Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Retina. 2019 Aug;39(8):1551-1561. doi: 10.1097/IAE.0000000000002201.
This work aimed to describe the morphology of pigment epithelial detachment (PED) using optical coherence tomography angiography and to investigate its potential to detect choroidal neovascularization in various types of PEDs.
In this retrospective study, 53 patients diagnosed with PED after undergoing both optical coherence tomography angiography (AngioPlex, CIRRUS HD-OCT) and spectral domain optical coherence tomography (Spectralis SD-OCT) were included.
Among the 53 eyes, flat vascularized PED (vPED) affected 21 eyes (40%), peaked vPED affected 10 eyes (19%), serous PED affected 12 eyes (23%), drusenoid PED affected 6 eyes (11%), and 4 eyes (7%) had multiple PED subtypes. The main underlying etiologies were pachychoroid spectrum disorder (30.2%), wet age-related macular degeneration (28.3%), central serous chorioretinopathy (18.9%), dry age-related macular degeneration (11.3%), and polypoidal choroidal vasculopathy (11.3%). Optical coherence tomography angiography identified neovascularization in 29 (94%) of the vPED eyes, 2 (17%) of the serous PED eyes, and all 4 (100%) mixed PED eyes.
Optical coherence tomography angiography successfully identified neovascularization in both vPEDs and PEDs previously considered to be nonneovascular. However, structural OCT and blood flow analysis should be combined to interpret PED-associated neovascularization accurately in the clinic.
本研究旨在利用光相干断层扫描血管造影术(OCTA)描述色素上皮脱离(PED)的形态,并探讨其在各种类型 PED 中检测脉络膜新生血管(CNV)的潜力。
本回顾性研究纳入了 53 例经 OCTA(AngioPlex,CIRRUS HD-OCT)和频域光相干断层扫描(Spectralis SD-OCT)诊断为 PED 的患者。
在这 53 只眼中,平坦型血管化 PED(vPED)累及 21 只眼(40%),高起型 vPED 累及 10 只眼(19%),浆液性 PED 累及 12 只眼(23%),类脂性 PED 累及 6 只眼(11%),4 只眼(7%)存在多种 PED 亚型。主要潜在病因包括厚脉络膜谱系疾病(30.2%)、湿性年龄相关性黄斑变性(28.3%)、中心性浆液性脉络膜视网膜病变(18.9%)、干性年龄相关性黄斑变性(11.3%)和息肉样脉络膜血管病变(11.3%)。OCTA 识别出 29 只 vPED 眼(94%)、2 只浆液性 PED 眼(17%)和所有 4 只混合 PED 眼(100%)存在新生血管。
OCTA 成功识别出 vPED 和先前认为非新生血管性 PED 中的新生血管。然而,在临床中应结合结构 OCT 和血流分析来准确解读与 PED 相关的新生血管。