Wang Xiao Na, You Qi Sheng, Li Qian, Li Yang, Mao Yu, Hu Feng, Zhao Hui Ying, Tsai Frank F, Peng Xiao Yan
Beijing Institute of Ophthalmology, Beijing Tong ren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tong ren Hospital, Capital Medical University, Beijing, China.
Sharp Rees Stealy Medical Group, San Diego, California, USA.
Ophthalmic Res. 2018;60(4):214-220. doi: 10.1159/000487488. Epub 2018 Apr 13.
To evaluate the vascular anatomy of eyes with Best vitelliform macular dystrophy (BVMD) using optical coherence tomography angiography (OCTA).
This retrospective case-control study enrolled 11 consecutive BVMD patients and 13 age-matched healthy participants. Both eyes of each participant were imaged using a macular OCTA scan (3 × 3 mm) by 70-kHz 840-nm spectral-domain OCT. The flow signal was calculated using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm.
Qualitative analysis showed uneven hypo- and hyperintense signal changes at the choriocapillary level in OCTA images of BVMD patients. Quantitative analysis showed significant reductions in the flow density of the superficial vascular layer (whole: 49.2% vs. 53.9%, p < 0.001) and the choriocapillary flow area (5.1 vs. 5.5 mm2, p = 0.02) in BVMD patients compared to controls. The choriocapillary flow area in the postvitelliform group was reduced compared to that of the vitelliform group. There was a statistically significant association between choriocapillary flow area and superficial vascular flow density (p = 0.045), choriocapillary flow area and foveal avascular zone area (p = 0.03).
Vascular changes in BVMD were apparent in the choriocapillary layer. The changes became more striking in late stages of the disease. OCTA provides useful quantitative measurements for staging and monitoring the progression of BVMD.
使用光学相干断层扫描血管造影（OCTA）评估Best卵黄样黄斑营养不良（BVMD）患者眼睛的血管解剖结构。
这项回顾性病例对照研究纳入了11例连续的BVMD患者和13名年龄匹配的健康参与者。使用70kHz 840nm光谱域光学相干断层扫描对每位参与者的双眼进行黄斑OCTA扫描（3×3mm）成像。采用分裂谱幅度去相关血管造影（SSADA）算法计算血流信号。
定性分析显示，BVMD患者OCTA图像中脉络膜毛细血管层存在不均匀的低信号和高信号变化。定量分析显示，与对照组相比，BVMD患者浅表血管层的血流密度显著降低（整体：49.2%对53.9%，p<0.001），脉络膜毛细血管血流面积减小（5.1对5.5mm²，p=0.02）。与卵黄样期组相比，后卵黄样期组的脉络膜毛细血管血流面积减小。脉络膜毛细血管血流面积与浅表血管血流密度之间存在统计学显著关联（p=0.045），脉络膜毛细血管血流面积与黄斑无血管区面积之间也存在统计学显著关联（p=0.03）。
BVMD的血管变化在脉络膜毛细血管层明显。这些变化在疾病晚期更为显著。OCTA为BVMD的分期和病情进展监测提供了有用的定量测量方法。
