Tunis Med. 2021;99(4):478-480.
We report a typical illustration of Swept source OCT-Angiography (SS-OCT-A) findings in type 3 macular neovascularization(MNV) or retinal angiomatous proliferation (RAP). This is a case of a 70-year-old Caucasian male patient presenting with an exudative type 3 neovascular age-related macular degeneration. En face SS-OCT-A could non-invasively detect a tiny perifoveal circular "clew-like" high-flow neovascular lesion, visible in the deep capillary plexus, the outer retina and communicating with the choriocapillaris, with a perilesional dark halo and associated to no-flow macular cysts in the deep capillary plexus slab. En face SS-OCT-A could also highlight the presence of a telangiectatic capillary dilation in the superficial capillary plexus appearing to be at the origin of the retinal neovascularization. Cross-sectional SS-OCT-A showed an intra-retinal vertical high vascular flow within the hyper-reflective neovascular lesion, with a typical hyperreflective "kissing sign" and associated to subretinal and intraretinal fluid. In conclusion, en face OCT-A is useful tool to diagnose type 3 MNV or RAP non-invasively and associated cross-sectional OCT-A scan is very helpful highlighting the linear vascular high-flow within the retinal neovascularization.
我们报告了一例典型的扫频源光相干断层扫描血管造影(SS-OCT-A)在 3 型黄斑新生血管(MNV)或视网膜血管瘤样增生(RAP)中的发现。这是一位 70 岁的白种男性患者,表现为渗出型 3 型年龄相关性黄斑变性。 层面 SS-OCT-A 可以非侵入性地检测到一个微小的旁中心环状“线索样”高流量新生血管病变,可见于深层毛细血管丛、外视网膜,并与脉络膜毛细血管相通,病变周围有暗晕,伴有深层毛细血管丛层面的无血流黄斑囊腔。 层面 SS-OCT-A 还可以突出浅层毛细血管丛中扩张的毛细血管扩张,似乎是视网膜新生血管的起源。 横截面 SS-OCT-A 显示在高反射性新生血管病变内存在视网膜内垂直高血管血流,具有典型的高反射性“亲吻征”,并伴有视网膜下和视网膜内液。 总之,层面 OCT-A 是一种非侵入性诊断 3 型 MNV 或 RAP 的有用工具,而横截面 OCT-A 扫描则非常有助于突出视网膜新生血管内的线性高血管血流。