Siedlecki Jakob, Hattenbach Lars-Olof, Feltgen Nikolas, Priglinger Siegfried G
Augenklinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Mathildenstr. 8, 80336, München, Deutschland.
Augenklinik, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen, Deutschland.
Ophthalmologie. 2022 Nov;119(11):1111-1120. doi: 10.1007/s00347-022-01732-1. Epub 2022 Oct 6.
Retinal vein occlusion, subdivided into central retinal and branch retinal vein occlusion, is one of the most frequent vascular diseases of the retina. Biomarkers of optical coherence tomography (OCT), OCT-angiography and (ultra-widefield) fluorescein angiography are of exceptional importance in the initial diagnosis and also in the treatment of complications associated with retinal vascular occlusion, particularly macular edema.
A systematic literature review was carried out in PubMed with the keywords central retinal vein occlusion, branch retinal vein occlusion, biomarker, OCT, OCT angiography, ultra-widefield fluorescein angiography with prioritization of the most important aspects.
Relevant biomarkers in OCT include central retinal thickness (CRT), macular fluid, the integrity of the photoreceptor bands (external limiting membrane and ellipsoid zone), disorganization of retinal inner layers (DRIL), hyperreflective foci, choroidal thickness and signs of ischemia, such as a prominent middle limiting membrane (p-MLM), paracentral acute middle maculopathy (PAMM) as well as hyperreflectivity of inner retinal layers (HIRL). The importance of OCT-angiography lies particularly in the assessment of microvascular alterations, especially vessel density in the deep retinal vascular plexus, the foveal avascular zone and of areas with no capillary perfusion. Biomarkers of ultra-widefield angiography, such as peripheral ischemia (ischemic index) and neovascularízation are essential with respect to treatment decisions for retinal laser.
A multitude of simple and complex biomarkers currently enable an effective individualized evaluation of treatment and prognosis in retinal vein occlusion. A shift from invasive to noninvasive biomarkers can be observed.
视网膜静脉阻塞分为视网膜中央静脉阻塞和视网膜分支静脉阻塞，是最常见的视网膜血管疾病之一。光学相干断层扫描（OCT）、OCT血管造影和（超广角）荧光素血管造影的生物标志物在初始诊断以及与视网膜血管阻塞相关并发症（尤其是黄斑水肿）的治疗中具有极其重要的意义。
在PubMed上进行了系统的文献综述，关键词为视网膜中央静脉阻塞、视网膜分支静脉阻塞、生物标志物、OCT、OCT血管造影、超广角荧光素血管造影，并对最重要的方面进行了优先排序。
OCT中的相关生物标志物包括视网膜中央厚度（CRT）、黄斑积液、光感受器带（外界膜和椭圆体带）的完整性、视网膜内层紊乱（DRIL）、高反射灶、脉络膜厚度和缺血迹象，如明显的中间限制膜（p-MLM）、黄斑旁急性中层病变（PAMM）以及视网膜内层高反射性（HIRL）。OCT血管造影的重要性尤其在于评估微血管改变，特别是深层视网膜血管丛、黄斑无血管区和无毛细血管灌注区域的血管密度。超广角血管造影的生物标志物，如周边缺血（缺血指数）和新生血管形成，对于视网膜激光治疗决策至关重要。
目前，众多简单和复杂的生物标志物能够对视网膜静脉阻塞的治疗和预后进行有效的个体化评估。可以观察到从侵入性生物标志物向非侵入性生物标志物的转变。
