Sequential Observations of Conversion from Nonischemic to Ischemic Central Retinal Vein Occlusion Using Optical Coherence Tomography Angiography.
Sequential Observations of Conversion from Nonischemic to Ischemic Central Retinal Vein Occlusion Using Optical Coherence Tomography Angiography.
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DOI：
10.1155/2018/1354217
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Kamei M
中科院分区：
文献类型：
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作者：
Fukutomi A;Tsuboi K;Ono H;Ishida Y;Kamei M
我们报告一个由非缺血性视网膜中央静脉阻塞（CRVO）转变为缺血性CRVO的病例，通过光学相干断层扫描血管造影（OCTA）观察到视网膜血管的连续变化。一位81岁的女性因为左眼视力丧失而来到我们的视网膜诊所。眼底镜检查显示静脉迂曲和视网膜内出血在所有四个象限的眼底。OCT显示黄斑水肿。血管造影（FA）和OCTA显示小毛细血管丢失。诊断为非缺血性CRVO。抗血管内皮生长因子（VEGF）治疗缓解了水肿，并改善了视力。然而，在随访期间，在OCTA上观察到毛细血管脱落，并逐渐扩大。最终，FA证实转化为缺血性CRVO。在这种情况下，使用OCTA进行的连续观察表明，非缺血性CRVO不会突然转化为缺血性CRVO，而是逐步发生的。此外，血管的变化始于静脉周围，深毛细血管丛的血流变化比浅毛细血管丛更明显。
We report the sequential changes of retinal vessels observed by optical coherence tomography angiography (OCTA) in a case of nonischemic central retinal vein occlusion (CRVO) that converted to ischemic CRVO. An 81-year-old woman visited our Retina Clinic because of visual acuity loss in the left eye. Funduscopic examination showed venous tortuosity and intraretinal hemorrhage in all four quadrants of the fundus. OCT showed macular edema. Fluorescein angiography (FA) and OCTA showed loss of small capillaries. Nonischemic CRVO was diagnosed. Antivascular endothelial growth factor (VEGF) treatment resolved the edema and improved visual acuity. However, during follow-up, capillary dropout was observed on OCTA, which gradually enlarged. Eventually, FA confirmed the conversion to ischemic CRVO. In this case, sequential observations using OCTA showed that nonischemic CRVO did not convert to ischemic CRVO abruptly but occurred stepwise. Additionally, vascular changes began around the veins and blood flow changes were observed more clearly in deep capillary plexus than in superficial capillary plexus.