OCTA在病理性近视脉络膜新生血管应用及其在人工智能的研究进展

Application of optical tomography angiography and artificial intelligence in choroidal neovascularization secondary to pathologic myopia

病理性近视(pathological myopia,PM)近年来发病率增高,是世界范围内导致视力障碍的主要原因,其不仅成为全球性的公共卫生问题,并且造成了沉重的社会负担。脉络膜新生血管(choroidal neovascularization,CNV)是PM的最严重并发症之一,它可以引起眼底黄斑区病变,导致视力下降,出现暗点,视物变形,视野缺损等,如长期不治疗可能导致失明。光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)技术是一种对视网膜、脉络膜自动精确分层,通过量化血流面积、无血流面积和血流密度区域,对视网膜、脉络膜多层面进行定性、定量的检查工具。OCTA在诊断PM继发的CNV中起到很大帮助,可以较为明确地显示新生血管的位置大小等。目前对于PM引起的CNV主要治疗方法有光动力治疗及抗血管内皮生长因子治疗,OCTA可以评估PM-CNV治疗效果,论文主要就近期关于OCTA在PM-CNV的诊断及治疗中应用的研究进行综述,并讨论其与人工智能相结合进行脉络膜显像时存在的问题与发展前景,以期为临床开展相关工作提供参考。

In recent years,the incidence of pathological myopia(PM)has increased.PM is a global eye-blinding problem and a heavy social burden.Choroidal neovascularization(CNV)is a severe complication of PM that can cause macular disorders.This may lead to central scotoma,metamorphopsia,visual field loss,and eventually blindness if left treated.Optical coherence tomography angiography(OCTA)provides an automatic and accurate visualization of the layers of the retina and choroid,which allows a qualitative and quantitative description of the microvascular areas of the retina and choroid.OCTA can be used to detect the pathogenesis of high myopia,at the microvascular level of the retina.OCTA helps diagnose CNV secondary to PM due to its ability to show the position and size of the CNV.As management,photodynamic and anti-vascular endothelial growth factor therapies have been used.OCTA can be used to evaluate the therapeutic effect of PM-CNV.This article provides an overview of the current research options on the diagnosis and treatment of CNV and discusses the problems and prospects when they are combined with artificial intelligence for choroidal imaging,to provide reference for clinical work.