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脉络膜大血管层的形态学特征:年龄相关性黄斑变性、息肉样脉络膜血管病变和中心性浆液性脉络膜视网膜病变。

Morphologic features of large choroidal vessel layer: age-related macular degeneration, polypoidal choroidal vasculopathy, and central serous chorioretinopathy.

作者信息

Baek Jiwon, Lee Jae Hyung, Jung Byung Joo, Kook Lee, Lee Won Ki

机构信息

Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #222 Banpodae-ro, Seocho-gu, Seoul, 06591, Republic of Korea.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2018 Dec;256(12):2309-2317. doi: 10.1007/s00417-018-4143-1. Epub 2018 Sep 27.

Abstract

PURPOSE

To compare choroidal vascular characteristics of age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), and central serous chorioretinopathy (CSC) by qualitative and quantitative analyses using swept-source en face optical coherence tomographic (OCT) images.

METHODS

Eyes with non-neovascular AMD (n = 32), neovascular AMD (n = 30), thick and thin choroid PCV (n = 33 and 27), and CSC (n = 34) were enrolled. Subfoveal choroidal thickness (SFCT) and the presence and patterns of pachyvessels were assessed. En face images of the large choroidal vessel layer were converted to binary images for the analysis of vascular density.

RESULTS

Pachyvessels were identified in 8 (25%), 14 (46%), 28 (85%), 26 (96%), and 34 (100%) non-neovascular AMD, neovascular AMD, thin choroid PCV, thick choroid PCV, and CSC eyes, respectively (P < 0.001). The pattern of pachyvessels was focal in non-neovascular AMD (100%), neovascular AMD (79%), and thin choroid PCV (89%) while the pattern was mostly diffuse in CSC (88%) and thick choroid PCV (81%). The mean choroidal vascular density in a 6 × 6 mm macular area of each group was 45.3%, 46.9%, 47.0%, 52.5%, and 54.8%, respectively (P < 0.001). Post hoc analysis revealed significantly higher vascular density in CSC compared with other types (all P < 0.001) except PCV with thick choroid (P = 0.066).

CONCLUSIONS

Similarities in vascular density of the large choroidal vessel layer and pachyvessel pattern were between CSC and thick choroid PCV and between AMD and thin choroid PCV, suggesting common pathophysiology involving choroidal changes in these eyes.

摘要

目的

通过使用扫频源正面光学相干断层扫描(OCT)图像进行定性和定量分析,比较年龄相关性黄斑变性(AMD)、息肉样脉络膜血管病变(PCV)和中心性浆液性脉络膜视网膜病变(CSC)的脉络膜血管特征。

方法

纳入非新生血管性AMD(n = 32)、新生血管性AMD(n = 30)、厚薄脉络膜PCV(n = 33和27)以及CSC(n = 34)的眼睛。评估黄斑中心凹下脉络膜厚度(SFCT)以及厚壁血管的存在情况和形态。将大脉络膜血管层的正面图像转换为二值图像以分析血管密度。

结果

在非新生血管性AMD、新生血管性AMD、薄脉络膜PCV、厚脉络膜PCV和CSC眼中,分别有8只(25%)、14只(46%)、28只(85%)、26只(96%)和34只(100%)发现厚壁血管(P < 0.001)。厚壁血管形态在非新生血管性AMD(100%)、新生血管性AMD(79%)和薄脉络膜PCV(89%)中为局灶性,而在CSC(88%)和厚脉络膜PCV(81%)中大多为弥漫性。每组6×6mm黄斑区域的平均脉络膜血管密度分别为45.3%、46.9%、47.0%、52.5%和54.8%(P < 0.001)。事后分析显示,与其他类型相比,CSC的血管密度显著更高(所有P < 0.001),厚脉络膜PCV除外(P = 0.066)。

结论

大脉络膜血管层的血管密度和厚壁血管形态在CSC与厚脉络膜PCV之间以及AMD与薄脉络膜PCV之间存在相似性,提示这些眼睛中涉及脉络膜变化的共同病理生理学机制。

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