IRCCS - Fondazione Bietti, Rome, Italy.
Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
Ophthalmologica. 2019;242(1):8-15. doi: 10.1159/000496195. Epub 2019 Feb 5.
To investigate retinal and choroidal microvascular changes and structural choroidal involvement in retinal vein occlusion (RVO).
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).
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).
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.
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。
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)。
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)。
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。