视网膜血管样条纹光相干断层扫描血管成像特征分析

目的观察分析视网膜血管样条纹(AS)的OCT血管成像(OCTA)影像特征。方法回顾性病例观察研究。2017年5月至2019年2月在云南省第二人民医院眼科经全身病史结合多模式影像检查手段确诊为AS的26例患者52只眼纳入研究。其中,男性18例,女性8例;平均年龄(50.8±6.9)岁。均为双眼发病。伴脉络膜新生血管(CNV)者20例34只眼;其中,病程1个月内13只眼,病程1个月以上16只眼,接受过抗VEGF药物治疗5只眼。所有患者行超广角眼底照相、红外眼底成像(IR)、OCT、FAF及FFA等检查。同时采用海德堡OCTA仪行OCTA检查,中心波长840 nm,采集速度85000次/s,宽度45 nm。获得3 mm×3 mm的扫描,每个立方体由2个重复体积的304 B扫描组成,使用两个正交捕获的成像体积的配准来执行运动校正。对比分析眼底彩色照相、IR、FAF、FFA、OCT及OCTA等多模式影像检查结果,总结AS及其继发CNV在OCTA中的影像特征。结果52只眼中,条纹区在OCTA上表现为脉络膜毛细血管阴影40只眼,可见Bruch膜与脉络膜毛细血管层面的脉络膜毛细血管较为稀疏,原本均匀的网状结构发生分离,显示线条样的无血流信号区;条纹区未见明显异常OCTA影像12只眼。OCTA可见视盘条纹附近区出现血管网10只眼,其血管密度丰富。继发CNV的34只眼,其CNV表现为不同形态。病程小于1个月且未经治疗的13只眼,CNV呈较小的"花环"状形态;病程长于1个月但未接受治疗的16只眼,CNV呈血管较为粗大的"扇形"形态。经过抗VEGF药物治疗的5只眼,CNV呈修剪后的"树枝"状形态。结论AS条纹本身在OCTA中表现为无血流信号区,部分AS患者可见视盘旁修复性血管网存在。不同病程及治疗经历的患者CNV表现有所差异。

Optical coherence tomography angiography features of angioid streaks

Objective To analyze the OCT angiography(OCTA)features of eyes affected with angioid streaks.Methods Retrospective analysis of 26 patients(52 eyes)diagnosed as angioid streaks by multimodal imaging in Ophthalmology Department of Yunnan Second People’s Hospital from May 2017 to February 2019 were included in this study.There were 18 males and 8 females,with the mean age of 50.8±6.9 years.All the patients were binocular.There were 34 eyes in 20 patients with CNV.Among them,13 eyes had a course of disease within 1 month,16 eyes had a course of disease over 1 month,and 5 eyes were treated with anti-VEGF drugs.All patients were examined by ultra-wide-angle fundus photography,infrared fundus imaging(IR),spectral-domain OCT,FAF and FFA.At the same time,the Heidelberg OCTA instrument was used for OCTA examination.The central wavelength was 840 nm,the acquisition speed was 85,000 times/s,and the width was 45 nm.A 3 mm×3 mm scan was obtained.Each cube consisted of two 304 B scans of repeated volumes,and motion correction was performed using two orthogonally captured image volume registration.The results of fundus color photography,IR,FAF,FFA,OCT and OCTA were compared and analyzed to summarize the image features of AS and its secondary CNV in OCTA.dus color photography,IR,FAF,FFA,OCT and OCTA were compared and analyzed to summarize the image features of AS and its secondary CNV in OCTA.Results Among 52 eyes,40 eyes showed choroidal capillary shadows in OCTA,and no obvious abnormal OCTA images in 12 eyes.Ten eyes OCTA showed a vascular network beseide the optic disc,FFA showed fluorescent staining instead of fluorescein leakage.Among the 52 eyes,34 eyes had secondary macular CNV,and 34 eyes had different forms of CNV.Different forms had a certain correlation with the length of medical history and treatment history.Among them,13 eyes with short course of disease(less than 1 month)and untreated patients had smaller flower-ring morphology,16 eyes with longer course(more than 1 month)but no treatment had larger fan-shaped segments,and 5 eyes with anti-VEGF therapy were trimmed after the dendritic shape.Conclusions AS streaks appeared no blood flow signal area in OCTA,and repairing vascular network beside the optic disc can be observed in some AS patients.The CNV performance with different disease course and treatment experience is different.