Optical coherence tomography angiography

光学相干断层扫描血管造影
  • 文章类型: Journal Article
    研究2019年原发性冠状病毒病(COVID-19)感染患者视网膜微血管的纵向变化。
    一组参与者,从未感染过COVID-19的人,于2022年12月至2023年5月在北京协和医院招募,中国。参与者接受了全面的眼科检查和眼底成像,其中包括彩色眼底摄影,自发荧光摄影,扫频源光学相干断层扫描(SS-OCT)和SS-OCT血管造影(SS-OCTA)。如果参与者在研究期间感染了COVID-19,在感染恢复后1周和2个月内采用一致的影像学方式进行随访.
    31名患者(61只眼),平均年龄为31.0±7.2岁,有资格参加这项研究。所有参与者在基线数据收集后一个月内感染了轻度COVID-19感染。第一次随访平均感染后10.9±2.0天,第二次随访平均61.0±3.5天。随访期间未观察到临床视网膜微血管病变特征。然而,SS-OCTA分析显示黄斑血管密度(MVD)从基线时的60.76±2.88%显着增加到首次随访时的61.59±3.72%(p=0.015),随后在两个月的随访中恢复到基线水平60.23±3.33%(p=0.162).中央凹无血管区(FAZ)在随访期间保持稳定,基线面积为0.339±0.097mm2,0.342±0.093mm2和0.344±0.098mm2。第一次随访(p=0.09)和第二次随访(p=0.052),分别。中央黄斑厚度,立方体体积和神经节细胞内丛状层在第一次随访时显示出短暂的减少(分别为p<0.001,p=0.039,p=0.002),并在2个月随访时升高至基线水平(分别为p=0.401,p=0.368,p=0.438).
    轻度COVID-19感染可能会暂时和可逆地影响视网膜微血管,以早期恢复阶段视网膜血流短暂增加为特征,感染后两个月恢复到感染前水平。
    UNASSIGNED: To investigate the longitudinal alterations of retinal microvasculature in patients with primary coronavirus disease 2019 (COVID-19) infection.
    UNASSIGNED: A cohort of participants, who had never been infected with COVID-19, was recruited between December 2022 and May 2023 at Peking Union Medical College Hospital in Beijing, China. Participants underwent comprehensive ophthalmologic examinations and fundus imaging, which included color fundus photography, autofluorescence photography, swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA). If participants were infected with COVID-19 during the study, follow-ups with consistent imaging modality were conducted within one week and two months after recovery from the infection.
    UNASSIGNED: 31 patients (61 eyes), with a mean age of 31.0 ± 7.2 years old, were eligible for this study. All participants contracted mild COVID-19 infection within one month of baseline data collection. The average period was 10.9 ± 2.0 days post-infection for the first follow-up and 61.0 ± 3.5 days for the second follow-up. No clinical retinal microvasculopathy features were observed during the follow-ups. However, SS-OCTA analysis showed a significant increase in macular vessel density (MVD) from 60.76 ± 2.88% at baseline to 61.59 ± 3.72%(p=0.015) at the first follow-up, which subsequently returned to the baseline level of 60.23 ± 3.33% (p=0.162) at the two-month follow-up. The foveal avascular zone (FAZ) remained stable during the follow-ups with areas of 0.339 ± 0.097mm2, 0.342 ± 0.093mm2, and 0.344 ± 0.098mm2 at the baseline, first follow-up (p=0.09) and second follow-up (p=0.052), respectively. Central macular thickness, cube volume and ganglion cell-inner plexiform layer showed a transient decrease at the first follow-up(p<0.001, p=0.039, p=0.002, respectively), and increased to baseline level at the two-month follow-up(p=0.401, p=0.368, p=0.438, respectively).
    UNASSIGNED: Mild COVID-19 infection may temporarily and reversibly impact retinal microvasculature, characterized by a transient increase in retinal blood flow during the early recovery phase, which returns to the pre-infection level two months post-infection.
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  • 文章类型: Journal Article
    随着科学技术水平的提高,眼科诊疗技术不断提高,尤其是随着光学相干层析成像技术的兴起。替代方法使临床医生获得了更多的信息,并在许多眼科疾病的发生和发展中取得了更大的突破。
    探讨老年糖尿病性白内障患者行白内障超声乳化术的黄斑区视网膜结构的变化。
    这是一项前瞻性队列研究。选取2018年12月至2021年12月我院眼科自愿接受超声乳化联合人工晶状体植入术的白内障患者68例(78眼)。根据是否合并糖尿病分为A(糖尿病)和B(非糖尿病)。收集手术前后白内障患者A组24例(28眼)和B组44例(50眼)。Day,1周,1个月,视网膜中央凹平均厚度和视盘周围视网膜神经纤维层厚度的数据(平均厚度,鼻部厚度,主题侧厚度,上部厚度,和较低的厚度)进行统计学分析。
    发现A组黄斑中心凹的平均视网膜厚度大于B组,然而,两组间差异无统计学意义。在第一周和第三周,A组视盘周围的视网膜神经纤维层增厚;两组之间没有明显差异。手术后一周零一个月,然而,显示与术前天数相比,上厚度有一周的差异。在术前和1天时间之间没有明显的变化。
    糖尿病性白内障患者和单纯年龄相关性白内障患者在手术后都会出现不同程度的中央凹视网膜厚度增加。然而,糖尿病患者的视网膜中央凹厚度增加更多。
    UNASSIGNED: With the improvement of the level of science and technology, diagnosis and treatment technology of ophthalmology has continuously improved, especially with the rise of optical coherence tomography. Alternative methods have enabled clinicians to obtain more information and make greater breakthroughs in the occurrence and development of many ophthalmic diseases.
    UNASSIGNED: To investigate changes in retinal structure in the macular area of senile diabetic cataract patients undergoing cataract phacoemulsification.
    UNASSIGNED: This was a prospective cohort study. A total of 68 cataract patients (78 eyes) who voluntarily received phacoemulsification combined with intraocular lens implantation in the Department of Ophthalmology of our hospital from December 2018 to December 2021 were selected. They were divided into A (diabetic) and B (non-diabetic) according to whether they were complicated with diabetes. There were 24 cases (28 eyes) in A and 44 cases (50 eyes) in B. Cataract patients were collected before and after surgery. Day, 1 week, and 1 month, data on the average thickness of the fovea retina and thickness of the retinal nerve fiber layer around the optic disc (average thickness, nasal thickness, topic side thickness, upper thickness, and lower thickness) were statistically analyzed analyze.
    UNASSIGNED: The average retinal thickness of the macular fovea in Group A was found to be greater than that of Group B, however, there was no statistically significant difference between the two groups. At week one and week thirty, Group A\'s layer of retinal nerve fibers surrounding the optic disc thickened; there was no discernible difference between the two groups. One week and one month following surgery, however, showed a one-week difference in upper thickness compared to preoperative days. There was no discernible change between the preoperative and 1-day times.
    UNASSIGNED: Both diabetic cataract patients and simple age-related cataract patients will have different degrees of increased foveal retinal thickness after surgery. However, the foveal retinal thickness of patients with diabetes increases more.
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  • 文章类型: Journal Article
    目的:分析无糖尿病视网膜病变(DR)临床体征的1型糖尿病(T1DM)患者在3年随访期间视网膜结构和功能损害的进展。
    方法:这是一项观察性纵向研究。没有DR临床体征的儿科T1DM患者,并在圣拉斐尔医院招募了性别和年龄匹配的健康受试者(米兰,意大利)。每位患者都接受了全面的眼科评估,包括光学相干断层扫描(OCT),OCT血管造影(OCT-A),视网膜静态和动态血管分析(DVA),和显微视野。
    结果:21眼T1DM患者(10例女性,24±2岁),纳入21名年龄和性别匹配的健康受试者。在基线,使用OCT-A,T1DM眼睛显示血管长度密度显着降低(在3×3和6×6mm图像中p<0.001和p=0.046),并且血管密度指数显着增加(在3×3和6×6mm图像中p=0.013和p=0.087)深毛细血管丛。DVA检测到血管对闪烁光的响应显著降低(p=0.002)。在糖尿病患者的下象限和上象限中,神经节细胞层直径为6mm的子场的厚度显着增加(两个子场中p<0.001)。在3年的随访中,所有分析均未发现明显的纵向变化。
    结论:伴随的亚临床微血管和神经退行性损伤可能是DR发病的早期体征,先于功能改变和DR发展的临床体征。随着时间的推移,这些变化显示出稳定的趋势。
    OBJECTIVE: To analyze the progression of structural and functional retinal impairment in type 1 diabetes mellitus (T1DM) patients with no clinical signs of diabetic retinopathy (DR) during a 3-year follow-up.
    METHODS: This was an observational longitudinal study. Post-pediatric T1DM patients without clinical signs of DR, and sex- and age-matched healthy subjects were recruited at San Raffaele Hospital (Milan, Italy). Each patient underwent a comprehensive ophthalmological evaluation, including optical coherence tomography (OCT), OCT-angiography (OCT-A), retinal static and dynamic vessel analysis (DVA), and microperimetry.
    RESULTS: 21 eyes of 21 T1DM patients (10 females; 24 ± 2 years old), and 21 age and sex-matched healthy subjects were enrolled. At baseline, T1DM eyes revealed a significantly decreased vessel length density using OCT-A (p < 0.001 and p = 0.046 in 3 × 3 and 6 × 6 mm images) and a significantly increased vessel density index (p = 0.013 and p = 0.087 in 3 × 3 and 6 × 6 mm images) of deep capillary plexus. DVA detected a significantly decreased vessel response to flicker light (p = 0.002). A significantly increased thickness of ganglion cellular layer 6-mm-diameter subfields in inferior and superior quadrants was found in diabetic patients (p < 0.001 in both subfields). At 3-years-follow-up no significant longitudinal changes were disclosed in all analyses.
    CONCLUSIONS: Concomitant subclinical microvascular and neurodegenerative damages could be early signs of DR onset that precede functional alterations and clinical signs of DR development. These alterations demonstrated a stable trend over time.
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  • 文章类型: Journal Article
    背景和目标:鉴于文献中存在相互矛盾的数据,本研究旨在探讨阻塞性睡眠呼吸暂停综合征(OSAS)对黄斑血管密度(VD)和灌注密度(PD)的影响。材料和方法:基于阻塞性呼吸暂停低通气指数(OAHI),61例前瞻性招募的患者被分配到对照组(n=12;OAHI<5/h)或OSAS组(n=49;OAHI≥5/h)。浅层和深层毛细血管丛的黄斑VD和PD(SCP和DCP,分别)使用ZeissPLEXElite9000(6×6mm)在牙侧和牙周区域进行测量。比较对照组和OSAS组之间的值。结果:与对照组相比,OSAS组表现出旁小室和小室周围区域的DCP的VD增加,而小室周围区域的DCP的PD增加。SCP的黄斑VD或PD均未观察到显着差异。OAHI与黄斑VD或PD之间没有相关性。结论:这项研究表明,OSAS患者的DCP会发生侧支血管形成和可能的视网膜血管舒张。
    Background and Objectives: Given the conflicting data available in the literature, this study aimed to investigate the impact of obstructive sleep apnea syndrome (OSAS) on the macular vascular density (VD) and perfusion density (PD). Materials and Methods: Based on the obstructive apnea-hypopnea index (OAHI), 61 prospectively recruited patients were assigned to either a control group (n = 12; OAHI < 5/h) or an OSAS group (n = 49; OAHI ≥ 5/h). The macular VD and PD of the superficial and deep capillary plexuses (SCP and DCP, respectively) were measured in the parafoveolar and perifoveolar areas using Zeiss PLEX Elite 9000 (6 × 6 mm). The values were compared between the control and OSAS groups. Results: Compared with the control group, the OSAS group demonstrated an increased VD of the DCP in the parafoveolar and perifoveolar areas and PD of the DCP in the perifoveolar area. No significant differences in either the macular VD or PD of the SCP were observed. There was no correlation between the OAHI and macular VD or PD. Conclusions: This study indicates that collateral vessel formation and possible retinal vasodilation occur in the DCP of patients with OSAS.
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  • 文章类型: Journal Article
    目的:为了评估重复性,眼间相关,与健康受试者的定量扫描源光学相干断层扫描血管造影(OCTA)视神经头(ONH)参数的一致性。
    方法:纳入健康受试者33例。使用3mmX3mm扫描协议通过扫频源OCTA对两只眼睛的ONH成像四次。通过定制的Matlab程序分析放射状乳头周围毛细血管的图像,和血管密度,分形维数,测量血管直径指数。通过组内相关系数(ICC)确定四次扫描的可重复性。然后从四次重复扫描中选择最中心的视盘,使用皮尔逊相关系数进行眼间相关性和一致性分析,ICC和Bland-Altman地块。
    结果:所有扫频源-OCTAONH参数均表现出一定的可重复性,ICC>0.760,变异系数(CoV)≤7.301%。乳头血管密度有明显的眼间相关性(ICC=0.857),血管直径指数(ICC=0.857)和分形维数(ICC=0.906),而周乳头血管密度表现出中度眼间相关性(ICC=0.687)。Bland-Altman地块显示,周围乳头血管密度的一致性范围为-5.26%至6.21%。
    结论:OCTAONH参数在健康受试者中表现出良好的可重复性。乳头状血管密度的眼间相关性,分形维数和血管直径指数较高,但是周围乳头血管密度的相关性是中等的。
    OBJECTIVE: To assess the repeatability, interocular correlation, and agreement of quantitative swept-source optical coherence tomography angiography (OCTA) optic nerve head (ONH) parameters in healthy subjects.
    METHODS: Thirty-three healthy subjects were enrolled. The ONH of both eyes were imaged four times by a swept-source-OCTA using a 3 mm ×3 mm scanning protocol. Images of the radial peripapillary capillary were analyzed by a customized Matlab program, and the vessel density, fractal dimension, and vessel diameter index were measured. The repeatability of the four scans was determined by the intraclass correlation coefficient (ICC). The most well-centered optic disc from the four repeated scans was then selected for the interocular correlation and agreement analysis using the Pearson correlation coefficient, ICC and Bland-Altman plots.
    RESULTS: All swept-source-OCTA ONH parameters exhibited certain repeatability, with ICC>0.760 and coefficient of variation (CoV)≤7.301%. The obvious interocular correlation was observed for papillary vessel density (ICC=0.857), vessel diameter index (ICC=0.857) and fractal dimension (ICC=0.906), while circumpapillary vessel density exhibited moderate interocular correlation (ICC=0.687). Bland-Altman plots revealed an agreement range of -5.26% to 6.21% for circumpapillary vessel density.
    CONCLUSIONS: OCTA ONH parameters demonstrate good repeatability in healthy subjects. The interocular correlations of papillary vessel density, fractal dimension and vessel diameter index are high, but the correlation for circumpapillary vessel density is moderate.
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  • 文章类型: Journal Article
    视网膜是大脑的突起,因此,研究人员最近提出了视网膜变化作为研究中枢神经系统疾病的新标志。目的探讨光学相干断层扫描血管造影(OCTA)评估的精神分裂症视神经乳头神经血管结构与健康受试者的比较。
    这项研究于2019年至2021年在马什哈德的伊本新浪精神病医院进行,伊朗。我们纳入了22例住院的已知精神分裂症病例,用利培酮作为抗精神病药物治疗,22名健康受试者两组患者年龄、性别匹配。在精神分裂症患者组中,阳性和阴性综合征量表检验用于评估疾病严重程度.所有受试者都进行了完整的眼科评估和OCTA成像。
    我们发现杯/盘面积比,垂直杯/盘比率,精神分裂症患者的杯和水平杯/盘比率明显高于健康受试者(p值分别为0.019、0.015和0.022)。精神分裂症组和健康组视神经乳头周围视网膜神经纤维层和视神经乳头血管参数差异无统计学意义。
    我们发现了关于精神分裂症与健康受试者相比视神经头断层摄影特性差异的证据。然而,ONH血管参数无明显差别。需要更多的研究才能得出明确的结论。
    UNASSIGNED: The retina is a protrusion of the brain, so researchers have recently proposed retinal changes as a new marker for studying central nervous system diseases. To investigate optic nerve head neurovascular structure assessed by optical coherence tomography angiography (OCTA) in schizophrenia compared to healthy subjects.
    UNASSIGNED: The study was conducted from 2019 to 2021 at the Ibn Sina Psychiatric Hospital in Mashhad, Iran. We enrolled 22 hospitalized known cases of schizophrenia, treated with risperidone as an antipsychotic drug, and 22 healthy subjects. The two groups were matched in age and gender. In the schizophrenic group, the positive and negative syndrome scale test was used to assess the illness severity. All subjects underwent complete ophthalmic evaluations and OCTA imaging.
    UNASSIGNED: We found that the cup/disc area ratio, vertical cup/disc ratio, and horizontal cup/disc ratio are significantly higher in patients with schizophrenia than in healthy subjects (with p-values of 0.019, 0.015, and 0.022, respectively). No statistically significant difference in the peripapillary retinal nerve fiber layer and vascular parameters of the optic nerve head was observed between schizophrenia and healthy groups.
    UNASSIGNED: We found evidence regarding the difference in the optic nerve head tomographic properties in schizophrenia compared to healthy subjects. However, ONH vascular parameters showed no significant difference. More studies are needed for a definite conclusion.
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  • 文章类型: Journal Article
    目的:评估1型糖尿病(T1D)儿童和青少年光学相干断层扫描血管造影(OCTA)指标的纵向变化。
    方法:这项前瞻性观察性队列研究纳入了30例没有糖尿病性视网膜病变(DR)病史的T1D儿童的32只眼,随访4年。参与者在基线和随访期间接受了OCTA检查。使用定制的MATLAB算法测量定量OCTA指标。使用广义混合效应模型来确定它们与DR发展的关系。使用最小绝对收缩和选择算子筛选系统参数和OCTA指标,以确定视觉功能的预测因子。
    结果:在4年期间,纳入的7只眼睛出现DR,大多数OCTA指标随着糖尿病病程的增加而降低。浅表毛细血管丛(SCP)中更高的乳头周围和旁凹鼻象限血管面积密度(VAD)以及SCP和深毛细血管丛(DCP)中的血管骨架密度(VSD)与T1D中DR的风险较低有关。颞侧和下象限的副凹DCPVSD和VAD与最佳矫正视力的变化是反相关的。
    结论:OCTA指标随糖尿病病程动态变化,可作为改善T1D儿童和青少年DR发展和视功能风险评估的生物标志物。
    OBJECTIVE: To evaluate longitudinal changes in optical coherence tomography angiography (OCTA) metrics in children and adolescents with type 1 diabetes (T1D).
    METHODS: This prospective observational cohort study included thirty-two eyes from thirty T1D children with no history of diabetic retinopathy (DR) who were followed up for 4 years. Participants underwent OCTA examinations at baseline and during follow-up. Quantitative OCTA metrics were measured using a customized MATLAB algorithm. Generalized mixed-effect models were used to determine their relationship with DR development. Systemic parameters and OCTA metrics were screened using least absolute shrinkage and selection operator to identify predictors for visual function.
    RESULTS: Over the 4-year period, seven of the included eyes developed DR, and most OCTA metrics decreased with diabetes duration. Higher peripapillary and parafoveal nasal quadrant vessel area density (VAD) in the superficial capillary plexus (SCP) and vessel skeleton density (VSD) in both the SCP and the deep capillary plexus (DCP) were associated with a lower risk of DR in T1D. Parafoveal DCP VSD and VAD in the temporal and inferior quadrants were anticorrelated with changes in best corrected visual acuity.
    CONCLUSIONS: OCTA metrics dynamically change over the duration of diabetes and can be used as biomarkers to improve the risk evaluation of DR development and visual function in T1D children and adolescents.
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  • 文章类型: Journal Article
    背景:我们旨在利用光学相干断层扫描血管造影(OCTA)来全面评估圆锥角膜患者角膜胶原交联(CCL)手术前后视神经头(ONH)和黄斑灌注的变化。
    方法:根据具体标准,共纳入了22名接受CCL手术的圆锥角膜患者,制定了细致的排除标准,以尽量减少潜在的混杂因素。参与者在CCL之前使用光谱OCT(海德堡)对ONH和黄斑进行了OCTA评估,以及在CCL后1个月和3个月。利用MATLAB软件进行图像分析。
    结果:参与者的平均年龄为20.09±6.11,其中59%为男性,术前平均眼压(IOP)为13.59±2.85mmHg。CCL后,乳头周围视网膜神经纤维层(ppRNFL)厚度和总体视网膜厚度保持稳定。然而,黄斑血管密度显著改变,强调血管反应的区域变化。对于黄斑大血管密度(LVD),浅血管复合体和深血管复合体(SVC和DVC)在术前和术后3个月随访之间均显示出显著差异(分别为p<0.001和p=0.002).视神经头标记物表现出相对稳定性,除了无血管复杂密度的变化,术前为49.2±2.2%,术后3个月降至47.6±1.7%(P值=0.005)。
    结论:虽然CCL似乎保持了某些眼部结构的完整性,CCL后黄斑灌注改变提示对视网膜供血的潜在影响.长期监测对于了解这些变化的影响至关重要,特别是在糖尿病等疾病的背景下。
    BACKGROUND: We aimed to employ Optical Coherence Tomography Angiography (OCTA) to comprehensively assess changes in the optic nerve head (ONH) and macular perfusion before and after the Corneal Collagen Cross-Linking (CCL) procedure in patients with keratoconus.
    METHODS: A total of 22 keratoconus patient\'s candidate for CCL procedures were included based on specific criteria, with meticulous exclusion criteria in place to minimize potential confounders. Participants underwent OCTA assessments of the ONH and macula using the Spectralis OCT (Heidelberg) before CCL, as well as at 1- and 3-months post-CCL. MATLAB software was utilized for image analysis.
    RESULTS: The mean age of the participants was 20.09 ± 6.11, including 59% male, and the mean intraocular pressure (IOP) before the surgery was 13.59 ± 2.85 mmHg. Peripapillary Retinal nerve fiber layer (ppRNFL) thickness and overall retinal thickness remained stable post-CCL. However, significant alterations were observed in macular vessel density, emphasizing regional variations in vascular response. For macular large vessel density (LVD), both superficial and deep vascular complex (SVC and DVC) demonstrated significant differences between before surgery and the 3 months post-surgery follow-up (p < 0.001 and p = 0.002, respectively). Optic nerve head markers demonstrated relative stability, except for changes in avascular complex density, which was 49.2 ± 2.2% before the surgery and decrease to 47.6 ± 1.7% three months after the operation (P-value = 0.005).
    CONCLUSIONS: While CCL appears to maintain the integrity of certain ocular structures, alterations in macular perfusion post-CCL suggest potential effects on retinal blood supply. Long-term monitoring is crucial to understand the implications of these changes, particularly in the context of conditions such as diabetes.
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  • 文章类型: Journal Article
    背景:本研究的目的是通过光学相干断层扫描血管造影(OCTA)检测视网膜和脉络膜血管的变化,通过比较有和没有强直性肌营养不良(DM)患者的定量OCTA参数。
    方法:横断面研究。纳入了41名受DM影响的连续患者。纳入标准为1型和2型DM的分子诊断。为了避免年龄对微血管变化的影响,并证明DM1和DM2患者之间的比较是合理的,建立了两个性别和年龄相匹配的对照组.
    结果:与对照组相比,糖尿病组黄斑区的血管密度明显降低,浅表毛细血管丛的中央凹和中央凹区域(DM1组p<0.001,p=0.001,p=0.005和p=0.026,对于DM2组),以及DM1的深毛细血管丛黄斑区(p=0.002)和DM2的深黄斑和中央凹区域(分别为p=0.007,p=0.001)。与对照组相比,DM1和DM2的中央凹无血管区没有显着差异(分别为p=0.320和p=0.945)。
    结论:我们的结果表明,DM不仅与经典的色素性改变有关,而且与浅表和深层视网膜微血管异常有关,提示这些变化可能与局部灌注不足有关。光学相干断层扫描血管造影是诊断和表征DM视网膜变化的有用工具,应成为这些患者标准评估的一部分。
    BACKGROUND: The aim of the study was to detect the changes in retinal and choroidal vasculature via optical coherence tomography angiography (OCTA) by comparing the quantitative OCTA parameters in patients with and without myotonic dystrophies (DM).
    METHODS: The cross-sectional study. Forty-one consecutive patients affected by DMs were enrolled. The inclusion criteria were molecular diagnosis of DM types 1 and 2. To avoid the age effect on microvascular changes and to justify a comparison between DM1 and DM2 patients, two control groups matched for sex and age were established.
    RESULTS: The vascular density was found to be significantly decreased in the DM groups compared to the controls in the macular, parafoveal and perifoveal zone of superficial capillary plexus (p < 0.001 for the DM1 group, and p = 0.001, p = 0.005 and p = 0.026, respectively, for the DM2 group), as well as in the macular zone in the deep capillary plexus for DM1 (p = 0.002) and deep macular and perifoveal zone for DM2 (p = 0.007, p = 0.001, respectively). The foveal avascular zone showed no significant differences between DM1 and DM2 compared to their control groups (p = 0.320 and p = 0.945, respectively).
    CONCLUSIONS: Our results show that DM is associated not only with the classic pigmentary changes but also with superficial and deep retinal microvasculature abnormalities, suggesting that these changes may be related to local hypoperfusion. Optical coherence tomography angiography is a useful tool for the diagnosis and characterization of retinal changes in DM and should be part of the standard evaluation of these patients.
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  • 文章类型: Journal Article
    目的:通过光学相干断层扫描血管造影术(OCTA),确定类固醇治疗前后活动性甲状腺眼眶病变(TO)患者的乳头周围和黄斑区的微血管和结构变化,并与非活动性TO和对照组进行比较。
    方法:这项横断面研究包括17名活跃TO患者的34只眼,54名不活跃患者的108只眼,和30只健康对照的60只眼。中央黄斑厚度(CMT),神经节细胞层-内网状层(GCL-IPL)厚度,中央脉络膜厚度(CCT),视网膜神经纤维层(RNFL)厚度,脉络膜厚度在乳头周围区域,浅表毛细血管丛(SCP),通过OCTA在活动性TO病例的12周类固醇治疗前后测定深毛细血管丛(DCP)和脉络膜毛细血管密度,不活动的TO和控制组。
    结果:在黄斑OCTA的三组之间,在SCP的下象限和鼻象限中观察到统计学上的显着差异(所有p=0.01),仅在颞侧象限脉络膜上观察到差异(p=0.005)。在乳头周围OCTA中,仅在中央脉络膜毛细血管中发现了统计学上的显着差异(p=0.03)。在活性组治疗前后的比较中,CMT和CCT有统计学上的显著下降;GCL-IPL有统计学上的显著增加(所有p<0.01)。SCP和DCP仅在中部有统计学上的显著下降(均p<0.01)。在治疗后的测量中,下象限黄斑SCP血管密度和平均黄斑DCP有统计学上的显着增加(分别为p=0.01和p=0.03)。治疗后乳头周围SCP和DCP血管密度增加(p<0.01)。
    结论:主动TO组血管密度低于不活动组,治疗后,血管密度增加。使用OCTA对视网膜和视神经盘灌注进行非侵入性定量分析可用于并发症发生之前的早期治疗和TO患者的监测。
    OBJECTIVE: To determine the microvascular and structural changes in the peripapillary and macular areas observed in patients with active thyroid orbitopathy(TO) before and after steroid treatment and compare with inactive TO and the control group by optical coherence tomography angiography (OCTA).
    METHODS: This cross-sectional study included 34 eyes of 17 active TO patients, 108 eyes of 54 inactive TO patients, and 60 eyes of 30 healthy controls. Central macular thickness (CMT), ganglion cell layer-inner plexiform layer (GCL-IPL) thickness, central choroidal thickness (CCT), retinal nerve fiber layer (RNFL) thickness, choroidal thickness in the peripapillary region, superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris vessel densities were determined by OCTA in before and after 12-week steroid treatment of active TO cases, inactive TO and control groups.
    RESULTS: Between the three groups in macula OCTA, a statistically significant difference was observed in the inferior and nasal quadrants in SCP (all p = 0.01) and only in the temporal quadrant choriocapillaris (p = 0.005). In peripapillary OCTA, a statistically significant difference was found only in the central choriocapillaris (p = 0.03). In the comparison of the active group before and after treatment, there was a statistically significant decrease in CMT and CCT; a statistically significant increase was observed in GCL-IPL (all p < 0.01). There was a statistically significant decrease in SCP and DCP only in the central (all p < 0.01). There was a statistically significant increase was found in the lower quadrant macular SCP vessel density and mean macular DCP in post-treatment measurements (p = 0.01 and p = 0.03, respectively). Peripapillary SCP and DCP vessel density was increased after treatment (p < 0.01).
    CONCLUSIONS: Active TO group had lower vessel density than inactive group and after treatment, vessel density was increased. Non-invasive quantitative analysis of retinal and optic disc perfusion using OCTA could be useful in early treatment before complications occur and monitoring patients with TO.
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