Kadomoto Shin, Muraoka Yuki, Uji Akihito, Tamiya Ryosuke, Ooto Sotaro, Murakami Tomoaki, Oritani Yasuyuki, Kawai Kentaro, Tsujikawa Akitaka
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Biomed Opt Express. 2020 Oct 5;11(11):6078-6092. doi: 10.1364/BOE.402331. eCollection 2020 Nov 1.
Retinal microaneurysms (MAs) associated with retinal vein occlusions often cause macular edema due to vascular leakage from the MAs, which can lead to severe vision loss. However, studies using conventional imaging modalities have not shown a significant association between MAs and retinal functional changes. The recent technological advancements to the adaptive optics scanning light ophthalmoscope (AOSLO) have enabled real-time observation of the human retinal microvasculature. Additionally, offsetting the confocal aperture in the AOSLO enables the blocking of specular reflection from the inner retina and the enhancement of the image contrast of the retinal capillaries. This study investigated the ultrastructure and hemodynamics of MAs examined by structural images and perfusion maps of the offset pinhole AOSLO and evaluated their associations with vascular leakage on fluorescein angiography. Our results show the diverse configurations of the MAs, some of which are occasionally accompanied by a cap structure on the aneurysmal surface. Moreover, the morphological and hemodynamic changes were significantly associated with vascular leakage.
与视网膜静脉阻塞相关的视网膜微动脉瘤（MAs）常常因微动脉瘤的血管渗漏而导致黄斑水肿，这可能会导致严重的视力丧失。然而，使用传统成像方式的研究并未显示微动脉瘤与视网膜功能变化之间存在显著关联。自适应光学扫描激光检眼镜（AOSLO）的最新技术进展使得能够实时观察人类视网膜微血管系统。此外，在AOSLO中偏移共焦孔径能够阻挡来自视网膜内层的镜面反射，并增强视网膜毛细血管的图像对比度。本研究通过偏移针孔AOSLO的结构图像和灌注图研究了微动脉瘤的超微结构和血流动力学，并评估了它们与荧光素血管造影上血管渗漏的相关性。我们的结果显示了微动脉瘤的多种形态，其中一些偶尔在动脉瘤表面伴有帽状结构。此外，形态和血流动力学变化与血管渗漏显著相关。
