Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan.
Sci Rep. 2019 Jan 24;9(1):595. doi: 10.1038/s41598-018-37384-y.
This study analyze the morphological characteristics of branching vascular networks (BVN) in polypoidal choroidal vasculopathy (PCV) using optical coherence tomography angiography (OCTA), and correlate imaging characteristics with clinical presentations. We presented a retrospective observational case series for fifty cases of PCV confirmed by indocyanine green angiography. Macular OCTA were done by the AngioVue. The PCV cases were classified by distinct morphologic patterns of BVN by two retina specialists and clinical features were analyzed. The sensitivity of polyp detection by OCTA was 86% after manual segmentation and that of BVN was 90%. Three distinct morphologic patterns of BVN were identified. (1) The "Trunk" pattern (47%) exhibited major vessel trunk with features including presence of drusens, thin choroid, and larger BVN area. (2) The "Glomeruli" pattern (33%) showed anastomotic vascular network without major trunk. (3) The "Stick" pattern (20%) had localized BVN and the thickest choroid. Subtypes 2 and 3 held higher recurrence rate. In conclusions, the precise visualization of BVN on OCTA supported that OCTA might be a noninvasive tool to study the morphology of BVN in PCV, which exhibits three different morphological types. Identifying the morphology of BVN has the potential to prognosticate outcomes in PCV patients.
本研究通过光相干断层扫描血管造影术（OCTA）分析息肉样脉络膜血管病变（PCV）中分支血管网络（BVN）的形态特征，并将影像学特征与临床表现相关联。我们回顾性观察了经吲哚青绿血管造影（ICGA）证实的 50 例 PCV 病例。黄斑 OCTA 由 AngioVue 完成。两名视网膜专家根据 BVN 的不同形态模式对 PCV 病例进行分类，并分析了临床特征。手动分割后 OCTA 检测息肉的敏感性为 86%，BVN 的敏感性为 90%。发现了三种不同形态的 BVN。（1）“主干”型（47%）表现为大血管主干，其特征包括存在玻璃膜疣、脉络膜变薄和更大的 BVN 面积。（2）“肾小球”型（33%）显示无主干的吻合血管网络。（3）“棍棒”型（20%）具有局限性 BVN 和最厚的脉络膜。亚型 2 和 3 的复发率更高。总之，OCTA 对 BVN 的精确可视化表明，OCTA 可能是研究 PCV 中 BVN 形态的一种非侵入性工具，其表现出三种不同的形态类型。识别 BVN 的形态有可能预测 PCV 患者的预后。
