Chen Xiuju, Zhu Wenyue, Li Xiaoxin
Xiamen Eye Center of Xiamen University, No. 989 Wutong West Road, Xiamen, 361000, Fujian, China.
University of Liverpool, 6 West Derby Street, Liverpool, UK.
Ophthalmol Ther. 2022 Oct;11(5):1913-1924. doi: 10.1007/s40123-022-00558-z. Epub 2022 Aug 18.
This study aimed to evaluate the optical coherence tomography (OCT) macular volume as a marker for active vascular leakage in patients with intermediate and pan uveitis.
In this single-center prospective longitudinal study, patients were included under three criteria: diagnosed with noninfectious intermediate or pan uveitis; presented vascular leakage at their initial visit; and were imaged with concurrent wide-field fluorescein angiography (FA) and OCT. A scoring system was employed to measure vascular leakage. OCT volume scans were performed on the patients to produce the corresponding thickness map. The central subfield thickness (CST) and macular volume (MV) were calculated. CST is defined as the average thickness within the 1-mm fovea circle, while MV includes the 3-mm and 6-mm circles on the thickness map. Mixed-effects models were applied to analyze the correlation between each patient's OCT and FA imaging results.
A total of 72 patients (115 eyes) were included. The median follow-up time was 11 months (interquartile range 1.8-16.1 months). A total of 679 observations across all time points were analyzed. Both CST and MV were found to be positively associated with the leakage scores (p < 0.001). In the mixed-effects models, MV in the 6-mm circle presented the strongest correlation with leakage scores, which explained 57% of the variation in leakage (p < 0.001). MV in the 3-mm circle and CST explained 45.8% and 39.5%, respectively.
CST and MV in both the 6-mm and the 3-mm circles demonstrated significant correlations with angiographic inflammatory activity. Among those imaging parameters, MV in the 6-mm circle has the highest correlation. The study results suggest that this parameter can be considered a quantitative and non-invasive alternative to FA for monitoring vasculitic inflammation in uveitis.
本研究旨在评估光学相干断层扫描（OCT）黄斑体积作为中度和全葡萄膜炎患者活动性血管渗漏的标志物。
在这项单中心前瞻性纵向研究中，纳入患者的标准有三条：诊断为非感染性中度或全葡萄膜炎；初诊时有血管渗漏；同时接受了广角荧光素血管造影（FA）和OCT检查。采用评分系统测量血管渗漏情况。对患者进行OCT容积扫描以生成相应的厚度图。计算中心子场厚度（CST）和黄斑体积（MV）。CST定义为1mm视盘圆内的平均厚度，而MV包括厚度图上的3mm和6mm圆。应用混合效应模型分析每位患者的OCT和FA成像结果之间的相关性。
共纳入72例患者（115只眼）。中位随访时间为11个月（四分位间距1.8 - 16.1个月）。分析了所有时间点的679次观察结果。发现CST和MV均与渗漏评分呈正相关（p < 0.001）。在混合效应模型中，6mm圆内的MV与渗漏评分的相关性最强，可解释渗漏变异的57%（p < 0.001）。3mm圆内的MV和CST分别解释了45.8%和39.5%。
6mm和3mm圆内的CST和MV均与血管造影炎症活动显著相关。在这些成像参数中，6mm圆内的MV相关性最高。研究结果表明，该参数可被视为用于监测葡萄膜炎血管炎症的一种定量且非侵入性的替代FA的方法。
