Hao Xinlei, Pu Jiaxin, Li Miaoling, Mi Lan, He Guiqin, Zhuang Xuenan, Ji Yuying, Wen Feng
From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.
From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.
Am J Ophthalmol. 2025 Aug 5;279:193-204. doi: 10.1016/j.ajo.2025.07.033.
To evaluate the choroidal vein distribution pattern in eyes with central serous chorioretinopathy (CSC) using widefield indocyanine green angiography (WF-ICGA) and widefield optical coherence tomography angiography (WF-OCTA).
Retrospective, comparative validity and reliability analysis.
Patients diagnosed with CSC between September 2022 and September 2024.
WF-ICGA and WF-OCTA were performed to obtain widefield imaging.
Choroidal venous drainage paths were classified as symmetry or asymmetry based on the presence of a dominant vein. In asymmetrically distributed eyes, the number and location of dominant vortex veins were recorded. Additionally, choroidal parameters were quantitatively assessed and compared among eyes with different choroidal vein distribution patterns.
105 subjects were included in this study, with a mean age of 46.32 years, of whom 86 were male. In the 151 affected eyes, WF-ICGA and WF-OCTA detected similar rates of asymmetric distribution (76.82% vs. 78.14%, P = .783). The number and location of dominant vortex veins also showed no significant differences (P > .05 for all). WF-ICGA and WF-OCTA recognized the highest proportion of cases with 1 dominant vortex vein (43.71% and 49.01%, respectively), followed by cases with 2 dominant veins (33.11% and 29.14%, respectively), and finally, those with symmetric venous distribution (23.18% and 21.85%, respectively). The WF-OCTA results displayed strong agreement with WF-ICGA results (κ = 0.838, P < .001). Among the 21 cases (13.91%) with inconsistent results, the discrepancy was attributed to the limited nasal field of view in WF-OCTA (7 eyes), misidentification of choroidal venous anastomoses as dominant vortex veins (10 eyes), and poor vessel visualization on WF-OCTA (4 eyes). Compared to eyes with symmetric venous distribution and those with 2 dominant veins, cases with 1 dominant vortex vein exhibited worse visual acuity and lower choriocapillaris flow density (P = .009 and P = .008, respectively).
WF-OCTA offers results comparable to WF-ICGA for assessing choroidal vein distribution patterns, establishing it as a reliable alternative for evaluating CSC choroidal vasculature.
使用广角吲哚菁绿血管造影（WF-ICGA）和广角光学相干断层扫描血管造影（WF-OCTA）评估中心性浆液性脉络膜视网膜病变（CSC）患者的脉络膜静脉分布模式。
回顾性、比较有效性和可靠性分析。
2022年9月至2024年9月期间诊断为CSC的患者。
进行WF-ICGA和WF-OCTA以获得广角成像。
根据是否存在优势静脉，将脉络膜静脉引流路径分为对称或不对称。在不对称分布的眼中，记录优势涡静脉的数量和位置。此外，对不同脉络膜静脉分布模式的眼睛进行脉络膜参数的定量评估和比较。
本研究纳入105名受试者，平均年龄46.32岁，其中86名男性。在151只患眼中，WF-ICGA和WF-OCTA检测到的不对称分布率相似（76.82%对78.14%，P = 0.783）。优势涡静脉的数量和位置也无显著差异（所有P>0.05）。WF-ICGA和WF-OCTA识别出优势涡静脉为1条的病例比例最高（分别为43.71%和49.01%），其次是优势静脉为2条的病例（分别为33.11%和29.14%），最后是静脉分布对称的病例（分别为23.18%和21.85%）。WF-OCTA结果与WF-ICGA结果显示出高度一致性（κ = 0.838，P < 0.001）。在结果不一致的21例（13.91%）中，差异归因于WF-OCTA鼻侧视野有限（7只眼）、脉络膜静脉吻合被误认作优势涡静脉（10只眼）以及WF-OCTA上血管可视化不佳（4只眼）。与静脉分布对称和有2条优势静脉的眼睛相比，有1条优势涡静脉的病例视力更差，脉络膜毛细血管血流密度更低（分别为P = 0.009和P = 0.008）。
WF-OCTA在评估脉络膜静脉分布模式方面提供了与WF-ICGA相当的结果，使其成为评估CSC脉络膜血管系统的可靠替代方法。
