Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
School of Computing, College of Computing and Digital Media, DePaul University, Chicago, IL, United States of America.
PLoS One. 2019 Jul 24;14(7):e0215790. doi: 10.1371/journal.pone.0215790. eCollection 2019.
To characterize the types of collaterals in eyes with retinal vein occlusion (RVO) and further investigate their correlations with vessel densities of the superficial (SCP) and the deep capillary plexus (DCP) using optical coherence tomography angiography (OCTA).
This cross-sectional study included 25 eyes of 23 patients with RVO. 3 x 3 mm2 OCTA macular scans were used to quantify the parafoveal vessel density (VD) of the SCP and DCP, and to classify the collaterals into one of four types (true superficial, true deep, superficial diving, and foveal collateral). Generalized estimating equation (GEE) regression analysis was performed to identify significant associations between parafoveal VD and collaterals. We further compared parafoveal VD between subgroups classified by the presence of specific collateral types based on the results of a clustering algorithm.
16 of 25 eyes (64%) developed collaterals. Of the 43 collateral vessels analyzed, 12/19 (63%) true superficial collaterals developed in eyes with central RVO, while all 10 superficial diving collaterals (100%) developed in eyes with branch RVO. Located exclusively in the SCP, true superficial collaterals were all arteriovenous (A-V), while diving collaterals were all veno-venular (V-V). We found a significant negative correlation between SCP VD and the total number of collaterals (P < 0.001) for the entire study cohort. Furthermore, BRVO eyes that developed superficial diving collaterals and CRVO eyes that developed true superficial collaterals demonstrated significantly lower SCP VD (P-value = 0.014) and DCP VD (P-value = 0.030), respectively, as compared to the eyes without collaterals in the respective RVO group.
Our data shows that decreased capillary perfusion in RVO is associated with the development of collaterals, while the RVO type largely dictates the type of collateral that ultimately develops.
利用光相干断层扫描血管造影术（OCTA），对视网膜静脉阻塞（RVO）患者的侧支循环类型进行特征描述，并进一步研究其与浅层（SCP）和深层毛细血管丛（DCP）血管密度的相关性。
本研究为横断面研究，共纳入 23 例 25 只眼的 RVO 患者。使用 3×3mm2 的 OCTA 黄斑扫描来定量评估 SCP 和 DCP 的中心凹旁血管密度（VD），并将侧支循环分为四种类型之一（真性浅层、真性深层、浅层穿支和中心凹旁侧支）。采用广义估计方程（GEE）回归分析来确定中心凹旁 VD 与侧支循环之间的显著相关性。我们根据聚类算法的结果，进一步比较了根据特定侧支类型的存在情况进行分组的中心凹旁 VD。
25 只眼中有 16 只（64%）发生了侧支循环。在分析的 43 条侧支血管中，19 条真性浅层侧支中有 12 条（63%）发生于中央 RVO 眼中，而 10 条浅层穿支侧支全部（100%）发生于分支 RVO 眼中。真性浅层侧支仅位于 SCP 中，均为动静脉（A-V），而浅层穿支侧支均为静脉-静脉（V-V）。我们发现整个研究队列中 SCP VD 与侧支总数之间存在显著负相关（P<0.001）。此外，与相应 RVO 组中无侧支的眼相比，发生浅层穿支侧支的 BRVO 眼和发生真性浅层侧支的 CRVO 眼的 SCP VD（P 值=0.014）和 DCP VD（P 值=0.030）均显著降低。
我们的数据表明，RVO 中毛细血管灌注减少与侧支循环的发生有关，而 RVO 类型在很大程度上决定了最终发生的侧支循环类型。
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