Zheng Zhaoxia, Liu Jing, Sun Jiayi, Zhang Yue, Gu Xiaoya, Song Shuang, Yu Xiaobing
Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China.
Graduate School of Peking Union Medical College, Beijing, China; Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Photodiagnosis Photodyn Ther. 2024 Dec;50:104366. doi: 10.1016/j.pdpdt.2024.104366. Epub 2024 Oct 12.
To quantitatively analyze three-dimensional (3D) choroidal changes in coronary artery disease (CAD) patients with swept-source optical coherence tomography angiography (SS-OCTA) based on a scan area of 12×12mm.
236 CAD patients and 78 controls were included after coronary angiography (CAG) evaluation in this prospective cross-sectional study. Choroidal and foveal avascular zone (FAZ) parameters were compared between the two groups. Choroidal morphological characteristics were also evaluated based on ETDRS quadrants. Receiver operating characteristics (ROC) curves were generated to determine the discriminative power of choroidal and FAZ parameters. Linear regression analysis was used to determine the relationships between Gensini score and choroidal parameters.
Choroidal thickness (CT), choroidal vascular volume/ area (CVV/a), and choroidal stromal volume/ area (CSV/a) were significantly reduced in CAD patients, while 2D vascular density decreased only in 1-6 mm, and no statistical difference in choroidal vascularity index (CVI) values was detected. The AUC values of choroidal parameters were greater in the inner-6 mm area than the outer-6 mm area, and good performance was found with a combination with FAZ parameters (AUC=0.77, P < 0.001). For morphological analysis, both groups showed the greatest values in superior quadrant and the lowest in nasal quadrant. After controlling for confounding factors, Gensini score was negatively associated with CT (β = -0.35, P = 0.003), CVV/a (β = -0.17, P = 0.004), and CSV/a (β = -0.18, P = 0.005).
The SS-OCTA provided excellent visualization and quantification of the choroid and showed decreased choroidal thickness and volume in CAD patients, but the morphological features were unchanged. The severity of coronary artery stenosis was independently associated with choroidal changes.
基于12×12mm扫描区域，采用扫频源光学相干断层扫描血管造影（SS-OCTA）对冠心病（CAD）患者的三维（3D）脉络膜变化进行定量分析。
在这项前瞻性横断面研究中，对236例CAD患者和78例对照者进行冠状动脉造影（CAG）评估后纳入研究。比较两组之间的脉络膜和黄斑无血管区（FAZ）参数。还基于早期糖尿病性视网膜病变研究（ETDRS）象限评估脉络膜形态特征。绘制受试者工作特征（ROC）曲线以确定脉络膜和FAZ参数的鉴别能力。采用线性回归分析确定Gensini评分与脉络膜参数之间的关系。
CAD患者的脉络膜厚度（CT）、脉络膜血管容积/面积（CVV/a）和脉络膜基质容积/面积（CSV/a）显著降低，而二维血管密度仅在1-6mm处降低，脉络膜血管指数（CVI）值未检测到统计学差异。脉络膜参数的AUC值在内侧6mm区域大于外侧6mm区域，与FAZ参数联合使用时表现良好（AUC=0.77，P<0.001）。对于形态学分析，两组均在上象限显示最大值，在下象限显示最小值。在控制混杂因素后，Gensini评分与CT（β=-0.35，P=0.003）、CVV/a（β=-0.17，P=0.004）和CSV/a（β=-0.18，P=0.005）呈负相关。
SS-OCTA能很好地可视化和定量分析脉络膜，显示CAD患者脉络膜厚度和容积降低，但形态特征未改变。冠状动脉狭窄的严重程度与脉络膜变化独立相关。
