Tan Tien-En, Ibrahim Farah, Chandrasekaran Priya R, Teo Kelvin Yi Chong
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Duke-NUS Medical School, Singapore, Singapore.
Front Med (Lausanne). 2023 Jun 8;10:1110166. doi: 10.3389/fmed.2023.1110166. eCollection 2023.
Retinal vein occlusions (RVOs) are the second most common retinal vascular disease after diabetic retinopathy, and are a significant cause of visual impairment, especially in the elderly population. RVOs result in visual loss due to macular ischemia, cystoid macular edema (CME), and complications related to neovascularization. Vascular assessment in RVOs traditionally relies on standard fluorescein angiography (FA) for assessment of macular and retinal ischemia, which aids in prognostication and guides intervention. Standard FA has significant limitations-it is time-consuming, requires invasive dye administration, allows for limited assessment of the peripheral retina, and is usually evaluated semi-qualitatively, by ophthalmologists with tertiary expertise. More recently, the introduction of ultra-widefield FA (UWF FA) and optical coherence tomography angiography (OCTA) into clinical practice has changed the tools available for vascular evaluation in RVOs. UWF FA allows for evaluation of peripheral retinal perfusion, and OCTA is non-invasive, rapidly-acquired, and provides more information on capillary perfusion. Both modalities can be used to provide more quantitative parameters related to retinal perfusion. In this article, we review the clinical utility and impact of UWF FA and OCTA in the evaluation and management of patients with RVOs.
视网膜静脉阻塞（RVO）是仅次于糖尿病视网膜病变的第二常见视网膜血管疾病，是导致视力损害的重要原因，尤其是在老年人群体中。RVO会因黄斑缺血、黄斑囊样水肿（CME）以及与新生血管形成相关的并发症而导致视力丧失。传统上，RVO的血管评估依赖于标准荧光素血管造影（FA）来评估黄斑和视网膜缺血，这有助于预后判断并指导干预。标准FA有显著局限性——耗时、需要进行有创染料注射、对周边视网膜的评估有限，且通常由具有专业经验的眼科医生进行半定性评估。最近，超广角荧光素血管造影（UWF FA）和光学相干断层扫描血管造影（OCTA）引入临床实践，改变了RVO血管评估的可用工具。UWF FA可用于评估周边视网膜灌注，OCTA是非侵入性的，获取迅速，并能提供更多关于毛细血管灌注的信息。这两种方法均可用于提供与视网膜灌注相关的更多定量参数。在本文中，我们综述了UWF FA和OCTA在RVO患者评估和管理中的临床应用及影响。
