Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
Ophthalmic Res. 2022;65(5):506-515. doi: 10.1159/000524488. Epub 2022 Apr 11.
Optical coherence tomography angiography (OCTA) facilitates the detection of choroidal neovascularization (CNV). This study explored the role of nonhomogenous hyperreflectivity implying putative CNV in the choriocapillaris layer on OCTA in central serous chorioretinopathy (CSCR).
Thirteen eyes out of 12 patients with CSCR were examined with OCTA. The nonhomogenous hyperreflectivity was compared with the histological morphology of experimental CNV. The effect of intravitreal anti-vascular endothelial growth factor (VEGF) was evaluated by analyzing the changes in central macular thickness (CMT) and the height of subretinal fluid (SRF).
Comparison of the nonhomogenous hyperreflectivity on OCTA with the established CNV in two animal models strongly indicated these signals are putative CNV. During following-up, these nonhomogenous hyperreflectivity in CSCR developed into visible CNV on OCTA. Moreover, anti-VEGF treatment was effective to reduce both the SRF and CMT in CSCR with nonhomogenous hyperreflectivity or secondary CNV within 2 months.
This study suggested that the nonhomogenous hyperreflectivity on OCTA could be served as a diagnostic biomarker for putative CNV in CSCR, implying early treatment with anti-VEGF.
光学相干断层扫描血管造影术（OCTA）有助于检测脉络膜新生血管（CNV）。本研究探讨了脉络膜毛细血管层 OCTA 上非均质性高反射性（提示可能存在 CNV）在中心性浆液性脉络膜视网膜病变（CSCR）中的作用。
对 12 例 CSCR 患者中的 13 只眼进行 OCTA 检查。将非均质性高反射性与实验性 CNV 的组织学形态进行比较。通过分析中央黄斑厚度（CMT）和视网膜下液（SRF）高度的变化，评估玻璃体内抗血管内皮生长因子（VEGF）的效果。
OCTA 上的非均质性高反射性与两种动物模型中已建立的 CNV 的比较强烈表明这些信号是潜在的 CNV。在随访过程中，CSCR 中的这些非均质性高反射性在 OCTA 上发展为可见的 CNV。此外，在有非均质性高反射性或继发性 CNV 的 CSCR 中，抗 VEGF 治疗在 2 个月内可有效降低 SRF 和 CMT。
本研究表明，OCTA 上的非均质性高反射性可作为 CSCR 中潜在 CNV 的诊断生物标志物，提示早期采用抗 VEGF 治疗。
