Martins Amélia, Farinha Cláudia, Raimundo Miguel, Lopes Marta, Santos Ana Rita, Melo Pedro, Marques Marco, Marques João Pedro, Barreto Patrícia, Cachulo Maria Luz, Neves Catarina, Cunha-Vaz José, Silva Rufino
Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Ophthalmic Res. 2018;59(2):88-97. doi: 10.1159/000481262. Epub 2017 Oct 25.
We conducted a multimodal, cross-sectional evaluation.
Eyes were divided into 4 study groups: controls, early/intermediate age-related macular degeneration (AMD), fellow eyes of retinal angiomatous proliferation (RAP), and RAP eyes. Patients were evaluated with spectral-domain optical coherence tomography (OCT), enhanced depth imaging-OCT, and OCT angiography (OCTA). OCTA images were processed to generate maps of the vessel density and perfusion density of the superficial and deep retinal layers (SRL and DRL) and the choriocapillaris level (CL). The thickness of the outer nuclear layer and choroid was manually assessed.
We included 135 eyes of 100 patients (51 controls, 30 AMD, 42 RAP, and 12 fellow eyes). The fellow eyes showed a significantly lower vascular perfusion of the SRL, DRL, and CL (p < 0.02) than the early/intermediate AMD and control eyes did. Similarly, RAP eyes presented a lower vascular perfusion of the DRL and CL (p < 0.05). Besides, structural analyses of the fellow eyes and RAP eyes revealed a significantly higher prevalence of macular pigmentary changes, atrophy of the retinal pigment epithelium, hyperreflective "clumps" above flat drusen, amongst others, than early/intermediate AMD and control eyes (p < 0.05).
We present the first report on the OCTA analysis of the fellow eye of patients with RAP. The reduced perfusion density and vessel density observed contributes, in association with clearly defined structural changes, to a wider characterization of RAP as a distinctive phenotype.
我们进行了一项多模态横断面评估。
将眼睛分为4个研究组：对照组、早期/中期年龄相关性黄斑变性（AMD）、视网膜血管瘤样增生（RAP）的对侧眼以及RAP患眼。对患者进行了频域光学相干断层扫描（OCT）、增强深度成像-OCT和OCT血管造影（OCTA）检查。对OCTA图像进行处理，以生成视网膜浅层和深层（SRL和DRL）以及脉络膜毛细血管层（CL）的血管密度和灌注密度图。手动评估外核层和脉络膜的厚度。
我们纳入了100例患者的135只眼（51例对照、30例AMD、42例RAP和12例对侧眼）。与早期/中期AMD和对照眼相比，对侧眼的SRL、DRL和CL血管灌注显著降低（p < 0.02）。同样，RAP患眼的DRL和CL血管灌注较低（p < 0.05）。此外，对侧眼和RAP患眼的结构分析显示，与早期/中期AMD和对照眼相比，黄斑色素改变、视网膜色素上皮萎缩、扁平玻璃膜疣上方的高反射“团块”等的患病率显著更高（p < 0.05）。
我们首次报告了RAP患者对侧眼的OCTA分析结果。观察到的灌注密度和血管密度降低，与明确的结构变化相关，有助于更全面地将RAP表征为一种独特的表型。
