Viggiano Pasquale, Boscia Giacomo, Sadeghi Elham, Cheung Gemmy, Borrelli Enrico, Alessio Giovanni, Chhablani Jay, Boscia Francesco
Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Italy.
Department of Translational Biomedicine Neuroscience, University of Bari "Aldo Moro", Italy.
Prog Retin Eye Res. 2025 Jul;107:101372. doi: 10.1016/j.preteyeres.2025.101372. Epub 2025 May 23.
Pachychoroid spectrum disorders (PSDs) represent a group of chorioretinal disorders characterized by abnormal choroidal thickening and various pathological changes in the choroid, retinal pigment epithelium, and retina. This review provides a comprehensive analysis of current multimodal imaging techniques in the diagnosis and management of PSDs. We examine the role of various imaging modalities including optical coherence tomography (OCT), OCT angiography (OCTA), en face OCT, fluorescein angiography (FA), indocyanine green angiography (ICGA), infrared imaging (IR), and fundus autofluorescence (FAF) in evaluating PSDs. Each imaging modality provides unique insights: OCT reveals characteristic choroidal thickening and structural changes; OCTA demonstrates alterations in choroidal flow and neovascularization; en face OCT allows detailed visualization of choroidal vasculature and intervortex anastomoses; FA shows patterns of leakage; ICGA reveals choroidal hyperpermeability and pachyvessels; IR imaging assists in RPE evaluation; and FAF highlights RPE dysfunction. The integration of these imaging techniques has enhanced our understanding of the pathophysiology of PSDs and improved our ability to diagnose, monitor, and treat these conditions. This review particularly emphasizes how OCTA has advanced our knowledge of choroidal circulation and neovascularization in PSDs. We also discuss future directions in imaging technology and their potential impact on personalized therapeutic approaches, including optimized photodynamic therapy based on imaging biomarkers. The synergistic use of multimodal imaging represents a cornerstone in the management of PSDs, enabling more precise diagnosis and tailored treatment strategies.
厚脉络膜谱系疾病（PSDs）是一组脉络膜视网膜疾病，其特征是脉络膜增厚异常以及脉络膜、视网膜色素上皮和视网膜出现各种病理变化。本综述对当前用于PSDs诊断和管理的多模态成像技术进行了全面分析。我们研究了各种成像方式的作用，包括光学相干断层扫描（OCT）、OCT血管造影（OCTA）、表面OCT、荧光素血管造影（FA）、吲哚菁绿血管造影（ICGA）、红外成像（IR）和眼底自发荧光（FAF）在评估PSDs中的作用。每种成像方式都提供了独特的见解：OCT揭示了特征性的脉络膜增厚和结构变化；OCTA显示了脉络膜血流和新生血管形成的改变；表面OCT允许详细观察脉络膜血管系统和涡静脉吻合；FA显示渗漏模式；ICGA揭示脉络膜高渗透性和厚壁血管；IR成像有助于评估视网膜色素上皮；FAF突出显示视网膜色素上皮功能障碍。这些成像技术的整合增强了我们对PSDs病理生理学的理解，并提高了我们诊断、监测和治疗这些疾病的能力。本综述特别强调了OCTA如何推进我们对PSDs中脉络膜循环和新生血管形成的认识。我们还讨论了成像技术的未来发展方向及其对个性化治疗方法的潜在影响，包括基于成像生物标志物的优化光动力疗法。多模态成像的协同使用是PSDs管理的基石，能够实现更精确的诊断和量身定制的治疗策略。
