Vitreous Retina Macula Consultants of New York, New York.
Department of Ophthalmology, New York University School of Medicine, New York.
JAMA Ophthalmol. 2018 Nov 1;136(11):1262-1270. doi: 10.1001/jamaophthalmol.2018.3586.
Analysis of collateral vessel formation following retinal vein occlusion may advance our understanding of the venous outflow anatomy in the macula.
To determine the location of collateral vessels with optical coherence tomography (OCT) angiography imaging.
DESIGN, SETTING, AND PARTICIPANTS: Observational retrospective cohort study. Collateral vessel formation was studied with OCT angiography (OCTA) in patients with retinal vein occlusion (RVO). The study took place at 2 retinal practices (Vitreous Retina Macula Consultants of New York and Stein Eye Institute, University of California, Los Angeles), with patient records retrieved from March 2015 to August 2017. Data analysis was completed in November 2017.
Collaterals identified with fundus photography and/or fluorescein angiography were analyzed with OCTA to determine their course through the superficial vascular plexus (SVP) and the deep vascular complex (DVC).
Collateral vessel pathways through the SVP and DVC were analyzed with cross-sectional and en face OCT and OCTA segmentation and color-coded volume renderings prepared from raw OCTA voxel data.
From 23 eyes (22 branch and 1 hemispheric retinal vein occlusion ) of 23 patients (mean [SD] age, 73 [11] years), 101 collateral vessels were identified and analyzed (mean [SD], 4.4 [2.0]; range, 2-9 collateral per eye). On OCTA, the collaterals appeared as curvilinear dilated flow signals that connected veins across the horizontal raphe or veins on opposite sides of an occluded venous segment within the same retinal hemisphere. Of the 101 collaterals analyzed, all showed greater flow signal in the DVC, and all had some portion of their course identified within the DVC. No collaterals were found exclusively in the SVP. Volume renderings for 3 cases confirmed qualitatively that retinal collateral vessels course through the retina predominantly at the level of the DVC.
Based on a limited number of cases, all collateral vessels associated with retinal vein occlusion were found to course through the DVC. The absence of collaterals isolated to the SVP supports a serial arrangement of the SVP and DVC, with venous drainage predominantly coursing through the DVC.
对视网膜静脉阻塞后侧支血管形成的分析可能有助于我们了解黄斑区静脉流出的解剖结构。
通过光相干断层扫描血管造影（OCTA）确定侧支血管的位置。
设计、地点和参与者：观察性回顾性队列研究。对视网膜静脉阻塞（RVO）患者的侧支血管形成进行了 OCT 血管造影（OCTA）研究。该研究在 2 家视网膜诊所（纽约玻璃体视网膜黄斑咨询公司和加利福尼亚大学洛杉矶分校的 Stein 眼科研究所）进行，患者记录于 2015 年 3 月至 2017 年 8 月检索。数据分析于 2017 年 11 月完成。
通过眼底照相和/或荧光素血管造影确定的侧支血管用 OCTA 进行分析，以确定它们在浅层血管丛（SVP）和深层血管复合体（DVC）中的走行。
通过横截面和全景 OCT 以及 OCTA 分割以及从原始 OCTA 体素数据制备的彩色容积渲染来分析 SVP 和 DVC 中的侧支血管通路。
在 23 名患者（22 名分支和 1 名半球性视网膜静脉阻塞）的 23 只眼中，共确定并分析了 101 条侧支血管（平均[标准差]年龄，73[11]岁）（平均[标准差]，4.4[2.0]；范围，每只眼 2-9 条侧支血管）。在 OCTA 上，侧支血管表现为连接水平横嵴的曲线状扩张血流信号，或在同一视网膜半球中阻塞静脉段的对侧静脉。在分析的 101 条侧支血管中，所有侧支血管的 DVC 中均显示出更大的血流信号，并且它们的一部分都在 DVC 中确定。没有仅在 SVP 中发现的侧支血管。3 例的容积渲染结果定性证实，视网膜侧支血管主要在 DVC 水平穿过视网膜。
基于有限数量的病例，所有与视网膜静脉阻塞相关的侧支血管均被发现穿过 DVC。没有孤立于 SVP 的侧支血管支持 SVP 和 DVC 的串联排列，静脉引流主要通过 DVC 进行。
