Microstructure of Nonjuxtapapillary Microvasculature Dropout in Healthy Myopic Eyes
Microstructure of Nonjuxtapapillary Microvasculature Dropout in Healthy Myopic Eyes
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DOI：
10.1167/iovs.61.2.36
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发表时间：
2020-02-01
影响因子：
4.4
通讯作者：
Kim, Tae-Woo
中科院分区：
文献类型：
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作者：
Kim, Gyu-Nam;Lee, Eun Ji;Kim, Tae-Woo
目的.本研究的目的是表征健康近视眼非视乳头微血管脱落（MvD）的显微结构。这项横断面研究包括来自126只患有视乳头旁萎缩（PPA）γ区的非青光眼性健康近视眼的50只眼睛（25只眼睛患有非视乳头MvD，25只年龄匹配的眼睛没有任何MvD）。在使用扫频源光学相干断层扫描（OCT）血管造影（OCTA）获得的正面图像中评价乳头旁深层微血管。非近端乳头状MvD定义为局限于非近端乳头状区域的PPA远端部分局部缺乏血管信号的区域。进行增强深度成像OCT扫描以评估乳头旁显微结构。25眼（19.8%）为非弥漫性乳头状MvD。18眼非视乳头MvD处的视乳头旁显微结构的特征是Bruch膜（BM）-视网膜色素上皮（RPE）复合体错位，这通过BM-RPE复合体的缺失和内层视网膜和巩膜的存在来鉴定。在7只眼睛的非视网膜乳头状MvD，但没有这种错位的BM-RPE复合体，RPE萎缩的位置观察到的非视网膜乳头状MvD。与年龄匹配的无任何MvD的对照眼相比，非视乳头MvD的眼轴长度（AXL; P = 0.013）更长，γ区更宽（P < 0.001）。在健康近视眼的非视乳头MvD的显微结构的特点是在约70%的眼睛的时间错位BM-RPE复合体。虽然非视乳头MvD的临床重要性仍有待确定，但应与青光眼中观察到的视乳头旁脉络膜MvD相鉴别。
PURPOSE. The purpose of this study was to characterize the microstructure of the nonjuxtapapillary microvasculature dropout (MvD) in healthy myopic eyes.METHODS. This cross-sectional study included 50 eyes (25 eyes with a nonjuxtapapillary MvD and 25 age-matched eyes without any MvD) from a cohort of 126 nonglaucomatous healthy myopic eyes having parapapillary atrophy (PPA) gamma-zone. The parapapillary deep-layer microvasculature was evaluated in en-face images obtained using swept-source optical coherence tomography (OCT) angiography (OCTA). A nonjuxtapapillary MvD was defined as an area with focal absence of vascular signals in the distal portion of PPA confined to the nonjuxtapapillary area. Enhanced depth-imaging OCT scanning was performed to assess the parapapillary microstructure.RESULTS. Nonjuxtapapillary MvD was found in 25 eyes (19.8%). The parapapillary microstructure at the nonjuxtapapillary MvD in 18 eyes was characterized by the misalignment of Bruch's membrane (BM)-retinal pigment epithelium (RPE) complex, which was identified by the absence of BM-RPE complex and the presence of the inner retina and sclera. In seven eyes with a nonjuxtapapillary MvD but without such misaligned BM-RPE complex, RPE atrophy was observed at the location of the nonjuxtapapillary MvD. Eyes with a nonjuxtapapillary MvD had a longer axial length (AXL; P = 0.013) and a wider gamma-zone (P < 0.001) than age-matched control eyes without any MvD.CONCLUSIONS. The microstructure at the nonjuxtapapillary MvD in healthy myopic eyes was characterized in approximately 70% of eyes by temporally misaligned BM-RPE complex. Although the clinical importance of the nonjuxtapapillary MvD remains to be determined, it should be differentiated from the parapapillary choroidal MvD observed in glaucoma.