Lan Ting, Huang Chuangxin, Tao Mengyin, Xu Xiaoyu, Zhou Jinxi, Lin Ying, Sadda SriniVas, Luo Yan
State Key Laboratory of Ophthalmology, Image Reading Center, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China.
Ophthalmology University of California, Artificial Intelligence & Imaging Research Doheny Eye Institute, the Doheny Image Reading Center, Doheny Eye Institute, Los Angeles.
Retina. 2025 Jun 24. doi: 10.1097/IAE.0000000000004593.
This study aimed to evaluate the feasibility of ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) in guiding laser photocoagulation for retinal vascular diseases.
A total of 285 eyes from 195 patients with retinal vein occlusion (RVO) and diabetic retinopathy (DR) were retrospectively evaluated at the Medical Retina Department of Zhongshan Ophthalmic Center, Sun Yat-sen University, from July 24 to October 27, 2023. All patients underwent UWF SS-OCTA (VG200, Intalight Imaging, Ltd., Luoyang, China) examination with a single scan using the widefield AngioMosaic protocol. A subset of patients also underwent fluorescein fundus angiography and fundus photography based on clinical discretion. Retinal non-perfusion area (NPA), a key biomarker for guiding laser photocoagulation, along with other findings such as existing laser spots, were analyzed to guide treatment.
The UWF SS-OCTA produced a 29×24 mm single-scan angiographic image and generated a 220° field-of-view montage. Images of the retinal superficial vascular complex (RSVC) could distinctly depict NPA, retinal neovascularization, and intraretinal microvascular abnormalities, while enhanced angio mode images of the choroidal capillary layer (CCL) effectively demonstrated the location of existing laser spots. Utilizing the UWF SS-OCTA findings, initial photocoagulation therapy was performed in 34.3% of RVO patients and 15.8% of DR patients, and supplementary photocoagulation was applied in 13.9% of RVO and 13.6% of DR cases.
UWF SS-OCTA images of the RSVC and the CCL with the enhanced angio mode, provide a non-invasive, efficient, and precise method for guiding retinal photocoagulation, representing a viable alternative to conventional invasive techniques.
本研究旨在评估超广角扫频光学相干断层扫描血管造影（UWF SS-OCTA）在指导视网膜血管疾病激光光凝治疗中的可行性。
回顾性分析2023年7月24日至10月27日在中山大学中山眼科中心视网膜内科就诊的195例视网膜静脉阻塞（RVO）和糖尿病视网膜病变（DR）患者的285只眼。所有患者均使用宽视野血管镶嵌协议进行单次扫描的UWF SS-OCTA（VG200，中国洛阳英特莱特影像有限公司）检查。根据临床判断，部分患者还接受了荧光素眼底血管造影和眼底照相。分析视网膜无灌注区（NPA）这一指导激光光凝治疗的关键生物标志物以及其他发现，如现有的激光光斑，以指导治疗。
UWF SS-OCTA生成了一幅29×24 mm的单次扫描血管造影图像，并生成了220°视野的拼接图像。视网膜浅表血管复合体（RSVC）的图像能够清晰地描绘NPA、视网膜新生血管和视网膜内微血管异常，而脉络膜毛细血管层（CCL）的增强血管模式图像有效地显示了现有激光光斑的位置。利用UWF SS-OCTA的检查结果，34.3%的RVO患者和15.8%的DR患者接受了初始光凝治疗，13.9%的RVO患者和13.6%的DR患者接受了补充光凝治疗。
具有增强血管模式的RSVC和CCL的UWF SS-OCTA图像为指导视网膜光凝治疗提供了一种非侵入性、高效且精确的方法，是传统侵入性技术的可行替代方案。
