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急性 Vogt-小柳-原田病的超广角血管造影表现。

Ultra-wide-field angiography findings in acute Vogt-Koyanagi-Harada disease.

机构信息

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

出版信息

Br J Ophthalmol. 2019 Jul;103(7):942-948. doi: 10.1136/bjophthalmol-2018-312569. Epub 2018 Aug 12.

Abstract

BACKGROUND/AIMS: To investigate the prevalence of abnormal central and peripheral ultra-wide-field (UWF) angiography findings, and their association with clinical features in acute Vogt-Koyanagi-Harada (VKH) disease.

METHODS

This retrospective, observational study included 26 eyes of 13 treatment-naïve patients with acute VKH disease who underwent UWF fluorescein angiography (FA). Sixteen eyes of eight patients also underwent UWF indocyanine green angiography (ICGA). A circle simulating the central 75° field was used to divide the acquired image into the central fundus area (CFA) and peripheral fundus area (PFA), in which the presence of six previously reported abnormal angiographic findings were analysed. Correlations between abnormal angiography findings in FA and clinical features were also investigated.

RESULTS

All eyes demonstrated more than one abnormal angiographic finding in both the CFA and PFA. UWF FA revealed three abnormal findings in the CFA versus the PFA: focal leakage (92.3% vs 76.9%); pooling with a dark rim (84.6% vs 53.8%); and retinal vascular leakage (0% vs 46.2%). UWF ICGA revealed three abnormal findings in the CFA versus the PFA: hypofluorescent dark dots (100% vs 100%); diffusely leaking fuzzy choroidal vessels (93.8% vs 75.0%); and late hypofluorescent patches (81.3% vs 31.3%). Pooling with a dark rim and retinal vascular leakage in the PFA were significantly associated with low initial visual acuity (p=0.03) and subfoveal choroidal thickness change ratio (p=0.04), respectively.

CONCLUSION

Abnormal UWF angiography findings were frequently detected in the CFA and PFA. Such findings may be useful in evaluation and monitoring of VKH disease.

摘要

背景/目的:本研究旨在调查急性 Vogt-小柳-原田病(VKH)患者中央及周边超广角(UWF)血管造影异常的发生率及其与临床特征的关系。

方法

本回顾性观察性研究纳入了 13 例未经治疗的急性 VKH 患者的 26 只眼,所有患者均接受了 UWF 荧光素血管造影(FA)检查。其中 8 例患者的 16 只眼还接受了 UWF 吲哚青绿血管造影(ICGA)检查。我们使用模拟中央 75°视野的圆形区域将采集图像分为中央眼底区(CFA)和周边眼底区(PFA),分析了这两个区域中之前报道的六种异常血管造影表现的存在情况。此外,我们还研究了 FA 中异常血管造影表现与临床特征之间的相关性。

结果

所有患者的 CFA 和 PFA 均存在不止一种异常血管造影表现。UWF FA 显示,CFA 中存在三种与 PFA 相比的异常表现:局灶性渗漏(92.3%比 76.9%);伴有暗晕的蓄积(84.6%比 53.8%);视网膜血管渗漏(0%比 46.2%)。UWF ICGA 显示,CFA 中存在三种与 PFA 相比的异常表现:低荧光暗点(100%比 100%);弥漫性渗漏的模糊脉络膜血管(93.8%比 75.0%);以及晚期低荧光斑(81.3%比 31.3%)。PFA 中伴有暗晕和视网膜血管渗漏与初始视力低(p=0.03)和中心凹下脉络膜厚度变化比(p=0.04)显著相关。

结论

CFA 和 PFA 中常可检测到异常的 UWF 血管造影表现。这些发现可能有助于 VKH 疾病的评估和监测。

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