Toledo Juan J, Asencio-Duran Mónica, García-Martinez Jesús R, López-Gaona Alejandro
Ophthalmology Department, Hospital Universitario Nuevo León, Monterrey, NL, Mexico.
Ophthalmology Department, Hospital La Paz, Madrid, Spain.
J Ophthalmol. 2017;2017:1573154. doi: 10.1155/2017/1573154. Epub 2017 Oct 19.
To describe OCTA findings in choroidal melanocytic tumors, especially the microcirculation patterns, and to try to correlate with the histopathological studies.
Cross-sectional, comparative, observational study. 70 cases, including 55 choroidal nevi and 15 choroidal melanomas. Three different observers evaluated specific variables in the choriocapillaris layer on AOCT images and searched for images which described histopathologic vascular patterns, and also, a general description of the images was made. Complementary multi-imaging studies included EDI SD-OCT, color and autofluorescence fundus imaging, Doppler ultrasound, and indocyanine/fluorescein angiography.
Good quality studies were acquired in 80% of the cases, with kappa indexes 0.768-0.958. Nevus OCTA images were described mainly as hyperreflective (72.7%), whereas choroidal melanoma as iso/hyporeflective (62.5%). Avascular areas were found in 50.96% and in 33.3% of choroidal nevus and choroidal melanomas, respectively. A neovascular membrane was found only in cases of choroidal nevus (16.3%). Only in cases of choroidal melanomas, we found vascular loops (6.6%) or vascular networks (6.6%).
OCTA is a promising new technology that can be used to study in vivo the differential characteristics of microcirculations between posterior segment melanocytic lesions. Today, larger studies are needed to corroborate these findings and to correlate it with malignancy.
描述脉络膜黑素细胞肿瘤的光学相干断层扫描血管造影（OCTA）表现，尤其是微循环模式，并尝试与组织病理学研究相关联。
横断面、对比、观察性研究。共70例，包括55例脉络膜痣和15例脉络膜黑色素瘤。三名不同的观察者评估了自适应光学相干断层扫描（AOCT）图像上脉络膜毛细血管层的特定变量，寻找描述组织病理学血管模式的图像，并对图像进行了总体描述。补充性多成像研究包括增强深度成像谱域光学相干断层扫描（EDI SD-OCT）、彩色和自发荧光眼底成像、多普勒超声以及吲哚菁绿/荧光素血管造影。
80%的病例获得了高质量的研究，kappa指数为0.768 - 0.958。脉络膜痣的OCTA图像主要表现为高反射（72.7%），而脉络膜黑色素瘤表现为等反射/低反射（62.5%）。脉络膜痣和脉络膜黑色素瘤的无血管区分别占50.96%和33.3%。仅在脉络膜痣病例中发现了新生血管膜（16.3%）。仅在脉络膜黑色素瘤病例中，发现了血管环（6.6%）或血管网络（6.6%）。
OCTA是一项有前景的新技术，可用于体内研究后部节段黑素细胞病变之间微循环的差异特征。目前，需要更大规模的研究来证实这些发现，并将其与恶性程度相关联。
