UNASSIGNED: We performed a comprehensive narrative review of the multimodal imaging findings that might be useful in the detection of VRL lesions.
UNASSIGNED: The most frequent ocular manifestations of VRL are vitritis, and retinal and sub-retinal Pigmented Epithelium (RPE) infiltrations. Color Fundus Photography (CFP) detects vitreous haze, optic nerve, retinal and sub-RPE infiltration. Ultra-wide field imaging allows visualization of different patterns of vitreous haze and monitoring of VRL evolution through the detection of chorio-retinal atrophy (CRA). Fundus Autofluorescence shows granular hypo- and hyper-autofluorescent pattern. Optical Coherence Tomography (OCT) reveals vitreous cells, vertical hyper-reflective lesions and sub-RPE infiltrates. Fluorescein Angiography (FA) shows hypo or hyperfluorescent round lesions at the late stages of the examination, while Indocyanine Green Angiography (ICGA) detects round areas of focal hypo-fluorescence in the early phases that gradually enlarge in the late phases. B-scan ultrasonography detects vitreous opacities and homogeneous hyperreflective corpuscular material in the vitreous, and is a strongly recommended tool in suspecting VRL and is particularly useful when vitreous haze is impeding retinal examination.
UNASSIGNED: Diagnostic vitrectomy with cytopathological analysis remains the gold standard for VRL diagnosis, however multimodal imaging allows the identification of suggestive retinal and vitreal lesions for early suspicion, diagnosis, and treatment and monitoring disease progression and response to treatment.
■我们对可能用于检测VRL病变的多模态影像学发现进行了全面的叙述性回顾。
■VRL最常见的眼部表现是玻璃体炎,和视网膜和视网膜下色素上皮(RPE)浸润。彩色眼底摄影(CFP)检测玻璃体雾霾,视神经,视网膜和下RPE浸润。超宽视野成像可以通过检测脉络膜视网膜萎缩(CRA)来可视化玻璃体雾霾的不同模式并监测VRL演变。眼底自发荧光显示颗粒低和高自发荧光模式。光学相干断层扫描(OCT)显示玻璃体细胞,垂直高反射病变和亚RPE浸润。荧光素血管造影(FA)在检查后期显示低或高荧光圆形病变,而吲哚菁绿血管造影(ICGA)在早期阶段检测局灶性低荧光的圆形区域,在晚期阶段逐渐扩大。B超检查可检测玻璃体混浊和玻璃体中均匀的高反射红细胞物质,并且是在怀疑VRL时强烈建议使用的工具,当玻璃体雾霾阻碍视网膜检查时特别有用。
■具有细胞病理学分析的诊断性玻璃体切除术仍然是VRL诊断的金标准,然而,多模式成像允许识别暗示性视网膜和玻璃体病变的早期怀疑,诊断,以及治疗和监测疾病进展和对治疗的反应。