Hirano Takao, Takahashi Yoshiaki, Hoshiyama Ken, Murata Toshinori
Department of Ophthalmology, Shinshu University School of Medicine, Japan.
Am J Ophthalmol Case Rep. 2022 Feb 16;26:101435. doi: 10.1016/j.ajoc.2022.101435. eCollection 2022 Jun.
To report a rare case of foveal retinal neovascularization (RNV) in a patient with diabetic retinopathy in whom the retinal microcirculation structure before and after the onset of the disease was evaluated using optical coherence tomography angiography (OCTA).
A 54-year-old woman with diabetes mellitus was referred to our department for fundus evaluation, and was diagnosed with cataract and severe non-proliferative diabetic retinopathy in the left eye. Two years after we performed cataract surgery and pan-retinal photocoagulation in the left eye, OCTA detected a previously unidentified foveal RNV arising from the perifoveal capillary network. The vitreous retinal interface slab of OCTA and cross-sectional OCT images confirmed that this foveal RNV was an aberrant vessel invading the vitreous cavity.
The findings in this case indicate that foveal RNV in diabetic retinopathy is derived from vessels outside the foveal avascular zone (FAZ), and OCTA is a useful examination for the diagnostic investigation of foveal RNV.
报告1例糖尿病视网膜病变患者发生黄斑区视网膜新生血管(RNV)的罕见病例,该病例利用光学相干断层扫描血管造影(OCTA)评估了疾病发生前后的视网膜微循环结构。
一名54岁糖尿病女性患者因眼底评估转诊至我科,诊断为左眼白内障和重度非增殖性糖尿病视网膜病变。在我们对左眼进行白内障手术和全视网膜光凝治疗两年后,OCTA检测到黄斑中心凹有一处之前未被发现的RNV,其起源于黄斑中心凹周围的毛细血管网。OCTA的玻璃体视网膜界面层面图像和横断面OCT图像证实,该黄斑区RNV是一条侵入玻璃体腔的异常血管。
该病例的研究结果表明,糖尿病视网膜病变中的黄斑区RNV起源于黄斑无血管区(FAZ)以外的血管,且OCTA是诊断黄斑区RNV的有用检查手段。