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应用广角光相干断层扫描血管成像和眼底荧光血管造影分析贝赫切特葡萄膜炎的眼底血管变化。

ANALYSIS OF VASCULAR CHANGES OF FUNDUS IN BEHCET UVEITIS BY WIDEFIELD SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND FUNDUS FLUORESCEIN ANGIOGRAPHY.

机构信息

From the First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing, People's Republic of China.

出版信息

Retina. 2023 May 1;43(5):841-850. doi: 10.1097/IAE.0000000000003709.

Abstract

PURPOSE

To investigate vascular changes of fundus in quiescent Behçet uveitis (BU) based on widefield swept source optical coherence tomography angiography and fluorescein angiography (FA).

METHOD

This case-control study included 33 patients with quiescent BU (57 eyes)and 35 healthy people (60 eyes) as the control. All participants underwent the widefield swept source optical coherence tomography angiography, and patients with BU additionally underwent the FA. The quantitative analysis of the widefield swept source optical coherence tomography angiography assessed the vessel density of nine anatomical locations in the fundus. Vascular leakage and retinal nonperfusion on FA were assessed in patients with BU.

RESULTS

Compared with the control group using Mann-Whitney U test, patients with BU had enlargement of foveal avascular zone ( P = 0.005, P = 0.04, respectively) and decreased vessel density within a 300 µ m width around the foveal avascular zone ( P = 0.001, P < 0.0001, respectively) both in the superficial and deep retina. Larger foveal avascular zone size and lower 300 µ m width around the foveal avascular zone were correlated with higher logarithm of the minimum angle of resolution best-corrected visual acuity in BU ( P ≤ 0.003, P < 0.0001, respectively). Vessel density of choriocapillaris, as the most widely involved of all layers of the retina and choroid, was lower in six locations ( P ≤ 0.03-0.0001) in the peripheral fundus of BU compared with the controls. Vascular leakage and retinal nonperfusion in the peripheral fundus were observed in 54.4% and 66.7% of the patients on FA.

CONCLUSION

Fovea and peripheral fundus were prone to the damage of ischemia as evidenced by significantly decreased vessel density of capillaries. Combination of swept source optical coherence tomography angiography with FA could accurately evaluate the changes in the retinal and choroidal vasculature in BU.

摘要

目的

基于广角扫频源光相干断层扫描血管造影(SS-OCTA)和荧光素血管造影(FA)研究静止期 Behcet 葡萄膜炎(BU)的眼底血管变化。

方法

本病例对照研究纳入 33 例静止期 BU 患者(57 只眼)和 35 名健康人(60 只眼)作为对照组。所有参与者均接受广角扫频源 OCTA 检查,BU 患者额外接受 FA 检查。广角扫频源 OCTA 的定量分析评估了眼底 9 个解剖部位的血管密度。评估 BU 患者 FA 上的血管渗漏和视网膜无灌注。

结果

与对照组相比,采用 Mann-Whitney U 检验,BU 患者的中心凹无血管区(FAZ)增大(P=0.005,P=0.04),FAZ 周围 300μm 宽度内的视网膜浅层和深层的血管密度降低(P=0.001,P<0.0001)。较大的 FAZ 大小和 FAZ 周围 300μm 宽度与 BU 患者最小分辨角视力对数的相关性更好(P≤0.003,P<0.0001)。脉络膜毛细血管是视网膜和脉络膜各层中受累最广泛的一层,在 BU 患者的周边眼底的 6 个部位(P≤0.03-0.0001)的血管密度较低。FA 显示 54.4%和 66.7%的患者周边眼底有血管渗漏和视网膜无灌注。

结论

广角扫频源 OCTA 与 FA 相结合,可准确评估 BU 患者视网膜和脉络膜血管的变化。FAZ 和周边眼底容易发生缺血损伤,表现为毛细血管的血管密度明显降低。

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