Treister Alison D, Nesper Peter L, Fayed Alaa E, Gill Manjot K, Mirza Rukhsana G, Fawzi Amani A
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Ophthalmology, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.
Transl Vis Sci Technol. 2018 Oct 1;7(5):19. doi: 10.1167/tvst.7.5.19. eCollection 2018 Sep.
To determine the prevalence of subclinical choroidal neovascularization (CNV) in fellow eyes of patients with unilateral exudative age-related macular degeneration (AMD) using optical coherence tomography angiography (OCTA) and to quantify choriocapillaris nonperfusion adjacent to CNV.
We retrospectively reviewed all patients with AMD who underwent OCTA and identified eyes with unilateral exudative AMD. We determined the presence of subclinical CNV on custom en face macular slabs of the outer retina and choriocapillaris and confirmed on cross-sectional scans. Two graders quantified the percent choriocapillaris area of nonperfusion (PCAN) in the entire choriocapillaris slab as well as in the "halo" zone (200 μm) surrounding subclinical and exudative CNV lesions.
Of 140 AMD patients who underwent OCTA, 34 had unilateral exudative AMD, with five of the 34 fellow eyes (14.7%) having subclinical CNV. Compared with PCAN in the entire slab (10.333 ± 4.288%), we found that "halo" PCAN, surrounding CNV, was significantly higher (13.045 ± 5.809%; < 0.001). Further, there was a trend for higher PCAN in exudative CNV eyes (15.267 ± 7.230%) compared with their fellow subclinical CNV eyes (10.823 ± 3.365%, = 0.115).
There is a notable prevalence of subclinical CNV in fellow eyes with unilateral exudative CNV, and significantly greater choriocapillaris nonperfusion adjacent to all CNV lesions. We identified a trend for increased choriocapillaris nonperfusion in exudative AMD eyes as compared with their fellow subclinical CNV eyes, which deserves further study.
OCTA can be useful in clinical practice to detect subclinical CNV and study choriocapillaris dysfunction.
使用光学相干断层扫描血管造影（OCTA）确定单侧渗出性年龄相关性黄斑变性（AMD）患者对侧眼中亚临床脉络膜新生血管（CNV）的患病率，并量化CNV附近的脉络膜毛细血管无灌注情况。
我们回顾性分析了所有接受OCTA检查的AMD患者，并确定了单侧渗出性AMD患者的眼睛。我们在定制的视网膜外层和脉络膜毛细血管黄斑表面图像上确定亚临床CNV的存在，并在横断面扫描上进行确认。两名分级人员对整个脉络膜毛细血管层以及亚临床和渗出性CNV病变周围的“晕”区（200μm）内的脉络膜毛细血管无灌注百分比（PCAN）进行量化。
在140例接受OCTA检查的AMD患者中，34例患有单侧渗出性AMD，34例对侧眼中有5例（14.7%）存在亚临床CNV。与整个层面的PCAN（10.333±4.288%）相比，我们发现CNV周围的“晕”区PCAN显著更高（13.045±5.809%；P<0.001）。此外，渗出性CNV眼的PCAN（15.267±7.230%）与对侧亚临床CNV眼（10.823±3.365%）相比有升高趋势（P=0.115）。
单侧渗出性CNV患者的对侧眼中亚临床CNV患病率显著，且所有CNV病变附近的脉络膜毛细血管无灌注明显增加。我们发现渗出性AMD眼与对侧亚临床CNV眼相比，脉络膜毛细血管无灌注有增加趋势，值得进一步研究。
OCTA在临床实践中可用于检测亚临床CNV并研究脉络膜毛细血管功能障碍。
