不同类型脉络膜新生血管光学相干断层扫描血管成像(OCTA)的图像特征

Image characteristics of different types of choroidal neovascularization on optical coherence tomography angiography

目的观察不同类型脉络膜新生血管(choroidal neovascularization,CNV)光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)的图像特征,探讨OCTA在CNV诊治中的作用。方法回顾性分析经荧光素眼底血管造影联合吲哚菁绿血管造影确诊的未经治疗的黄斑部Ⅰ型及Ⅱ型CNV患者的OCTA图像,观察不同类型CNV的OCTA图像特点,采用Image J图像分析软件测量不同类型CNV在OCTA图像上的异常血管面积。结果31例31眼患者符合纳入标准,其中男19例、女12例;Ⅰ型CNV 17眼,血管构型较疏松,形状不规则,异常血管长、直,面积较大,为(1.565±1.400)mm 2;Ⅱ型CNV 14眼,血管分支浓密,多呈圆形或类圆形,异常血管相对粗短,呈绒球状构型,面积较小,为(0.418±0.374)mm 2。Ⅰ型CNV和Ⅱ型CNV异常血管面积比较,差异有统计学意义(P=0.008)。结论不同类型的CNV有不同的OCTA图像特征,这些特征与荧光素眼底血管造影和(或)吲哚菁绿血管造影所显示的特征一致。OCTA可作为CNV诊断、分型的重要工具。

Objective To observe the image characteristics of optical coherence tomography angiography(OCTA)in different types of choroidal neovascularization(CNV),and to explore the roles of OCTA in the diagnosis and treatment of CNV.Methods The OCTA images of untreated patients with typeⅠand typeⅡCNV in macular region confirmed by fluorescein fundus angiography and indocyanine green angiography were retrospectively analyzed.The characteristics of OCTA images of different types of CNV were observed.The abnormal blood vessel area of different types of CNV on OCTA images was measured by Image J.Results Totally 31 eyes of 31 patients met the inclusion criteria,including 19 males and 12 females;17 eyes of type I CNV had looser vascular configuration,irregular shape,long and straight abnormal blood vessels with a larger area of(1.565±1.400)mm 2;14 eyes of typeⅡCNV had dense vascular branches,mostly round or quasi-circular,relatively thick and short abnormal blood vessels with a smaller area of(0.418±0.374)mm 2.There was a significant difference in the area of abnormal vessels between type I CNV and typeⅡCNV(P=0.008).Conclusion Different types of CNV have different characteristics of OCTA images,which are consistent with the characteristics of fluorescein angiography and/or indocyanine green angiography,so OCTA can be used as an important tool for diagnosing and typing CNV.