Tan Colin S, Ting Dominic S, Lim Louis W
Fundus Image Reading Centre, National Healthcare Group Eye Institute, Singapore; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ophthalmol Retina. 2019 May;3(5):400-409. doi: 10.1016/j.oret.2019.01.009. Epub 2019 Jan 18.
Polypoidal choroidal vasculopathy (PCV) is a variant of neovascular age-related macular degeneration with distinct phenotypes, treatment, and visual prognosis. Multicolor imaging is a novel noninvasive imaging method that enables visualization of structures located at different layers of the retina and may be useful in detecting features of diseases. The features of PCV seen on multicolor imaging have not been studied. We aimed to describe the features of PCV detected using multicolor imaging and to compare these with standard color fundus photography (CFP).
Hospital-based, cross-sectional study.
Fifty consecutive treatment-naive patients diagnosed with PCV seen in a tertiary referral center.
Multimodal imaging was performed using standardized protocols, and included CFP, multicolor imaging, fluorescein angiography, and indocyanine green angiography (ICGA). The CFP and ICGA images were independently graded by reading center-certified retinal specialists to confirm the diagnosis of PCV and identify lesion components. The features of the lesion components seen on multicolor images were compared with those detected using CFP and ICGA.
Frequency and features of lesions associated with PCV, specifically, polyps, branching vascular network (BVN), pigment epithelial detachments (PEDs), hemorrhages, and drusen.
The mean age of the 50 participants was 67.9 years, and 60% were male. Polyps were most clearly seen on the infrared reflectance image and detected in 49 of 50 eyes (98%), appearing as dark gray oval lesions with distinct margins. On the multicolor composite images, polyps appeared as dark green oval lesions. The BVN appeared as mottled gray regions on infrared reflectance imaging and were seen less frequently compared with polyps (30/50 eyes, 60%). The margins of the BVN were less distinct compared with polyps. Other clinical features detected using multicolor imaging included PEDs (26%), subretinal hemorrhages (40%), and drusen (66%).
Multicolor imaging is able to detect polypoidal lesions in most patients with PCV. The appearance of PCV lesions on multicolor imaging differs from standard CFP, although the location and shape of lesions correlate well with features seen on CFP and ICGA. Multicolor imaging is a useful, noninvasive adjunct to detect features suggestive of PCV, which may prompt definitive investigations such as ICGA.
息肉样脉络膜血管病变（PCV）是新生血管性年龄相关性黄斑变性的一种变体，具有独特的表型、治疗方法和视觉预后。多色成像技术是一种新型的非侵入性成像方法，能够显示位于视网膜不同层次的结构，可能有助于检测疾病特征。多色成像下PCV的特征尚未得到研究。我们旨在描述通过多色成像检测到的PCV特征，并将其与标准彩色眼底照相术（CFP）进行比较。
基于医院的横断面研究。
在一家三级转诊中心连续纳入50例未经治疗的确诊为PCV的患者。
采用标准化方案进行多模态成像，包括CFP、多色成像、荧光素血管造影和吲哚菁绿血管造影（ICGA）。CFP和ICGA图像由经阅读中心认证的视网膜专科医生独立分级，以确诊PCV并识别病变成分。将多色图像上病变成分的特征与CFP和ICGA检测到的特征进行比较。
与PCV相关的病变的频率和特征，特别是息肉、分支血管网（BVN）、色素上皮脱离（PED）、出血和玻璃膜疣。
50名参与者的平均年龄为67.9岁，60%为男性。息肉在红外反射图像上最清晰可见，50只眼中有49只（98%）检测到息肉，表现为边缘清晰的深灰色椭圆形病变。在多色合成图像上，息肉表现为深绿色椭圆形病变。BVN在红外反射成像上表现为斑驳的灰色区域，与息肉相比较少见（30/50只眼，60%）。BVN的边缘与息肉相比不那么清晰。多色成像检测到的其他临床特征包括PED（26%）、视网膜下出血（40%）和玻璃膜疣（66%）。
多色成像能够在大多数PCV患者中检测到息肉样病变。PCV病变在多色成像上的表现与标准CFP不同，尽管病变的位置和形状与CFP和ICGA上看到的特征相关性良好。多色成像对于检测提示PCV的特征是一种有用的非侵入性辅助手段，这可能促使进行如ICGA等确定性检查。
