Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil University Paris Est Créteil, 40 Avenue de Verdun, 94000, Créteil, France.
Department of Ophthalmology, IRCCS Hospital San Raffaele, University Vita-Salute, Milan, Italy.
Graefes Arch Clin Exp Ophthalmol. 2020 Aug;258(8):1597-1605. doi: 10.1007/s00417-020-04732-6. Epub 2020 May 14.
To describe the "dimple," a previously unreported structural optical coherence tomography (OCT) finding in vascularized serous pigment epithelial detachment (PED) secondary to neovascular age-related macular degeneration (AMD).
Retrospective, longitudinal, case series study. Clinical charts and multimodal imaging including OCT (structural and angiography) and dye-based angiography (fluorescein and indocyanine green) examinations of patients with dimple-defined as a localized invagination of the vascularized serous PED-were analyzed in 2 high-volume referral centers.
Nineteen eyes of 18 patients were included. Mean follow-up was at 64.1 ± 35.8 months. The greater basal and height diameters of the vascularized serous PED were respectively 3425.8 ± 1049.6 μm and 667.1 ± 279.9 μm at baseline and 3076.2 ± 1649.9 μm (p = 0.8) and 368.3 ± 295.1 at last follow-up (p = 0.0006). OCT analysis identified 2 phenotypes of dimple: type 1 or ("top denting") (9 eyes) and type 2 (or "side denting") (10 eyes). Both phenotypes are associated with hyper-reflective holding sub-retinal pigment epithelium (RPE) band encompassing the posterior face of the RPE and extending to the Bruch's membrane. Hyper-reflective holding band is not correlated with angiographic signs of neovascular tissue in all cases. During follow-up, no case of RPE tear was observed.
We describe the characteristics of the dimple and its association with hyper-reflective holding sub-RPE bands in the context of large vascularized serous PED in neovascular AMD. The presence of a dimple does not seem to be an additional risk factor for the development of RPE tearing in high-risk PED secondary to neovascular AMD.
描述血管化浆液性色素上皮脱离（PED）继发于新生血管性年龄相关性黄斑变性（AMD）的“酒窝”这一先前未报道的结构光相干断层扫描（OCT）表现。
回顾性、纵向、病例系列研究。对 2 家高容量转诊中心的酒窝定义为血管化浆液性 PED 的局部内陷患者的临床图表和多模态成像（包括 OCT[结构和血管造影]和染料基血管造影[荧光素和吲哚菁绿]）进行分析。
纳入 18 例患者的 19 只眼。平均随访时间为 64.1±35.8 个月。血管化浆液性 PED 的基底直径和高度直径分别在基线时为 3425.8±1049.6μm和 667.1±279.9μm，在最后一次随访时分别为 3076.2±1649.9μm（p=0.8）和 368.3±295.1μm（p=0.0006）。OCT 分析确定酒窝有 2 种表型：1 型或“顶部凹陷”（9 只眼）和 2 型（或“侧面凹陷”）（10 只眼）。两种表型均与环绕 RPE 后表面并延伸至 Bruch 膜的高反射固定 RPE 下带相关。在所有病例中，高反射固定带均与新生血管组织的血管造影征象无关。在随访期间，未观察到 RPE 撕裂。
我们描述了在新生血管性 AMD 大血管化浆液性 PED 背景下酒窝的特征及其与高反射固定 RPE 下带的关系。酒窝的存在似乎不是继发于新生血管性 AMD 的高危 PED 中 RPE 撕裂的额外危险因素。
