Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
Invest Ophthalmol Vis Sci. 2024 Nov 4;65(13):4. doi: 10.1167/iovs.65.13.4.
To investigate microvascular growth defects in the temporal midperipheral retina and their correlations with vitreoretinal microstructural abnormalities (VRMAs) in early-stage familial exudative vitreoretinopathy (FEVR).
We enrolled 127 patients (127 eyes) with early-stage FEVR and 31 healthy subjects (31 eyes). Widefield optical coherence tomography angiography was conducted for all enrolled eyes. Vessel density (VD), vessel diameter index (VDI), and vessel index (VI; VD/VDI) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in temporal midperiphery were further evaluated. The distance from the vessel sprouting point of the optic disc to the avascular area margin (Optic-AVA) was measured to assess retinal vascular dysplasia.
In early-stage FEVR, 61.42% of eyes showed retinal microvascular abnormalities (MVAs) in the temporal midperiphery, all combined with VRMAs. Common MVAs presented disordered vascular anastomoses in the SCP and capillary loss in the DCP, corresponding to deficient neuroretina. The preretinal vasculature (PRV) was detected in 36 eyes. VD and VI were lower in FEVR eyes compared to controls, whereas the VDI in the SCP was larger (all P < 0.001). Optic-AVA was positively correlated with VD and VI in both plexuses and negatively correlated with the VDI in the SCP. PRV existence was independently correlated with decreased VI in the DCP (odds ratio [OR] = 0.322; P < 0.001), and VRMA existence was independently correlated with decreased VI in SCP and DCP (SCP OR = 0.282, P = 0.010; DCP OR = 0.562, P = 0.002).
MVAs in the temporal midperipheral retina were revealed. Microvascular loss may be correlated with Optic-AVA reduction, PRV, and the presence of VRMAs.
探讨早期家族渗出性玻璃体视网膜病变(FEVR)中颞侧周边视网膜微血管生长缺陷及其与玻璃体视网膜微观结构异常(VRMA)的相关性。
共纳入 127 例(127 只眼)早期 FEVR 患者和 31 例健康对照者(31 只眼)。所有纳入的眼均进行广角光学相干断层扫描血管造影。进一步评估颞侧周边浅层毛细血管丛(SCP)和深层毛细血管丛(DCP)的血管密度(VD)、血管直径指数(VDI)和血管指数(VI;VD/VDI)。测量从视盘血管发芽点到无血管区边缘(Optic-AVA)的距离,以评估视网膜血管发育不良。
在早期 FEVR 中,61.42%的眼颞侧周边出现视网膜微血管异常(MVAs),均伴有 VRMA。常见的 MVAs 表现为 SCP 中血管吻合紊乱和 DCP 中毛细血管丢失,对应于神经视网膜缺失。36 只眼检测到视网膜前血管(PRV)。FEVR 眼的 VD 和 VI 均低于对照组,而 SCP 的 VDI 较大(均 P<0.001)。Optic-AVA 与 SCP 和 DCP 中的 VD 和 VI 呈正相关,与 SCP 中的 VDI 呈负相关。PRV 的存在与 DCP 中的 VI 降低独立相关(优势比[OR] = 0.322;P<0.001),VRMA 的存在与 SCP 和 DCP 中的 VI 降低独立相关(SCP OR = 0.282,P = 0.010;DCP OR = 0.562,P = 0.002)。
揭示了颞侧周边视网膜的 MVAs。微血管丢失可能与 Optic-AVA 减少、PRV 和 VRMA 的存在有关。