用于近视性脉络膜新生血管的视频彩色光学相干断层扫描血管造影

Video Color OCT Angiography for Myopic Choroidal Neovascularization.

作者信息

Milani Paolo, Setaccioli Marco, Selvi Federico, Tremolada Gemma, Cammarata Gabriella, Criscuoli Alessandra, Toto Francesca, Soranna Davide, Zambon Antonella, Bergamini Fulvio

机构信息

Ophthalmology Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy.

出版信息

Ophthalmol Retina. 2025 Mar;9(3):232-242. doi: 10.1016/j.oret.2024.09.009. Epub 2024 Sep 23.

DOI:10.1016/j.oret.2024.09.009

PMID:39321872

Abstract

PURPOSE

To investigate the myopic macular neovascularization (mMNV) features on dynamic video color OCT angiography (OCTA) and the diagnostic rate versus the static, 4-segmentations visualization mode.

DESIGN

Retrospective cohort study.

PARTICIPANTS

Fifty-four patients with mMNV.

METHODS

Sixty-two eyes with high myopia complicated by mMNV were included. Clinical charts, fluorescein angiography, and structural OCT were used as standard references to assess lesion activity. Static and video color OCTA were then analyzed and compared by 2 independent reviewers.

MAIN OUTCOME MEASURES

Morphology description of mMNV on video color OCTA and differences in the proportion of diagnosis between video color and static OCTA.

RESULTS

Sixty-two eyes from 54 patients (mean age, 63.22 years) were enrolled. Thirty-four (55%) mMNVs were active and 28 (45%) inactive. Twenty-two (65%) active mMNVs presented on video color OCTA as an interlacing vascular network in the outer retina and the choriocapillaris. A tapered form was the prevalent size (72.7%). In 3 eyes (9%), an abnormal and irregular vascular network (AVN) was disclosed and in 5 (15%) only some blood flow alteration. All the lesions extended in both the outer retina and the choriocapillaris. Eleven (39%) inactive mMNVs also presented on video color OCTA as an interlacing vascular network in the outer retina and the choriocapillaris. Eight (29%) inactive mMNVs had some AVN, and 6 (21%) only some blood flow alteration. The diagnostic rate of video color versus static OCTA was 95% (95% confidence interval [CI], 86%-99%) versus 77% (95% CI, 86%-99%; P = 0.0009), and showed an advantage in favor of video color OCTA of 15% (95% CI, 3%-27%) and 22% (95% CI, 7%-38%) in active and inactive lesions, respectively (P < 0.026). Lesion extension within both the outer retina and the choriocapillaris was present in 90% and 69% of cases on dynamic OCTA and static OCTA, respectively, with a proportion difference of 20% (95% CI, 10%-31%; P = 0.0005). Concordance between the 2 examiners was high: 0.95 (95% CI, 0.88-1.00) and 0.96 (95% CI, 0.91-1.00) for active and inactive lesions, respectively.

CONCLUSIONS

Video color-enhanced OCTA may help in diagnosing mMNV and should be considered in addition to structural OCT and static OCTA.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

摘要

目的

研究动态视频彩色光学相干断层扫描血管造影（OCTA）上近视性黄斑新生血管（mMNV）的特征，以及与静态四分割可视化模式相比的诊断率。

设计

回顾性队列研究。

参与者

54例患有mMNV的患者。

方法

纳入62只高度近视合并mMNV的眼睛。使用临床病历、荧光素血管造影和结构OCT作为评估病变活动的标准参考。然后由2名独立的审阅者对静态和视频彩色OCTA进行分析和比较。

主要观察指标

视频彩色OCTA上mMNV的形态描述，以及视频彩色和静态OCTA之间诊断比例的差异。

结果

纳入了54例患者的62只眼睛（平均年龄63.22岁）。34只（55%）mMNV为活动性，28只（45%）为非活动性。22只（65%）活动性mMNV在视频彩色OCTA上表现为外层视网膜和脉络膜毛细血管中的交错血管网络。锥形是最常见的形态（72.7%）。3只眼睛（9%）显示出异常且不规则的血管网络（AVN），5只眼睛（15%）仅出现一些血流改变。所有病变均在外层视网膜和脉络膜毛细血管中延伸。11只（39%）非活动性mMNV在视频彩色OCTA上也表现为外层视网膜和脉络膜毛细血管中的交错血管网络。8只（29%）非活动性mMNV有一些AVN，6只（21%）仅出现一些血流改变。视频彩色与静态OCTA的诊断率分别为95%（95%置信区间[CI]，86%-99%）和77%（95%CI，67%-85%；P = 0.0009），在活动性和非活动性病变中，视频彩色OCTA分别比静态OCTA有15%（95%CI，3%-27%）和22%（95%CI，7%-38%）的优势（P < 0.026）。动态OCTA和静态OCTA分别有90%和69%的病例在外层视网膜和脉络膜毛细血管中出现病变延伸，比例差异为20%（95%CI，10%-31%；P = 0.0005）。两位检查者之间的一致性很高：活动性和非活动性病变的一致性分别为0.95（95%CI，0.88-1.00）和0.96（95%CI，0.91-1.00）。