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脉络膜血管指数:一种基于增强深度光学相干断层扫描的参数,用于确定增殖性和非增殖性黄斑毛细血管扩张症患者的血管状态。

Choroidal vascularity index: an enhanced depth optical coherence tomography-based parameter to determine vascular status in patients with proliferative and non-proliferative macular telangiectasia.

机构信息

Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mah, Bereketzade Sok. No:2, 34421, Beyoğlu, Istanbul, Turkey.

School of Medicine Department of Ophthalmology Istanbul, Acibadem University, Istanbul, Turkey.

出版信息

Int Ophthalmol. 2021 Oct;41(10):3505-3513. doi: 10.1007/s10792-021-01917-8. Epub 2021 Jun 28.

DOI:10.1007/s10792-021-01917-8
PMID:34181193
Abstract

KEY MESSAGES

The pathogenesis of subretinal neovascularization (SRNV) due to macular telengiectasia (MacTel 2) has not fully elucidated. This optical coherence tomography (OCT)-based method can provide better understanding of the pathogenesis of SRNV due to MacTel 2.

PURPOSE

To evaluate the choroidal vascular index (CVI) through optical coherence tomography (OCT) on eyes with proliferative macular telangiectasia type 2 (MacTel 2) or non-proliferative MacTel 2, and in healthy individuals.

METHODS

Macular enhanced depth imaging OCT scans on 42 eyes of 21 patients with non-proliferative MacTel 2, on 32 eyes of 20 patients with proliferative MacTel 2, and on 38 eyes of 32 control patients were analyzed by adjusting for age-gender-axial length. Proliferative MacTel 2 was diagnosed when subretinal neovascularization (SRNV) was simultaneously observed in the non-proliferative phase. Binarization methods of ImageJ software were used to analyze images, and total choroid area (TCA), luminal area (LA) and stromal area (SA) were obtained. CVI was characterized as the ratio of LA to TCA.

RESULTS

The mean TCA and SA were significantly higher in group 1 and group 2 when compared with group 3 (3.36 ± 0.29 mm vs. 3.27 ± 0.76 mm vs. 2.49 ± 0.24 mm, p < 0.001; 1.15 ± 0.31 mm vs. 1.10 ± 0.69 mm vs. 0.35 ± 0.23 mm, respectively; p < 0.001). Although LA was relatively higher in group 1 and group 2 than group 3, no statistically significant difference was observed (2.22 ± 0.14 mm vs. 2.17 ± 0.15 mm vs. 2.13 ± 0.21 mm) (p = 0.088). CVI was significantly lower in group 1 than other groups (0.65 ± 0.01 vs 0.67 ± 0.02 vs 0.68 ± 0.02) (p < 0.001).

CONCLUSION

As an OCT screening method, CVI may be used to assess the vascular status of the choroid on the eyes which are naive for or were exposed to SRNV secondary to MacTel 2, and to elucidate the pathogenesis of this disease.

摘要

主要信息

黄斑毛细血管扩张症 2 型(MacTel 2)所致的视网膜下新生血管(SRNV)的发病机制尚未完全阐明。这种基于光学相干断层扫描(OCT)的方法可以更好地了解 MacTel 2 所致 SRNV 的发病机制。

目的

通过光学相干断层扫描(OCT)评估增殖性 MacTel 2 型(MacTel 2)或非增殖性 MacTel 2 以及健康个体的脉络膜血管指数(CVI)。

方法

对 21 例非增殖性 MacTel 2 患者的 42 只眼、20 例增殖性 MacTel 2 患者的 32 只眼和 32 例对照患者的 38 只眼进行黄斑增强深度成像 OCT 扫描。当在非增殖期同时观察到视网膜下新生血管(SRNV)时,诊断为增殖性 MacTel 2。使用 ImageJ 软件的二值化方法分析图像,并获得总脉络膜面积(TCA)、管腔面积(LA)和基质面积(SA)。CVI 的特征是 LA 与 TCA 的比值。

结果

与第 3 组相比,第 1 组和第 2 组的平均 TCA 和 SA 显著升高(3.36 ± 0.29mm 比 3.27 ± 0.76mm 比 2.49 ± 0.24mm,p < 0.001;1.15 ± 0.31mm 比 1.10 ± 0.69mm 比 0.35 ± 0.23mm,p < 0.001)。尽管第 1 组和第 2 组的 LA 相对高于第 3 组,但差异无统计学意义(2.22 ± 0.14mm 比 2.17 ± 0.15mm 比 2.13 ± 0.21mm,p = 0.088)。第 1 组的 CVI 明显低于其他组(0.65 ± 0.01 比 0.67 ± 0.02 比 0.68 ± 0.02)(p < 0.001)。

结论

作为一种 OCT 筛查方法,CVI 可用于评估 MacTel 2 继发的 SRNV 初次发生或已暴露眼的脉络膜血管状态,并阐明该疾病的发病机制。

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