年龄相关性黄斑变性中息肉样脉络膜新生血管与 1 型脉络膜新生血管的分形分析研究。

POLYPOIDAL CHOROIDAL NEOVASCULARIZATION VERSUS TYPE 1 CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION: A Fractal Analysis Study.

机构信息

Department of Surgical and Biomedical Sciences, University of Sassari, Sassari, Italy.

Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, Monserrato, Cagliari, Italy.

出版信息

Retina. 2022 Jun 1;42(6):1005-1011. doi: 10.1097/IAE.0000000000003439. Epub 2022 Feb 14.

DOI:10.1097/IAE.0000000000003439

PMID:35594074

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9112963/

Abstract

PURPOSE

To compare quantitative optical coherence tomography angiography parameters between polypoidal choroidal neovascularizations (PCNVs) and Type 1 choroidal neovascularizations (CNVs) in patients with age-related macular degeneration.

METHODS

PCNV and Type 1 CNV lesions were retrospectively recruited in a cohort of patients with age-related macular degeneration. All the patients underwent a comprehensive ophthalmic evaluation, including best-corrected visual acuity, fluorescein and indocyanine green angiography, structural optical coherence tomography (OCT), and optical coherence tomography angiography.Vascular perfusion density, fractal dimension, and lacunarity were computed by means of fractal analysis of neovascular en face optical coherence tomography angiography slabs.

RESULTS

Sixty-eight eyes were included in the analysis. Of them, 35 of 68 eyes (51.5%) had PCNV and 33 of 68 (48.5%) had Type 1 CNV. Patients with PCNV were significantly younger (P = 0.0003) and had a higher best-corrected visual acuity (P < 0.0001). The mean vascular perfusion density was 0.83 ± 0.11% in PCNVs and 0.46 ± 0.10% in Type 1 CNVs (P < 0.0001). The mean fractal dimension was 1.44 ± 0.1 in PCNVs and 1.45 ± 0.09 in Type 1 CNVs (P = 0.86) while the mean lacunarity was 2.46 ± 1.03 in PCNVs and 1.86 ± 0.52 in Type 1 CNVs (P = 0.006).

CONCLUSION

PCNVs resulted to be more heterogeneous and characterized by higher vascular perfusion density and lacunarity values than Type 1 CNVs. These interesting findings seem to support the idea that PCNVs and Type 1 CNVs are two separate clinical entities. However, future studies based on optical coherence tomography angiography fractal analysis, but also involving other relevant parameters such as demographics, presentation, morphology on multimodal imaging, and response to treatment, are necessary before drawing any definitive conclusions on whether PCNV is a specific clinical entity or a neovascular age-related macular degeneration variant.

摘要

目的

比较年龄相关性黄斑变性患者中息肉状脉络膜血管病变（PCNV）和 1 型脉络膜新生血管（CNV）的定量光相干断层扫描血管造影（OCTA）参数。

方法

回顾性招募了年龄相关性黄斑变性患者的 PCNV 和 1 型 CNV 病变队列。所有患者均接受全面眼科评估，包括最佳矫正视力、荧光素和吲哚青绿血管造影、结构光相干断层扫描（OCT）和 OCTA。通过新血管面 OCTA 平板的分形分析计算血管灌注密度、分形维数和空隙度。

结果

共纳入 68 只眼。其中，35 只眼（51.5%）为 PCNV，33 只眼（48.5%）为 1 型 CNV。PCNV 患者明显更年轻（P = 0.0003），最佳矫正视力更高（P < 0.0001）。PCNV 中的平均血管灌注密度为 0.83 ± 0.11%，1 型 CNV 中的为 0.46 ± 0.10%（P < 0.0001）。PCNV 中的平均分形维数为 1.44 ± 0.1，1 型 CNV 中的为 1.45 ± 0.09（P = 0.86），而 PNCV 中的平均空隙度为 2.46 ± 1.03，1 型 CNV 中的为 1.86 ± 0.52（P = 0.006）。

结论

PCNV 比 1 型 CNV 更具异质性，表现为更高的血管灌注密度和空隙度值。这些有趣的发现似乎支持这样一种观点，即 PCNV 和 1 型 CNV 是两种不同的临床实体。然而，在得出关于 PCNV 是否是一种特定的临床实体或新生血管性年龄相关性黄斑变性的变体的任何明确结论之前，还需要基于 OCTA 分形分析的进一步研究，同时还需要涉及其他相关参数，如人口统计学、表现、多模态成像上的形态和对治疗的反应。