School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Centre de l'Od'eon, Paris, France.
Br J Ophthalmol. 2018 Sep;102(9):1204-1207. doi: 10.1136/bjophthalmol-2017-311000. Epub 2017 Oct 26.
To characterise the vasculature of the retina in patients with Stargardt disease (STGD) using optical coherence tomography angiography (OCTA) and to compare these functional findings with fundus autofluorescence (FAF) imaging.
This observational study included consecutive patients with STGD. The choriocapillaris (CC) layer was analysed on OCTA and retinal pigment epithelium (RPE) changes were assessed on FAF. Areas of CC and RPE impairment were quantified and correlated.
Twenty-two patients suffering from different stages of STGD were enrolled. OCTA revealed a vascular rarefaction with vascular prominence in 15 (35%) eyes while the remaining cases had pure vascular rarefaction. On FAF imaging, 25 (58%) eyes had a peripapillary halo, a hypofluorescent lesion in foveal area and the presence of both hypofluorescent and hyperfluorescent changes. On FAF imaging, the average area of RPE impairment was 6.7±4.4 mm while on OCTA a hypointense area of 4.2±3.6 mm was shown at the level of the CC layer. Mann-Whitney U test showed a statistically significant difference in terms of lesion extension between these two findings (p=0.004).
RPE damage on FAF appears to be significantly larger than CC layer vessel loss on OCTA, which suggests that RPE damage might precede that of CC.
使用光相干断层扫描血管造影术（OCTA）描述斯塔加特病（STGD）患者的视网膜血管结构，并将这些功能发现与眼底自发荧光（FAF）成像进行比较。
本观察性研究纳入了连续的 STGD 患者。在 OCTA 上分析脉络膜毛细血管（CC）层，在 FAF 上评估视网膜色素上皮（RPE）变化。量化和相关性分析 CC 和 RPE 损伤区域。
共纳入 22 名患有不同阶段 STGD 的患者。OCTA 显示 15 只（35%）眼存在血管稀疏伴血管突出，其余病例为单纯血管稀疏。在 FAF 成像上，25 只（58%）眼有视盘周围晕环，黄斑区出现荧光减弱病变，以及同时存在荧光减弱和增强改变。在 FAF 成像上，RPE 损伤的平均面积为 6.7±4.4 mm，而在 OCTA 上，CC 层显示出 4.2±3.6 mm 的低信号区域。Mann-Whitney U 检验显示这两种发现的病变扩展程度存在统计学显著差异（p=0.004）。
FAF 上的 RPE 损伤似乎明显大于 OCTA 上的 CC 层血管丢失，这表明 RPE 损伤可能先于 CC 层。
