Non-invasive method of monitoring retinal vasculitis in patients with birdshot chorioretinopathy using optical coherence tomography
Non-invasive method of monitoring retinal vasculitis in patients with birdshot chorioretinopathy using optical coherence tomography
复制标题
DOI：
10.1136/bjophthalmol-2016-309837
复制
发表时间：
2018-06-01
影响因子：
4.1
通讯作者：
Sen, H. Nida
中科院分区：
文献类型：
--
作者：
Knickelbein, Jared E.;Tucker, William;Sen, H. Nida
目的探讨蒙太奇光学相干断层扫描(OCT)厚度图监测大血管视网膜血管炎患者血管周围厚度的价值。方法对11例(22眼)有鸟拍型脉络膜视网膜病变(BCR)视网膜血管炎病史的患者进行回顾性队列研究。所有患者均行中心凹、视神经及视网膜上下血管近端分支的6x6 mm立方体OCT扫描。分析了各区域的OCT厚度变化图。临床指征时，通过荧光素血管造影(FA)评估血管活性来确认血管周围厚度的变化。结果在3例患者中，蒙太奇OCT扫描在诊断时获得，并通过初始治疗连续获得。在所有三名患者中，口服强的松治疗后，蒙太奇OCT显示血管周围增厚减少，FA证实这一点显示双眼血管渗漏减少。8例患者在BCR诊断和初步治疗后进行了系列蒙太奇OCT扫描。其中4名患者在闪光和治疗期间表现出血管周围厚度的波动，这在FA上血管渗漏的增加或减少中得到证实。其余4例患者均未接受免疫抑制治疗，血管周围厚度未见变化。结论OCT扫描评估大血管周围厚度可能是一种无创性监测后极大血管视网膜血管炎的方法。
Background/aims To investigate the utility of using montaged optical coherence tomography (OCT) thickness maps to monitor perivascular thickness as a marker of vasculitic activity in patients with large-vessel retinal vasculitis.Methods This is a retrospective cohort study of 22 eyes of 11 patients with a history of retinal vasculitis associated with birdshot chorioretinopathy (BCR). Patients had serial spectral domain 6x6mm cube OCT scans centred on the fovea, optic nerve and proximal branches of the superior and inferior retinal vessels. OCT thickness change maps for each respective region were analysed. Changes in perivascular thickness were confirmed by assessing vasculitic activity on fluorescein angiography (FA), when clinically indicated.Results In three patients, montaged OCT scans were acquired at diagnosis and serially through initial treatment. In all three patients, montaged OCT demonstrated reduced perivascular thickening with oral prednisone treatment, which was confirmed by FA showing reduced vascular leakage in both eyes. Eight patients had serial montaged OCT scans after diagnosis and initial treatment of BCR. Four of these patients showed fluctuations in perivascular thickness during flares and treatment that were confirmed by either increased or decreased vascular leakage on FA. The other four patients remained quiet on their immunosuppressive treatment regimens, and no changes in perivascular thickness were detected.Conclusions Evaluating large-vessel perivascular thickness on OCT scans may be a useful method for non-invasively monitoring posterior pole large-vessel retinal vasculitis.