Imaging Retinal Pigment Epithelial Proliferation Secondary to PASCAL Photocoagulation In Vivo by Polarization-sensitive Optical Coherence Tomography
Imaging Retinal Pigment Epithelial Proliferation Secondary to PASCAL Photocoagulation In Vivo by Polarization-sensitive Optical Coherence Tomography
复制标题
DOI：
10.1016/j.ajo.2012.12.017
复制
发表时间：
2013-06-01
影响因子：
4.2
通讯作者：
Schmidt-Erfurth, Ursula
中科院分区：
文献类型：
--
作者：
Lammer, Jan;Bolz, Matthias;Schmidt-Erfurth, Ursula
目得：采用偏振敏感光学相干断层扫描（OCT）对糖尿病黄斑病变患者黄斑激光术后视网膜色素上皮（RPE）进行成像，并监测随时间推移的体内愈合反应。设计：前瞻性、非随机临床试验。在这个单中心试验中（Department of Ophthalmology and Optometry，Medical University of维也纳，维也纳，Austria），13名患者（13只眼）接受了网格光凝治疗糖尿病黄斑病变。在3个月的过程中连续跟踪视网膜愈合过程。一个偏振敏感的OCT原型被使用，允许检测和测量的RPE变化的基础上，他们的特定的偏振扰quality.RESULTS：1天后，视网膜内的光凝病变急剧划定，而RPE的变化是相当微妙的。在1周时，所有病变均表现出视网膜内层向RPE的牵引和感光细胞的损失。在组织敏感偏振敏感OCT成像中，在RPE水平发现偏振扰频柱。在随访过程中，在极化混乱的RPE层中观察到不同的愈合反应，从过度增殖到局灶性萎缩。由于后向散射光的偏振态的性质，偏振敏感OCT揭示了视网膜激光治疗后RPE和视网膜外层的特定形态学变化，而基于强度的光谱域OCT无法检测到。在3个月的过程中杂乱的组织表明比先前在啮齿动物研究中表征的更强烈的愈合反应和RPE细胞的增殖。(c)2013年，Elsevier Inc. All rights reserved.
PURPOSE: To image the retinal pigment epithelium (RPE) after macular laser and to monitor healing responses over time in vivo in patients with diabetic maculopathy using polarization-sensitive optical coherence tomography (OCT).DESIGN: Prospective, nonrandomized clinical trial.METHODS: In this single-center trial (Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria), 13 patients (13 eyes) underwent grid photocoagulation for diabetic maculopathy. Retinal healing processes were continuously followed over the course of 3 months. A polarization-sensitive OCT prototype was used, allowing detection and measurement of the RPE changes based on their specific polarization-scrambling qualities.RESULTS: After 1 day, the intraretinal photocoagulation lesions were sharply demarcated, whereas RPE changes were rather subtle. At 1 week, all lesions exhibited traction of the inner retinal layers toward the RPE and loss of photoreceptor cells. In tissue-sensitive polarization-sensitive OCT imaging, polarization-scrambling columns were found at the level of the RPE. During follow-up, different healing responses were seen in the polarization-scrambling RPE layer, ranging from hyperproliferation to focal atrophy.CONCLUSION: Because of the properties of the polarization state of backscattered light, polarization-sensitive OCT revealed specific morphologic changes in the RPE and outer retinal layers secondary to retinal laser treatment undetectable with intensity-based spectral-domain OCT. The increase in polarization-scrambling tissue over the course of 3 months indicates a more intense healing reaction and proliferation of RPE cells than previously characterized in rodent studies. (c) 2013 by Elsevier Inc. All rights reserved.