Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Invest Ophthalmol Vis Sci. 2024 Jan 2;65(1):16. doi: 10.1167/iovs.65.1.16.
The purpose of this study was to present our findings of the distribution pattern of choroidal arteries and large veins in patients with age-related macular degeneration (AMD) using indocyanine green angiography (ICGA).
A retrospective analysis was conducted on 980 patients who underwent ICGA at The Second Affiliated Hospital of Xi'an Jiaotong University from 2017 to 2023, including 240 patients with AMD. Secondary image processing was applied to the angiographic videos to obtain posterior distribution maps of choroidal arteries and large veins. Differences between different distribution patterns regarding age, gender, eye laterality, and circulation time were compared. We also conducted a comparison of choroidal vascular distribution characteristics between patients with AMD and patients with diabetic retinopathy (DR) and provided a summary of choroidal vascular distribution patterns in AMD.
The filling patterns of choroidal arteries can be classified into the invisible trunk arteries type, the partially masked trunk arteries type, and the exposed trunk arteries type. The vascular topography of the large choroidal vein can be classified into the watershed type, the non-watershed type, and the unknown type, further divided into six subtypes. The distribution patterns of choroidal arteries and veins were significantly correlated with age (P < 0.001). Left eye, older age, and the exposed trunk arteries type were independent risk factors for non-watershed large choroidal vein (P < 0.05). The non-watershed type was the main characteristic of the venous phase in AMD.
The distribution characteristics of the arterial and venous patterns in AMD suggest atrophy of the small blood vessels in the choroid and insufficient perfusion pressure of the blood flow.
本研究旨在通过吲哚菁绿血管造影（ICGA）展示年龄相关性黄斑变性（AMD）患者脉络膜动脉和大静脉分布模式的研究结果。
回顾性分析了 2017 年至 2023 年在西安交通大学第二附属医院行 ICGA 的 980 例患者，其中包括 240 例 AMD 患者。对血管造影视频进行二次图像处理，以获得脉络膜动脉和大静脉的后分布图谱。比较不同分布模式之间的年龄、性别、眼侧别和循环时间差异。我们还比较了 AMD 患者与糖尿病视网膜病变（DR）患者的脉络膜血管分布特征，并总结了 AMD 脉络膜血管分布模式。
脉络膜动脉的充盈模式可分为不可见主干动脉型、部分遮挡主干动脉型和暴露主干动脉型。大脉络膜静脉的血管拓扑结构可分为分水岭型、非分水岭型和未知型，进一步分为六种子型。脉络膜动脉和静脉的分布模式与年龄显著相关（P < 0.001）。左眼、年龄较大和暴露主干动脉型是大脉络膜非分水岭静脉的独立危险因素（P < 0.05）。非分水岭型是 AMD 静脉期的主要特征。
AMD 的动脉和静脉模式分布特征提示脉络膜小血管萎缩和血流灌注压不足。
