Parodi Maurizio Battaglia, Arrigo Alessandro, Calamuneri Alessandro, Aragona Emanuela, Bandello Francesco
Department of Ophthalmology, San Raffaele Hospital, Milano, Lombardia, Italy.
Department of Ophthalmology, San Raffaele Hospital, Milano, Lombardia, Italy
Br J Ophthalmol. 2022 Apr;106(4):564-567. doi: 10.1136/bjophthalmol-2020-317635. Epub 2020 Dec 8.
To analyse multimodal imaging alterations in the subclinical form of best vitelliform macular dystrophy (BVMD).
The study was designed as an observational, cross-sectional case series. Eleven eyes of 7 subclinical patients with BVMD and 12 age-matched and sex-matched controls were included. Multimodal imaging included fundus blue-light autofluorescence, near-infrared autofluorescence (NIR-AF), structural optical coherence tomography (OCT) and OCT angiography (OCTA). The quantitative analysis included the calculation of the following parameters: vessel density (VD), vessel tortuosity (VT), vessel dispersion (Vdisp), vessel rarefaction (VR), foveal avascular zone (FAZ) area, reflectivity of the outer retinal bands and choriocapillaris porosity (CCP).
Mean best-corrected visual acuity was 0.0±0.0 LogMAR in both groups. The round central hypoautofluorescent alteration on NIR-AF corresponded to a significant reflectivity attenuation of the outer retinal bands on structural OCT (0.55±0.18 vs 0.75±0.08; p<0.001). VD, VT, VR and Vdisp were normal compared with controls (all p>0.05). The FAZ area turned out to be significantly restricted at the level of the deep capillary plexus in subclinical BVMD eyes (p<0.001). Furthermore, quantitative OCTA revealed a significant central increase of CCP, compared with controls (18.25±2.43 vs 4.58±1.36; p<0.001).
The subclinical stage of BVMD is characterised by significant alterations of the outer retinal bands and the choriocapillaris. Quantitative multimodal imaging assessment suggests that subclinical BVMD is affected by the functional impairment of the outer retinal structures, leading to an alteration in melanin and growth factor production.
分析最佳视锥细胞营养不良（BVMD）亚临床型的多模态成像改变。
本研究设计为一项观察性横断面病例系列研究。纳入了7例BVMD亚临床患者的11只眼以及12名年龄和性别匹配的对照者。多模态成像包括眼底蓝光自发荧光、近红外自发荧光（NIR-AF）、结构光学相干断层扫描（OCT）和OCT血管造影（OCTA）。定量分析包括计算以下参数：血管密度（VD）、血管迂曲度（VT）、血管离散度（Vdisp）、血管稀疏度（VR）、黄斑无血管区（FAZ）面积、视网膜外层带的反射率和脉络膜毛细血管孔隙率（CCP）。
两组的平均最佳矫正视力均为0.0±0.0 LogMAR。NIR-AF上圆形的中央低自发荧光改变对应于结构OCT上视网膜外层带反射率的显著衰减（0.55±0.18对0.75±0.08；p<0.001）。与对照组相比，VD、VT、VR和Vdisp均正常（所有p>0.05）。结果显示，亚临床BVMD眼深层毛细血管丛水平的FAZ面积显著受限（p<0.001）。此外，定量OCTA显示，与对照组相比，CCP在中央显著增加（18.25±2.43对4.58±1.36；p<0.001）。
BVMD的亚临床阶段以视网膜外层带和脉络膜毛细血管的显著改变为特征。多模态成像定量评估表明，亚临床BVMD受视网膜外层结构功能损害的影响，导致黑色素和生长因子产生改变。
