Diaz J Daniel, Wang Jay C, Oellers Patrick, Lains Inês, Sobrin Lucia, Husain Deeba, Miller Joan W, Vavvas Demetrios G, Miller John B
Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
J Vitreoretin Dis. 2018 May-Jun;2(3):146-154. doi: 10.1177/2474126418771805. Epub 2018 Apr 16.
To evaluate the deeper choroidal vasculature in eyes with various ocular disorders using spectral domain (SD) optical coherence tomography angiography (OCTA) and swept source (SS) OCTA.
Patients underwent OCTA imaging with either SD-OCTA (Zeiss Cirrus Angioplex or Optovue AngioVue) or SS-OCTA (Topcon Triton). Retinal pigment epithelium (RPE) integrity, structural visualization of deep choroidal vessels on en face imaging, and OCTA of deep choroidal blood flow signal were analyzed. Choroidal blood flow was deemed present if deeper choroidal vessels appeared bright after appropriate segmentation.
Structural visualization of choroidal vessels was feasible in all eyes by en face imaging. In both SD-OCTA and SS-OCTA, choroidal blood flow signal was present in all eyes with overlying RPE atrophy (100% of eyes with RPE atrophy, 28.6% of all imaged eyes, P < .001).
While choroidal vessels can be visualized anatomically in all eyes by en face imaging, choroidal blood flow detection in deep choroidal vessel is largely restricted to areas with overlying RPE atrophy. Intact RPE acts as a barrier for reliable detection of choroidal flow using current OCTA technology, inhibiting evaluation of flow in deeper choroidal vessels in most eyes.
使用光谱域（SD）光学相干断层扫描血管造影（OCTA）和扫频源（SS）OCTA评估患有各种眼部疾病的眼睛中更深层的脉络膜血管系统。
患者接受了SD-OCTA（蔡司Cirrus Angioplex或欧普特视AngioVue）或SS-OCTA（拓普康Triton）的OCTA成像。分析视网膜色素上皮（RPE）的完整性、正面成像时深层脉络膜血管的结构可视化以及深层脉络膜血流信号的OCTA。如果在适当分割后深层脉络膜血管显得明亮，则认为存在脉络膜血流。
通过正面成像，在所有眼睛中脉络膜血管的结构可视化都是可行的。在SD-OCTA和SS-OCTA中，所有伴有RPE萎缩的眼睛中都存在脉络膜血流信号（100%的RPE萎缩眼睛，占所有成像眼睛的28.6%，P <.001）。
虽然通过正面成像可以在所有眼睛中解剖学地观察到脉络膜血管，但深层脉络膜血管中的脉络膜血流检测在很大程度上仅限于伴有RPE萎缩的区域。完整的RPE对使用当前OCTA技术可靠检测脉络膜血流起到屏障作用，抑制了大多数眼睛中深层脉络膜血管血流的评估。
