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两种不同的光相干断层扫描血管造影设备分析视网膜静脉阻塞的微血管视网膜和脉络膜变化。

Microvascular Retinal and Choroidal Changes in Retinal Vein Occlusion Analyzed by Two Different Optical Coherence Tomography Angiography Devices.

机构信息

IRCCS - Fondazione Bietti, Rome, Italy.

Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.

出版信息

Ophthalmologica. 2019;242(1):8-15. doi: 10.1159/000496195. Epub 2019 Feb 5.

Abstract

PURPOSE

To investigate retinal and choroidal microvascular changes and structural choroidal involvement in retinal vein occlusion (RVO).

METHODS

Retrospective analysis of treatment-naïve macular edema secondary to RVO, studied by optical coherence tomography (OCT) and OCT angiography (OCTA), before and after the loading phase of intravitreal injections of ranibizumab (IVR-LP). OCTA was performed using two different devices: AngioVue RTVue XR Avanti (spectral-domain OCTA) and Zeiss PLEX® Elite 9000 (swept-source OCTA).

RESULTS

30 eyes of 30 consecutive patients (17 branch and 13 central RVO) were included. Central macular thickness and subfoveal choroidal thickness (SCT) were significantly reduced after IVR-LP (p < 0.001 and p = 0.046, respectively). 23 eyes were eligible for OCTA analysis. Baseline vessel density (VD) in deep capillary plexus (DCP) was significantly reduced in RVO eyes compared with fellow eyes (p = 0.03 and p = 0.002 for PLEX® Elite and AngioVue, respectively). After IVR-LP, no significant VD changes in any vascular layer was found. PLEX® Elite VD analysis showed significant differences in DCP between ischemic versus non-is-chemic eyes (p = 0.011).

CONCLUSION

OCTA suggests a retinal vascular impairment of DCP but no involvement of choroid in RVO eyes. A greater baseline SCT could be due to a choroidal exudation. OCTA imaged with PLEX® Elite allowed to differentiate ischemic and non-ischemic patients at baseline.

摘要

目的

研究视网膜静脉阻塞(RVO)中视网膜和脉络膜微血管变化及脉络膜结构受累情况。

方法

回顾性分析经光学相干断层扫描(OCT)和 OCT 血管造影(OCTA)检查的未经治疗的 RVO 继发黄斑水肿患者,这些患者在接受玻璃体腔注射雷珠单抗(IVR-LP)负荷期前后的情况。OCTA 使用两种不同的设备进行:AngioVue RTVue XR Avanti(谱域 OCTA)和 Zeiss PLEX® Elite 9000(扫频源 OCTA)。

结果

共纳入 30 只眼(17 只分支 RVO 和 13 只中央 RVO)30 例连续患者。IVR-LP 后中央黄斑厚度和中心凹下脉络膜厚度(SCT)明显降低(p<0.001 和 p=0.046)。23 只眼符合 OCTA 分析条件。与对侧眼相比,RVO 眼的深层毛细血管丛(DCP)血管密度(VD)明显降低(PLEX® Elite 和 AngioVue 分别为 p=0.03 和 p=0.002)。IVR-LP 后,任何血管层的 VD 均无明显变化。PLEX® Elite 的 VD 分析显示,缺血眼与非缺血眼之间 DCP 存在显著差异(p=0.011)。

结论

OCTA 提示 RVO 眼存在 DCP 视网膜血管损伤,但脉络膜无受累。更大的基线 SCT 可能是由于脉络膜渗出。PLEX® Elite 成像的 OCTA 可以在基线时区分缺血和非缺血患者。

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