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后葡萄膜炎的诊断和治疗中眼底成像的逐步方法。

Stepwise approach for fundus imaging in the diagnosis and management of posterior uveitis.

机构信息

Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Department of Ophthalmology, Maastricht University Medical Center+, Maastricht, The Netherlands; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.

Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.

出版信息

Surv Ophthalmol. 2023 May-Jun;68(3):446-480. doi: 10.1016/j.survophthal.2023.01.006. Epub 2023 Jan 29.

Abstract

An array of retinochoroid imaging modalities aid in comprehensive evaluation of the immunopathological changes in the retina and choroid, forming the core component for the diagnosis and management of inflammatory disorders such as uveitis. The recent technological breakthroughs have led to the development of imaging platforms that can evaluate the layers of retina and choroid and the structural and functional alteration in these tissues. Ophthalmologists heavily rely on imaging modalities such as dye-based angiographies (fluorescein angiography and indocyanine green angiography), optical coherence tomography, fundus autofluorescence, as well as dye-less angiography such as optical coherence tomography angiograph,y for establishing a precise diagnosis and understanding the pathophysiology of the diseases. Furthermore, these tools are now being deployed with a 'multimodal' approach for swift and accurate diagnosis. In this comprehensive review, we outline the imaging platforms used for evaluation of posterior uveitis and discuss the organized, algorithmic approach for the assessment of the disorders. Additionally, we provide an insight into disease-specific characteristic pathological changes and the established strategies to rule out disorders with overlapping features on imaging.

摘要

一系列的眼底视网膜成像模式有助于全面评估视网膜和脉络膜的免疫病理学变化,形成了诊断和治疗葡萄膜炎等炎症性疾病的核心组成部分。最近的技术突破带来了成像平台的发展,可以评估视网膜和脉络膜的各层以及这些组织的结构和功能变化。眼科医生严重依赖于成像模式,如染料基血管造影(荧光素血管造影和吲哚青绿血管造影)、光学相干断层扫描、眼底自发荧光,以及无染料血管造影,如光学相干断层扫描血管造影,以建立精确的诊断并了解疾病的病理生理学。此外,现在这些工具正被用于一种“多模态”的方法,以快速准确地诊断。在这篇全面的综述中,我们概述了用于评估后葡萄膜炎的成像平台,并讨论了评估疾病的有组织的、算法化的方法。此外,我们还深入了解了疾病特异性的特征性病理变化,以及在影像学上具有重叠特征的疾病的排除策略。

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