Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Sci Rep. 2021 Jul 22;11(1):14942. doi: 10.1038/s41598-021-94412-0.
Accumulating evidence points to pachychoroid possibly being caused by vortex vein congestion which results in remodeling of choroidal drainage routes via intervortex vein anastomosis. This hypothesis prompted us to investigate vortex vein hemodynamics by studying videos of indocyanine green angiography (ICGA) in a retrospective case series of 295 eyes with pachychoroid spectrum diseases. In the early phase of the video-ICGA, pulsatile vortex venous flow was observed in 76 eyes (25.8%) at the vortex veins connected with anastomosis between superior and inferior vortex veins. The patients with pulsatile vortex venous flow were significantly older than those without pulsatile vortex venous flow (67.8 ± 13.2 vs. 63.9 ± 14.5 years, P < 0.05). Pulsatile vortex venous flow was 1.84 times more common in the inferior quadrants than in the superior quadrants. Interestingly, 14 of 76 eyes (18.4%) with pulsatile vortex venous flow showed retrograde pulsatile blood flow in the vortex veins. This retrograde pulsatile blood flow was 2.50 times more common in the inferior than in the superior quadrants. These findings indicate altered vortex vein hemodynamics due to vortex vein congestion in pachychoroid spectrum diseases.
越来越多的证据表明，厚脉络膜可能是涡静脉充血引起的，这导致脉络膜引流途径通过涡静脉吻合重建。这一假说促使我们通过研究 295 只患有厚脉络膜谱疾病的眼睛的吲哚菁绿血管造影（ICGA）视频的回顾性病例系列，来研究涡静脉血液动力学。在视频-ICGA 的早期阶段，在与上下涡静脉之间吻合的涡静脉中观察到 76 只眼睛（25.8%）的脉动涡静脉血流。有脉动涡静脉血流的患者明显比没有脉动涡静脉血流的患者年龄大（67.8±13.2 岁比 63.9±14.5 岁，P<0.05）。在下象限中，脉动涡静脉血流比在上象限中更常见，为 1.84 倍。有趣的是，76 只眼睛中有 14 只（18.4%）有脉动涡静脉血流的眼睛中，涡静脉出现逆行性脉动血流。这种逆行性脉动血流在下象限比在上象限更常见，为 2.50 倍。这些发现表明，厚脉络膜谱疾病中涡静脉充血导致涡静脉血液动力学改变。
