜特征，且无年龄相关性黄斑变性或任何其他退行性改变。在同一次就诊时进行荧光素血管造影（FA）/吲哚菁绿血管造影（ICGA）和OCTA检查。使用光谱域光学相干断层扫描通过增强深度成像测量黄斑下脉络膜厚度。
患者的平均年龄为59.1岁。平均黄斑下脉络膜厚度为388μm。FA显示非特异性特征，包括视网膜色素上皮（RPE）改变、窗样缺损、渗漏点和不明来源的渗漏。ICGA在8只眼睛（42%）中显示脉络膜血管斑块，在5只眼睛（26%）中显示可疑斑块。在6只眼睛（32%）中观察到非新生血管特征，如高通透性或脉络膜血管扩张。OCTA显示14只眼睛（74%）有脉络膜新生血管。对于所有ICGA显示存在CNV的眼睛，OCTA也显示有CNV，并且在1例中还揭示了新生血管网络的息肉样特征。OCTA还能够在所有有可疑斑块的眼睛中检测到CNV，并且在1只ICGA未显示CNV的眼睛中也检测到了CNV。
在厚脉络膜谱系疾病病例中，OCTA在检测1型CNV方面比传统染料血管造影具有更高的敏感性。
