Furnon Lucas, Labarere José, Trucco Emanuele, Hogg Stephen, MacGillivray Tom, Chiquet Christophe
Univ Grenoble Alpes, Department of Ophthalmology, Grenoble, France.
Clinical epidemiology unit, University Hospital, Grenoble, France.
Acta Ophthalmol. 2023 Jun;101(4):392-402. doi: 10.1111/aos.15291. Epub 2022 Nov 16.
To identify the retinal vessel vasculature parameters associated with birdshot chorioretinopathy (BSCR).
This retrospective observational study included 28 prevalent cases of BSCR with a median time from diagnosis of 6 years and 28 controls matched for age, arterial hypertension, diabetes and refraction. Forty-five-degree fundus images of both dilated eyes were acquired with a fundus camera (Canon CR-2, Tokyo, Japan). The summary diameter of the arterial retinal vessels (central retinal artery equivalent, CRAE), venous retinal vessels (central retinal vein equivalent, CRVE), vascular tortuosity and fractal dimension (FD) were measured using VAMPIRE software. Retinal vasculitis was characterized using fluorescein angiography and active choroiditis using indocyanine green angiography.
At baseline, BSCR was associated with lower FD compared with matched controls (mean difference, -0.04; 95% confidence interval [CI], -0.06 to -0.02, p < 0.001). No other VAMPIRE parameters (CRAE, CRVE, arterial and venous tortuosity) differed. Among BSCR patients, retinal vein vasculitis was associated with higher CRAE (mean difference, 21 μ; 95% CI, 2.6-40, p = 0.03), venous tortuosity (geometric mean ratio, 1.79; 95% CI, 1.18-2.72, p = 0.007) and FD (mean difference, -0.04; 95% CI, -0.06 to -0.01, p = 0.007). Resolution of retinal vein vasculitis during follow-up was paralleled by decrease in CRAE, CRVE and venous tortuosity values and increase in venous FD, respectively.
BSCR is associated with lower FD value, suggesting that chronic retinal inflammation induces microvascular remodelling. Efficient treatment of retinal vasculitis may reverse changes in retinal vascular parameters. Changes in retinal vascular parameters could be potentially useful for assessing patients with BSCR disease.
确定与鸟枪弹样脉络膜视网膜病变（BSCR）相关的视网膜血管系统参数。
这项回顾性观察研究纳入了28例BSCR患者，诊断后的中位时间为6年，以及28名在年龄、动脉高血压、糖尿病和屈光度方面相匹配的对照者。使用眼底相机（佳能CR - 2，日本东京）获取双眼散瞳后的45度眼底图像。使用VAMPIRE软件测量视网膜动脉血管（视网膜中央动脉等效值，CRAE）、静脉血管（视网膜中央静脉等效值，CRVE）的总直径、血管迂曲度和分形维数（FD）。使用荧光素血管造影对视网膜血管炎进行特征描述，使用吲哚菁绿血管造影对活动性脉络膜炎进行特征描述。
在基线时，与匹配的对照者相比，BSCR患者的FD值较低（平均差异为 - 0.04；95%置信区间[CI]， - 0.06至 - 0.02，p < ０.００１）。其他VAMPIRE参数（CRAE、CRVE、动脉和静脉迂曲度）没有差异。在BSCR患者中，视网膜静脉血管炎与较高的CRAE（平均差异为21μm；95%CI，2.6 - 40，p = 0.03）、静脉迂曲度（几何平均比为1.79；95%CI，1.18 - 2.72，p = 0.007）和FD（平均差异为 - 0.04；95%CI， - 0.06至 - 0.01，p = 0.007）相关。随访期间视网膜静脉血管炎的消退分别与CRAE、CRVE和静脉迂曲度值的降低以及静脉FD的增加平行。
BSCR与较低的FD值相关，表明慢性视网膜炎症会诱导微血管重塑。视网膜血管炎的有效治疗可能会逆转视网膜血管参数的变化。视网膜血管参数的变化可能对评估BSCR疾病患者有潜在帮助。
