脉络膜视网膜色素上皮层（RPE）破坏和超传递是结构 OCT 中伴有点状内层脉络膜病变的继发性脉络膜新生血管（CNV）的早期迹象。
RPE disruption and hyper-transmission are early signs of secondary CNV with punctate inner choroidopathy in structure-OCT.
机构信息
Xiamen University affiliated Xiamen Eye Center, Wutong West Road 989, Hu Li District, Xiamen, 361100, Fujian, China.
Eye Institute of Xiamen University; School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China.
出版信息
BMC Ophthalmol. 2021 Dec 10;21(1):427. doi: 10.1186/s12886-021-02197-7.
PURPOSE
To study whether retinal pigment epithelium (RPE) disruption and choroidal hyper-transmission on spectral-domain optical coherence tomography (SD-OCT) are signs of inflammatory neovascularization (CNV) in punctate inner choroidopathy (PIC).
METHODS
This is a prospective cohort study. Seventeen patients (18 eyes) were diagnosed as PIC without CNV at baseline. Changes of morphological characteristics including choroidal hyper-transmission, hypo-transmission, RPE disruption, and ellipsoid zone (EZ) damage on SD-OCT were observed and recorded at baseline, 4, 8 and 12 weeks, respectively. The occurrence of CNV was detected by OCTA at each visit. Fisher's exact test was used to compare the relationship with each morphological sign and evaluate the predictable capability of secondary CNV in PIC (PIC+CNV) based on the structure changes on OCT.
RESULTS
Among the 18 eyes, a total of 5 eyes (27.8%) developed PIC+CNV subsequently within 4 weeks follow-up. At 4, 8 and 12 weeks of follow-up, RPE disruption and choroidal hyper-transmission were found in all 5 PIC+CNV eyes. The incidence of RPE disruption was significant higher in PIC+CNV eyes compared with PIC eyes (P=0.001). PIC eyes with hyper-transmission had a higher risk for developing CNV compared with those without hyper-transmission (P=1.17×10). 2 out of 5 PIC+CNV eyes had a choroidal hypo-transmission component adjacent to hyper-transmission zone at 4 weeks of follow-up, and hypo-transmission could be observed in all 5 PIC+CNV eyes at 8 weeks of follow-up. The incidence of choroidal hypo-transmission was significant higher in PIC+CNV eyes than PIC eyes after 8 weeks. EZ damage began to recover at 4 weeks of follow-up and had no significant difference in the PIC eyes and PIC+CNV eyes (P=0.150, 0.196, 0.353).
CONCLUSION
The presence of choroidal hyper-transmission and RPE disruption on SD-OCT is associated with the PIC+CNV. SD-OCT imaging facilitates the differentiation and track of the progression of inflammatory lesions and secondary CNV in PIC.
目的
研究脉络膜在频域光学相干断层扫描（SD-OCT）上的高透过性和视网膜色素上皮（RPE）破坏是否是斑点状内层脉络膜病变（PIC）中炎症性新生血管（CNV）的标志。
方法
这是一项前瞻性队列研究。17 名患者（18 只眼）基线时诊断为无 CNV 的 PIC。分别在基线、4 周、8 周和 12 周时观察和记录包括脉络膜高透过性、低透过性、RPE 破坏和椭圆体带（EZ）损伤在内的形态学特征的变化。每次就诊时均通过 OCTA 检测 CNV 的发生。采用 Fisher 确切概率法比较各形态学标志与 CNV 的关系，并根据 OCT 上的结构变化评估 PIC 中继发 CNV 的预测能力（PIC+CNV）。
结果
在 18 只眼中，共有 5 只眼（27.8%）在 4 周的随访中随后发展为 PIC+CNV。在 4、8 和 12 周的随访中，所有 5 只 PIC+CNV 眼中均出现 RPE 破坏和脉络膜高透过性。与 PIC 眼相比，PIC+CNV 眼中 RPE 破坏的发生率明显更高（P=0.001）。与无高透过性的患者相比，高透过性的 PIC 眼发生 CNV 的风险更高（P=1.17×10）。在 4 周的随访中，5 只 PIC+CNV 眼中有 2 只眼的脉络膜低透过性区与高透过性区相邻，在 8 周的随访中，所有 5 只 PIC+CNV 眼中均可观察到低透过性。与 PIC 眼相比，8 周后 PIC+CNV 眼中脉络膜低透过性的发生率明显更高。EZ 损伤在 4 周时开始恢复，在 PIC 眼和 PIC+CNV 眼中无显著差异（P=0.150、0.196、0.353）。
结论
SD-OCT 上脉络膜的高透过性和 RPE 破坏与 PIC+CNV 相关。SD-OCT 成像有助于 PIC 中炎症性病变和继发 CNV 的区分和进展的跟踪。
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