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使用光学相干中层毛细血管造影描述健康和糖尿病眼特征

Park JJ, Soetikno BT, Fawzi AA

期刊名称:Retina

卷期:2016年第36卷第11期

摘要

目的:旨在评估光学相干断层扫描血管造影对视网膜中层毛细血管丛(MCP)成像的能力,并描述MCP作为从浅表和深层毛细血管丛(DCP)分离的一种独特血管网络的特征。方法:使用Avanti XR光学相干断层扫描血管造影仪(Optovue IncFremontCA)对健康和糖尿病眼进行成像检查。使用手动视网膜分层,作者创造了一种面部血管造影以区分三个毛细血管丛(浅表毛细血管丛,MCPDCP)。结果:在健康眼的中,小动脉可显示MCP不同的分支,小静脉可显示DCP中突出的涡状分支。中心凹无血管区在MCP水平最明显,并且在DCP中具有更大的面积。在糖尿病眼中,三个毛细血管丛表现出不同程度的非灌注,包括中央凹无血管区的可变形状和程度,伴有MCP边界完整性缺失。所有三种毛细血管丛均可见微动脉瘤。结论:在光学相干断层扫描血管造影中使用定制的分割分析,作者发现MCP在质量和功能上不同于浅表毛细血管丛和DCP,这可以帮助澄清不同中度视网膜缺血性病变的发病机理并为糖尿病视网膜病变的视网膜缺血提供新的见解。

PURPOSE:To assess the ability of optical coherence tomography angiography to image the retinal middle capillary plexus (MCP), and to characterize the MCP as a unique vascular network separate from the superficial and deep capillary plexus (DCP).METHODS:Healthy and diabetic eyes were imaged using the Avanti XR optical coherence tomography angiography instrument (Optovue Inc, Fremont, CA). Using manual segmentation of the retinal layers, the authors generated en face angiograms to distinguish the three capillary plexuses (superficial capillary plexus, MCP, DCP).RESULTS:In healthy eyes, arterioles gave rise to distinct branches in the MCP, and venules gave rise to prominent vortex like branches in the DCP. The foveal avascular zone was most well-defined at the level of the MCP, and had a larger area in the DCP. In diabetic eyes, the three capillary plexuses showed varying degrees of nonperfusion, including variable shapes and extent of the foveal avascular zone, with loss of border integrity at the MCP. Microaneurysms appeared in all the three capillary plexuses.CONCLUSION:Using customized segmentation analysis in optical coherence tomography angiography, the authors demonstrate that the MCP is qualitatively and functionally distinct from the superficial capillary plexus and DCP, which may help clarify the pathogenesis of different middle retinal ischemic entities and provide new insights into retinal ischemia in diabetic retinopathy.


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