息肉状脉络膜血管病变的光相干断层扫描血管成像检查特征

Evaluation of polypoidal choroidal vasculopathy with optical coherence tomography angiography

目的观察息肉状脉络膜血管病变(PCV)息肉病灶和脉络膜分支血管网(BVN)的光相干断层扫描血管成像(OCTA)特征。方法采用系列病例观察研究设计,收集2016年5月至2017年4月在北京协和医院就诊的未经治疗的PCV患者42例45眼,其中男26例27眼,女16例18眼;平均年龄为(68.59±8.52)岁。所有患眼均行荧光素眼底血管造影(FFA)、吲哚菁绿血管造影(ICGA)和OCTA检查,观察息肉和BVN的OCTA影像特征,并计算其OCTA的检出率。结果所有PCV患者ICGA图像上均可观察到明确的高荧光息肉病灶,其中38眼的ICGA图像上可观察到BVN结构。OCTA图像显示息肉为点状、环状、团簇状或结节状高反射信号,共检测出45眼中35眼的息肉病灶信号,检出率为77.8%。OCTA能清晰显示38眼的BVN血管结构,检出率为100.0%。结论OCTA能无创地显示PCV的息肉病灶和BVN结构,结合en face图像和B扫描图像能实现对病灶的定位。

Objective To investigate the characteristics of polypoidal lesions and abnormal branching vascular network(BVN)in patients with polypoidal choroidal vasculopathy(PCV)by optical coherence tomography angiography(OCTA).Methods A case series study was conducted.Untreated 45 eyes of 42 patients with initial diagnosis of PCV from May 2016 to April 2017 in Peking Union Medical College Hospital were enrolled.There were 26 males(27 eyes)and 16 females(18 eyes)with the average age of(68.59±8.52)years.All patients underwent fundus fluorescein angiography(FFA),indocyanine green angiography(ICGA)and OCTA.The OCTA image features and detection rate of polypoidal lesion and BVN were analyzed.The study protocol was approved by the Ethics Committee of Peking Union Medical College Hospital(No.S-K631).Written informed consent was obtained from each patient prior to any examination.Results ICGA images showed obvious polyps with higper fluorescence in all PCV patients,and BVN structure was observed in the ICGA images of 38 eyes.Ring,circle,cluster or node like hyper-reflective structures were detected in polypoidal lesions in the en face OCTA images of 35 eyes,and the detection rate was 77.8%(35/45).The BVN structure was detected in the OCTA images of all the 38 eyes,with the 100%(38/38)detection rate.Conclusion OCTA can detect polypoidal lesions and BVN of PCV non-invasively,which can locate the lesion in combination with en face image and B-scan image.