Arrigo Alessandro, Romano Francesco, Aragona Emanuela, di Nunzio Carlo, Sperti Andrea, Bandello Francesco, Battaglia Parodi Maurizio
Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan, Italy.
Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco University Hospital, Milan, Italy.
Transl Vis Sci Technol. 2019 Dec 5;8(6):26. doi: 10.1167/tvst.8.6.26. eCollection 2019 Nov.
The aim of the present study was to analyze quantitative optical coherence tomography (OCT) and OCT angiography (OCTA) parameters to identify clinically relevant cutoff values able to detect clinically different Stargardt's disease (STGD) subgroups.
Consecutive STGD patients were recruited and underwent complete ophthalmologic examination, including multimodal imaging. Several quantitative parameters were extracted both from structural OCT and OCTA images and were statistically analyzed. A post hoc analysis was performed to identify a quantitative cutoff able to distinguish two clinically different STGD subgroups. Main outcome measures were total retinal thickness, central macular thickness (CMT), retinal layers thickness, retinal and choroidal hyperreflective foci (HF) number, vessel density (VD), vessel tortuosity (VT), vessel dispersion (Vdisp), and vessel rarefaction (VR) of macular and optic nerve head plexa.
Overall, 54 eyes of 54 STGD patients (18 males) and 54 eyes of 54 healthy age- and sex-matched controls were included in the analysis. All quantitative parameters resulted significantly worse in STGD than controls ( < 0.01). Moreover, a VT cutoff of 5 allowed to distinguish the following two categories: a functionally and anatomically better STGD group and a worse group. BCVA resulted 0.42 ± 0.28 logMAR in the best group versus 1.09 ± 0.36 logMAR in the worst ( < 0.01). Structural OCT and OCTA parameters significantly differed between the two STGD groups.
Quantitative OCTA was able to detect different morphofunctional STGD phenotypes.
OCTA-based classification of STGD patients detected different patients' subgroups, differing in terms of morphologic and functional features, with a potential impact on clinical and research settings.
本研究旨在分析定量光学相干断层扫描（OCT）和OCT血管造影（OCTA）参数，以确定能够检测临床上不同类型的斯塔加特病（STGD）亚组的临床相关临界值。
连续招募STGD患者，并对其进行包括多模态成像在内的完整眼科检查。从结构OCT和OCTA图像中提取了几个定量参数，并进行了统计分析。进行事后分析以确定能够区分两个临床上不同的STGD亚组的定量临界值。主要观察指标包括总视网膜厚度、中心黄斑厚度（CMT）、视网膜各层厚度、视网膜和脉络膜高反射灶（HF）数量、血管密度（VD）、血管迂曲度（VT）、血管离散度（Vdisp）以及黄斑和视神经乳头丛的血管稀疏（VR）。
总体而言，分析纳入了54例STGD患者（18例男性）的54只眼和54例年龄及性别匹配的健康对照者的54只眼。所有定量参数在STGD患者中均显著差于对照组（<0.01）。此外，VT临界值为5时可区分以下两类：功能和解剖结构较好的STGD组和较差的组。最佳组的最佳矫正视力（BCVA）为0.42±0.28 logMAR，最差组为1.09±0.36 logMAR（<0.01）。两个STGD组之间的结构OCT和OCTA参数存在显著差异。
定量OCTA能够检测不同形态功能的STGD表型。
基于OCTA对STGD患者进行分类可检测出不同的患者亚组，这些亚组在形态和功能特征方面存在差异，对临床和研究环境可能产生影响。
