Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Eur J Ophthalmol. 2024 May;34(3):781-788. doi: 10.1177/11206721231203265. Epub 2023 Sep 18.
To describe the retinal vascular changes in birdshot chorioretinopathy (BSCR) using optical coherence tomography angiography (OCTA) and to compare them with changes in macular thickness.
In this multicenter study, patients with a diagnosis of BSCR and a positive HLA-A29 underwent fluorescein angiography, spectral domain optical coherence tomography (SD-OCT), and OCTA. The foveal avascular zone (FAZ) and the area of capillary non-perfusion were manually measured by two examiners in fluorescein angiography (FA) and 3 × 3-mm OCTA images of the superficial retinal layer. These measurements were compared to central retinal thickness. To calculate normal capillary density, we collected data from 22 controls who had OCTA performed on one visit only.
A total of 44 eyes with BSCR were enrolled. The mean automated parafoveal superficial capillary density in BSCR eyes was 0.47 ± 0.03. The differences between the foveal capillary density of BSCR patients and healthy subjects were statistically significant (< 0.001). The mean area of FAZ manually measured on the 3 × 3 mm unsegmented OCTA images was larger in eyes with BSCR (1.34 ± 0.41 mm; < 0.0001). Measurement of FAZ area showed good interobserver ( 0.88) and intraobserver repeatability ( 0.79) on OCTA images. The intraclass correlation coefficient for FAZ measurements on FA between the two observers was 0.48. The OCT retinal thickness maps of all BSCR eyes demonstrated statistically significant thinning compared to those of control subjects (< 0.01).
Our study demonstrates the potential contribution of OCTA as a new non-invasive imaging technology that monitors disease activity in BSCR patients.
利用光相干断层扫描血管造影术（OCTA）描述鸟枪弹样脉络膜视网膜病变（BSCR）的视网膜血管变化，并将其与黄斑厚度变化进行比较。
在这项多中心研究中，对诊断为 BSCR 且 HLA-A29 阳性的患者进行荧光素血管造影、谱域光学相干断层扫描（SD-OCT）和 OCTA 检查。两名检查者在荧光素血管造影（FA）和浅层视网膜 3×3mm OCTA 图像上手动测量中心凹无血管区（FAZ）和毛细血管无灌注区的面积。这些测量值与中心视网膜厚度进行比较。为了计算正常毛细血管密度，我们仅从 22 名接受过一次 OCTA 检查的对照者中收集数据。
共纳入 44 只 BSCR 眼。BSCR 眼自动旁中心浅层毛细血管密度的平均值为 0.47±0.03。BSCR 患者与健康对照者中心凹毛细血管密度的差异具有统计学意义（<0.001）。在未分段的 3×3mm OCTA 图像上手动测量的 FAZ 平均面积在 BSCR 眼中更大（1.34±0.41mm；<0.0001）。OCTA 图像上 FAZ 面积的测量具有良好的观察者间（0.88）和观察者内（0.79）可重复性。两名观察者之间 FA 上 FAZ 测量的组内相关系数为 0.48。所有 BSCR 眼的 OCT 视网膜厚度图与对照者相比均显示出统计学上的显著变薄（<0.01）。
本研究表明，OCTA 作为一种新的非侵入性成像技术，具有监测 BSCR 患者疾病活动的潜力。
