Herbort Carl P, Takeuchi Masaru, Papasavvas Ioannis, Tugal-Tutkun Ilknur, Hedayatfar Alireza, Usui Yoshihiko, Ozdal Pinar C, Urzua Cristhian A
Retinal and Inflammatory Eye Diseases, Center for Ophthalmic Specialised Care (COS), Rue Charles-Monnard 6, 1003 Lausanne, Switzerland.
Department of Ophthalmology, National Defence Medical College, Tokorozawa 258-8513, Japan.
Diagnostics (Basel). 2023 Feb 7;13(4):601. doi: 10.3390/diagnostics13040601.
The global and precise follow-up of uveitis has become possible with the availability of dual fluorescein (FA) and indocyanine green angiography (ICGA) since the mid-1990s. Progressively, additional non-invasive imaging methods have emerged, bringing value-added precision to the imaging appraisal of uveitis, including, among others, optical coherence tomography (OCT), enhanced-depth imaging OCT (EDI-OCT) and blue light fundus autofluorescence (BAF). More recently, another complementary imaging method, OCT-angiography (OCT-A), further allowed retinal and choroidal circulation to be imaged without the need for dye injection.
The purpose of this review was aimed at examining the evidence in published reports indicating whether OCT-A could possibly replace dye angiographic methods, as well as the real practical impact of OCT-A.
A literature search in the PubMed database was performed using the terms OCT-angiography and uveitis, OCTA and uveitis and OCT-A and uveitis. Case reports were excluded. Articles were classified into technical reports, research reports and reviews. Articles in the two latter categories were analyzed in a more detailed, individual fashion. Special attention was paid to whether there were arguments in favor of an exclusive rather than complementary use of OCT-A. Furthermore, a synthesis of the main practical applications of OCT-A in the management of uveitis was attempted.
Between 2016 (the year of the first articles) and 2022, 144 articles containing the search terms were identified. After excluding case report articles, 114 articles were retained: 4 in 2016, 17 in 2017, 14 in 2018, 21 in 2019, 14 in 2020, 18 in 2021 and 26 in 2022. Seven articles contained technical information or consensus-based terminology. Ninety-two articles could be considered as clinical research articles. Of those, only two hinted in their conclusions that OCT-A could hypothetically replace dye methods. The terms mostly used to qualify the contribution of the articles in this group were "complementary to dye methods", "adjunct", "supplementing" and other similar terms. Fifteen articles were reviews, none of which hinted that OCT-A could replace dye methods. The situations where OCT-A represented a significant practical contribution to the practical appraisal of uveitis were identified.
To date, no evidence was found in the literature that OCT-A can replace the classic dye methods; however, it can complement them. Promoting the possibility that non-invasive OCT-A can substitute the invasive dye methods is deleterious, giving the elusive impression that dye methods are no longer inevitable for evaluating uveitis patients. Nevertheless, OCT-A is a precious tool in uveitis research.
自20世纪90年代中期以来，随着双荧光素血管造影（FA）和吲哚菁绿血管造影（ICGA）技术的出现，对葡萄膜炎进行全面而精确的随访成为可能。逐渐地，更多的非侵入性成像方法应运而生，为葡萄膜炎的成像评估带来了更高的精准度，其中包括光学相干断层扫描（OCT）、增强深度成像OCT（EDI - OCT）和蓝光眼底自发荧光（BAF）。最近，另一种辅助成像方法——光学相干断层扫描血管造影（OCT - A），进一步实现了无需注射染料即可对视网膜和脉络膜循环进行成像。
本综述旨在研究已发表报告中的证据，以确定OCT - A是否有可能取代染料血管造影方法，以及OCT - A的实际应用影响。
在PubMed数据库中使用搜索词“OCT - angiography”和“uveitis”、“OCTA”和“uveitis”以及“OCT - A”和“uveitis”进行文献检索。排除病例报告。文章分为技术报告、研究报告和综述。对后两类文章进行更详细的单独分析。特别关注是否有支持OCT - A单独使用而非辅助使用的观点。此外，尝试总结OCT - A在葡萄膜炎管理中的主要实际应用。
在2016年（第一篇相关文章发表年份）至2022年期间，共识别出144篇包含搜索词的文章。排除病例报告文章后，保留114篇：2016年4篇，2017年17篇，2018年14篇，2019年21篇，2020年14篇，2021年18篇，2022年26篇。7篇文章包含技术信息或基于共识的术语。92篇文章可视为临床研究文章。其中，只有两篇在结论中暗示OCT - A可能理论上取代染料方法。用于描述该组文章贡献的术语大多是“对染料方法的补充”、“辅助”、“补充”等类似术语。15篇文章为综述，均未暗示OCT - A可取代染料方法。确定了OCT - A对葡萄膜炎实际评估有重大实际贡献的情况。
迄今为止，文献中未发现OCT - A可取代经典染料方法的证据；然而，它可以对其进行补充。宣扬非侵入性的OCT - A可替代侵入性染料方法的可能性是有害的，会给人一种错误印象，即评估葡萄膜炎患者时染料方法不再是必不可少的。尽管如此, OCT - A仍是葡萄膜炎研究中的宝贵工具。
