Vortex Vein Anastomosis at the Watershed in Pachychoroid Spectrum Diseases
Vortex Vein Anastomosis at the Watershed in Pachychoroid Spectrum Diseases
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DOI：
10.1016/j.oret.2020.03.024
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发表时间：
2020-09-01
影响因子：
4.5
通讯作者：
Akiyama, Hideo
中科院分区：
文献类型：
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作者：
Matsumoto, Hidetaka;Hoshino, Junki;Akiyama, Hideo
目的：评价厚膜脉络膜谱系疾病（包括中心性浆液性脉络膜视网膜病变（CSC）、不伴息肉样病变的厚膜脉络膜新生血管病变（PNV）和伴息肉样病变的厚膜脉络膜新生血管病变）后极涡静脉的血管变化（息肉状脉络膜血管病变[PCV]）。设计：回顾性病例对照研究。参与者：对于每种厚脉络膜谱系疾病，89例CSC患者的92只眼、59例PNV患者的61只眼、61例PCV患者的63只眼以及25名年龄和性别匹配的参与者的25只健康对照眼。对厚脉络膜谱系疾病患者和健康对照者的临床记录进行了回顾。对各组的多模态图像进行分析。扫描源OCT获得的B型和正面图像在厚脉络膜疾病患者和健康对照。所有患者均接受荧光素血管造影、吲哚菁绿色血管造影和OCT.Main Outcome Measures：在患者和健康对照组中，使用正面OCT确定分水岭处的涡静脉吻合，使用B型OCT测量中心脉络膜厚度（CCT）。结果：CSC患者年龄最小，其次是PNV患者，然后是PCV患者（P < 0.01，CSC与PNV和PNV与PCV），而CSC眼显示最高CCT值，其次是PNV，然后是PCV眼（P < 0.01，CSC与PNV; P < 0.05，PNV与PCV）。中央脉络膜厚度显着大于厚脉络膜谱系疾病比健康对照组。在健康对照组中没有发现显著的CCT差异。在超过90%的患有厚脉络膜谱系疾病的眼睛中观察到上级和下涡静脉之间的吻合，使得该发现比健康对照组显著更频繁（P < 0.01，每种厚脉络膜谱系疾病与对照组）。结论：上级涡静脉与下涡静脉吻合是脉络膜血管病的常见特征。长时间的涡旋静脉充血可能导致厚脉络膜谱系疾病的发展。脉络膜充血可通过涡静脉吻合术形成新的引流路径来补偿。(C)2020年美国眼科学会
Purpose: To evaluate the vascular changes in vortex veins at the posterior pole in pachychoroid spectrum diseases, including central serous chorioretinopathy (CSC), pachychoroid neovasculopathy without polypoidal lesions (PNV), and pachychoroid neovasculopathy with polypoidal lesions (polypoidal choroidal vasculopathy [PCV]).Design: Retrospective case-control study.Participants: Ninety-two eyes of 89 patients with CSC, 61 eyes of 59 patients with PNV, 63 eyes of 61 patients with PCV, and 25 healthy control eyes of 25 age- and gender-matched participants for each pachychoroid spectrum disease.Methods: Clinical records of patients with pachychoroid spectrum diseases and healthy controls were reviewed. Multimodal images of each group were analyzed. Swept-source OCT was performed to obtain B-mode and en face images in patients with pachychoroid spectrum diseases and healthy controls. All patients underwent fluorescein angiography, indocyanine green angiography, and OCT.Main Outcome Measures: Vortex vein anastomosis at the watershed, determined using en face OCT, and central choroidal thickness (CCT), measured using B-mode OCT, were examined in patients and healthy controls. Patient ages also were taken into consideration.Results: Patients with CSC were the youngest, followed by patients with PNV, and then those with PCV (P < 0.01, CSC vs. PNV and PNV vs. PCV), whereas CSC eyes showed the highest CCT values, followed by the PNV and then the PCV eyes (P < 0.01, CSC vs. PNV; P < 0.05, PNV vs. PCV). Central choroidal thickness was significantly greater in pachychoroid spectrum diseases than in healthy controls. No significant CCT differences were found among healthy controls. Anastomosis between superior and inferior vortex veins was observed in more than 90% of eyes with pachychoroid spectrum diseases, making this finding significantly more frequent than in healthy controls (P < 0.01, each pachychoroid spectrum disease vs. control). Polypoidal choroidal vasculopathy showed a significantly higher rate of anastomosis than CSC (P < 0.05).Conclusions: Anastomosis between superior and inferior vortex veins was found to be a common feature in pachychoroid spectrum diseases. Longstanding vortex vein congestion may lead to the development of pachychoroid spectrum diseases. Choroidal congestion may be compensated for by new drainage routes formed via vortex vein anastomosis. (C) 2020 by the American Academy of Ophthalmology