Optical coherence tomography identification of occult choroidal neovascularization in age-related macular degeneration
Optical coherence tomography identification of occult choroidal neovascularization in age-related macular degeneration
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DOI：
10.1016/j.ajo.2007.06.014
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发表时间：
2007-10-01
影响因子：
4.2
通讯作者：
Soubrane, Gisele
中科院分区：
文献类型：
--
作者：
Coscas, Florence;Coscas, Gabriel;Soubrane, Gisele
目的：评价和描述老年性黄斑变性诊断时隐匿性脉络膜新生血管的各种光学相干断层扫描(OCT)特征。设计：前瞻性、连续性、观察性病例系列。方法：对经扫描激光检眼镜、荧光素血管造影和吲哚青绿血管造影术确诊的黄斑下隐匿性CNV患者153只眼进行OCT检查。血管造影上隐匿性CNV的诊断标准为黄斑区异质性强荧光伴迟发性渗漏伴色素上皮脱离(PED)、斑点状强荧光斑点和恶化迹象。结果：98%(150只眼)在OCT上观察到视网膜色素上皮(RPE)局限性升高(54只眼，35.3%1)或完全脱离(96只眼，62.7%)。隐匿性CNV对应于与RPE带接触的高反射区，62.7%的眼可检出隐匿性CNV。在纤维血管性PED中，63只眼(65.5%)的RPE升高被低反射腔上的中等反射带突出。在浆液性PED中，腔内仍为光学空洞。脱离区RPE表现为碎裂等改变(137只眼，占89.5%)。OCT还显示视网膜内液体(12 2眼，占79.7%)和视网膜下液体(眼，占41.8%)。结论：分析本研究观察到的各种OCT特征，证实了AMD隐匿性CNV的多态性质、渗出反应、PED的几乎恒定存在以及RPE条带的不同变化。因此，OCT检查为确定上皮下隐匿性CNV的特征提供了有价值的数据。
PURPOSE: To evaluate and describe the various optical coherence tomography (OCT) features of occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD) at the time of diagnosis.DESIGN: Prospective, consecutive, observational case series.METHODS: One hundred and fifty-three eyes of 130 consecutive patients with subfoveal occult CNV diagnosed on scanning laser ophthalmoscope (SLO) fluorescein angiography (FA) and SLO indocyanine green angiography (ICGA) were evaluated with OCT. The diagnostic criteria for occult CNV on angiography were heterogeneous hyperfluorescence with late leakage in the macular region associated with pigment epithelial detachment (PED), stippled hyperfluorescent dots, and signs of deterioration. OCT findings were evaluated and described.RESULTS: A PED was observed on OCT in 98% (150 eyes) either as a limited retinal pigment epithelium (RPE) elevation (54 eyes [35.3%1) or a complete detachment (96 eyes [62.7%]). Occult CNV corresponded to zones of hyperreflectivity in contact with the RPE band and was detected in 62.7% of eyes. In fibrovascular PED (63 eyes [65.5%]), the elevated RPE was highlighted posteriorly by a moderately reflective band overlying a hyporeflective cavity. In serous PED, the cavity remained optically empty. The RPE in the detached zone showed changes such as fragmentation (13 7 eyes [89.5 %]). OCT also showed intraretinal (122 eyes [79.7%]) and subretinal (64 eyes [41.8%]) fluid.CONCLUSIONS: Analysis of the various OCT features observed in this study confirms the polymorphic nature of occult CNV in AMD, their exudative reactions, the almost constant presence of PED, and the different changes in the RPE band. OCT examination, therefore, provides valuable data to confirm the features of subepithelial occult CNV.