Kilani Adnan, Vogt Denise, Wolf Armin, Vounotrypidis Efstathios
Department of Ophthalmology, Ulm University, Prittwitzstraße 43, 89075 Ulm, Germany.
Eur J Ophthalmol. 2025 Jan;35(1):306-313. doi: 10.1177/11206721241257976. Epub 2024 May 27.
To characterize and monitor choroidal neovascularisation (CNV) secondary to angioid streaks (AS) using multimodal imaging and to compare the results with conventional fluorescein angiography (FA).
A total of 11 eyes with CNV secondary to AS were included in this retrospective study. Multimodal morphological and functional assessment, including spectral-domain optical coherence tomography (SD-OCT), spectral-domain optical coherence tomography angiography (SD-OCTA), and fundus autofluorescence (FAF), were used to assess for evidence of CNV activity and compared with conventional FA. Morphological features of CNV were analyzed and treatment was continuously monitored using SD-OCT and SD-OCTA.
Our results showed that SD-OCTA provided reliable results for the detection of secondary CNV in AS that were comparable to conventional FA. With SD-OCTA, a total of 13 CNVs were detected in 11 eyes and analyzed by means of outer retinal choriocapillaris depth (ORCC) segmentation and the corresponding B-scans. Twelve of the 13 CNVs were classified as active and therefore required treatment. For treatment monitoring during intravitreal therapy (IVT), SD-OCTA was found to be a valuable diagnostic tool over a mean follow-up of 76 weeks.
Our study demonstrates that SD-OCTA can be routinely used to identify ill-defined CNV without dye-based angiography, especially in cases of CNV secondary to AS, where Bruch's membrane (BM) defects limit the diagnostic value of FA. Our results showed that non-invasive multimodal imaging facilitates sufficient CNV monitoring and treatment guidance. Further studies are warranted to provide more evidence in this rare retinal disease.
使用多模态成像技术对继发于血管样条纹（AS）的脉络膜新生血管（CNV）进行特征描述和监测，并将结果与传统荧光素血管造影（FA）进行比较。
本回顾性研究纳入了11例继发于AS的CNV患者的眼睛。采用多模态形态学和功能评估，包括光谱域光学相干断层扫描（SD-OCT）、光谱域光学相干断层扫描血管造影（SD-OCTA）和眼底自发荧光（FAF），以评估CNV活动的证据，并与传统FA进行比较。分析CNV的形态特征，并使用SD-OCT和SD-OCTA持续监测治疗情况。
我们的结果表明，SD-OCTA在检测AS继发的CNV方面提供了可靠的结果，与传统FA相当。通过SD-OCTA，在11只眼中共检测到13个CNV，并通过外层视网膜脉络膜毛细血管深度（ORCC）分割和相应的B扫描进行分析。13个CNV中有12个被归类为活动性，因此需要治疗。在玻璃体内注射治疗（IVT）期间进行治疗监测时，发现SD-OCTA在平均76周的随访期内是一种有价值的诊断工具。
我们的研究表明，SD-OCTA可常规用于识别不明确的CNV，而无需基于染料的血管造影，特别是在继发于AS的CNV病例中，其中布鲁赫膜（BM）缺陷限制了FA的诊断价值。我们的结果表明，非侵入性多模态成像有助于充分的CNV监测和治疗指导。有必要进行进一步的研究，以提供更多关于这种罕见视网膜疾病的证据。
