Perivascular Flower-Bud-like Lesions on En Face Optical Coherence Tomography Angiography in Patients with Vitreoretinal Lymphoma
Perivascular Flower-Bud-like Lesions on En Face Optical Coherence Tomography Angiography in Patients with Vitreoretinal Lymphoma
复制标题
玻璃体视网膜淋巴瘤患者 En Face 光学相干断层扫描血管造影血管周围花芽样病变
DOI：
10.1097/iae.0000000000003579
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Qing Chang
中科院分区：
文献类型：
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作者：
Wenwen Chen;Junxiang Gu;Shixue Liu;Zhenyang Zhao;Tingting Jiang;Gezhi Xu;Qing Chang
目的：描述血管周围花蕾样病变是玻璃体视网膜淋巴瘤的新特征。方法：回顾分析2018年1月至2021年3月经手术病理证实的23例(35只眼)玻璃体视网膜淋巴瘤患者的临床资料。对干预前后的面部OCT血管造影图像进行分析。结果：8例患者12只眼(34.3%)发现血管周围花蕾样病变，其中8只眼最佳矫正视力达20/40以上。在12只眼中，有10只眼在症状出现后6个月内检测到PFBL。在面部OCT血管造影上，PFBL呈点状或融合带环绕视网膜血管，累及动脉和静脉。12只眼中4只眼主要累及动脉。在OCT B超上，PFBL通常表现为视网膜内高反射性全层病变，与视网膜下色素上皮沉积(3眼，25%)和视网膜色素上皮异常(4眼，33.3%)共存。然而，PFBL并不总是在眼底照片和荧光素眼底血管造影术等其他影像检查中被发现。结论：PFBL是玻璃体视网膜淋巴瘤的特征性影像表现，有助于玻璃体视网膜淋巴瘤的早期诊断，从而获得更及时、更有效的治疗。
Purpose:To describe perivascular flower-bud-like lesions (PFBLs) as novel characteristics of vitreoretinal lymphoma on en face optical coherence tomography (OCT) angiography.Methods:A retrospective chart review was performed on 23 consecutive patients (35 eyes), who had biopsy-proven vitreoretinal lymphoma between January 2018 and March 2021. En face OCT angiography images were analyzed before and after intervention. PFBLs were initially identified on midretinal slabs of en face OCT angiography, and were further characterized by other imaging modalities.Results:Perivascular flower-bud-like lesions were detected in 12 eyes (34.3%) of 8 patients, of which 8 eyes had best-corrected visual acuity of 20/40 or better. In 10 of the 12 eyes, PFBLs were detected within 6 months of symptom onset. On en face OCT angiography, PFBLs presented as punctate points or confluent bands surrounding retinal vessels, with arterial and venous involvement. In 4 of the 12 eyes, arteries were mainly affected. On OCT B-scans, PFBLs commonly appeared as hyperreflective full-thickness intraretinal lesions that colocalized with subretinal pigment epithelium deposits (3 eyes, 25%) and retinal pigment epithelium irregularities (4 eyes, 33.3%). However, PFBLs could not always be identified on other imaging modalities such as fundus photographs and fundus fluorescein angiography. In all eyes with follow-up, PFBLs attenuated or resolved months after receiving chemotherapy or diagnostic vitrectomy.Conclusion:PFBLs are characteristic imaging findings of vitreoretinal lymphoma and may facilitate an early diagnosis of vitreoretinal lymphoma, which would in turn lead to more timely and effective treatment.