Arrigo Alessandro, Aragona Emanuela, Battaglia Parodi Maurizio, Bandello Francesco
Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Eye Repair Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Ophthalmol Retina. 2024 Dec;8(12):1118-1126. doi: 10.1016/j.oret.2024.05.019. Epub 2024 Jun 6.
To differentiate intraretinal fluid (IRF) cysts from degenerative pseudocysts in neovascular age-related macular degeneration (AMD) by quantitative multimodal imaging.
Observational, cross-sectional.
Patients affected by macular neovascularization secondary to AMD.
All patients were analyzed by OCT, OCT angiography (OCTA), and dense automatic real-time (ART) OCTA. New-onset cysts were considered IRF, whereas those cysts that were found to be persistent for at least 3 months were categorized as degenerative pseudocysts. Intraretinal cysts were automatically segmented to calculate cyst circularity. Peri-cyst space was quantitatively analyzed to assess the presence of perfusion signal and hyperreflective foci (HF).
Best-corrected visual acuity, cyst circularity, peri-cyst perfusion, peri-cyst HF, fibrosis, and outer retinal atrophy.
We analyzed 387 cysts collected from 35 eyes of 35 patients with neovascular AMD (14 men; mean age, 80 ± 5 years). We classified 302 IRF cysts and 85 degenerative pseudocysts. Intraretinal fluid cysts were characterized by significantly higher circularity (0.86; range, 0.81-0.91), perfusion signal in the peri-cyst space, and peri-cyst HF in 89% of cases (all P < 0.05). Degenerative pseudocysts showed significantly lower circularity (0.68; range, 0.64-0.76), no perfusion signal in the peri-cyst space, and peri-cyst HF in only 29% of cases (all P < 0.05). The adopted quantitative metrics significantly correlated with disease duration, number of injections, fibrosis, and outer retinal atrophy.
Intraretinal fluid cysts can be discriminated from degenerative pseudocysts using a quantitative multimodal imaging approach. These findings are clinically relevant and should be included in future training models for artificial intelligence algorithms to improve the diagnostic power and fluid monitoring in neovascular AMD.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
通过定量多模态成像鉴别新生血管性年龄相关性黄斑变性（AMD）中的视网膜内液（IRF）囊肿与退行性假性囊肿。
观察性横断面研究。
继发于AMD的黄斑新生血管患者。
所有患者均接受光学相干断层扫描（OCT）、OCT血管造影（OCTA）和密集自动实时（ART）OCTA检查。新出现的囊肿被视为IRF，而那些持续至少3个月的囊肿被归类为退行性假性囊肿。自动分割视网膜内囊肿以计算囊肿的圆形度。对囊肿周围间隙进行定量分析，以评估灌注信号和高反射灶（HF）的存在情况。
最佳矫正视力、囊肿圆形度、囊肿周围灌注、囊肿周围HF、纤维化和外层视网膜萎缩。
我们分析了从35例新生血管性AMD患者（14例男性；平均年龄80±5岁）的35只眼中收集的387个囊肿。我们将302个囊肿分类为IRF囊肿，85个囊肿分类为退行性假性囊肿。视网膜内液囊肿的特征是圆形度显著更高（0.86；范围0.81 - 0.91），囊肿周围间隙有灌注信号，89%的病例有囊肿周围HF（所有P < 0.05）。退行性假性囊肿的圆形度显著更低（0.68；范围0.64 - 0.76），囊肿周围间隙无灌注信号，仅29%的病例有囊肿周围HF（所有P < 0.05）。所采用的定量指标与疾病持续时间、注射次数、纤维化和外层视网膜萎缩显著相关。
使用定量多模态成像方法可以区分视网膜内液囊肿与退行性假性囊肿。这些发现具有临床相关性，应纳入未来人工智能算法的训练模型中，以提高新生血管性AMD的诊断能力和液体监测水平。
作者对本文讨论的任何材料均无专利或商业利益。
