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中心性浆液性脉络膜视网膜病变中与液体渗漏相关的脉络膜血管形态变化;光学相干断层扫描血管造影(OCTA)与吲哚菁绿血管造影(ICGA)的比较

Changes in choroidal vessel morphology associated with fluid leakage in central serous chorioretinopathy; a comparison of OCTA and ICGA.

作者信息

Kabiri Payam, Künzel Steffen, Ashraf-Vaghefi Shirin, Bonaventura Theresa, Rübsam Anne, Joussen Antonia, Zeitz Oliver

机构信息

Department of Ophthalmology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2025 Aug 6. doi: 10.1007/s00417-025-06918-2.

Abstract

PURPOSE

To identify changes in choroidal morphology crucial for CSCR this study assessed the relationship between pachychoroidal changes and the occurrence of CSCR. Additionally, given the undefined role of optical coherence tomography angiography (OCTA) in CSCR diagnosis, this study evaluated OCTA as an alternative to indocyanine green angiography (ICGA).

METHODS

Multimodal imaging of 99 patients affected by unilateral or bilateral CSCR was retrospectively assessed to identify pachychoroidal changes. Through logistic regression the relationship between these choroidal changes and CSCR occurrence was examined. Evaluation of ICGA and OCTA images was conducted separately, followed by a comparative analysis of the obtained results.

RESULTS

Presence of intervortex venous anastomoses significantly increased the likelihood of CSCR affection (P = 0.0004, odds ratio 4.829), whereas presence of pachyvessels did not (P = 0.7947). Comparative evaluation of pachychoroidal changes between OCTA and ICGA images resulted in 95.16% of cases in coinciding results. OCTA images exhibited less impairment in quality due to subretinal fluid than ICGA images.

CONCLUSION

Intervortex venous anastomoses were significantly associated with the presence of subretinal fluid and serous pigment epithelium detachment; however, longitudinal studies are required to establish a causal relationship. OCTA has emerged as a non-invasive alternative to ICGA to assess pachychoroidal changes in patients with CSCR.

摘要

目的

为了确定对中心性浆液性脉络膜视网膜病变(CSCR)至关重要的脉络膜形态变化,本研究评估了厚脉络膜变化与CSCR发生之间的关系。此外,鉴于光学相干断层扫描血管造影(OCTA)在CSCR诊断中的作用尚不明确,本研究评估了OCTA作为吲哚菁绿血管造影(ICGA)的替代方法。

方法

对99例单侧或双侧CSCR患者的多模态成像进行回顾性评估,以确定厚脉络膜变化。通过逻辑回归分析这些脉络膜变化与CSCR发生之间的关系。分别对ICGA和OCTA图像进行评估,然后对所得结果进行比较分析。

结果

涡静脉吻合支的存在显著增加了CSCR发病的可能性(P = 0.0004,比值比4.829),而厚血管的存在则没有(P = 0.7947)。OCTA和ICGA图像之间厚脉络膜变化的比较评估结果在95.16%的病例中一致。与ICGA图像相比,OCTA图像因视网膜下液导致的质量损害较小。

结论

涡静脉吻合支与视网膜下液和浆液性色素上皮脱离的存在显著相关;然而,需要纵向研究来建立因果关系。OCTA已成为评估CSCR患者厚脉络膜变化时ICGA的一种非侵入性替代方法。

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