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光学相干断层扫描血管造影在评估地理性萎缩区域扩展中的应用 Optical Coherence Tomography Angiography in the Evaluation of Geographic Atrophy Area Extension

Corbelli, E., Sacconi, R., Rabiolo, A., et al.

期刊名称:Investigative Ophthalmology & Visual Science

卷期:2017年第58卷第12期

关键词:
断层 光学 血管

摘要

摘要:目的:旨在探讨光学相干断层扫描血管造影(OCT-A)在老年黄斑变性(AMD)继发性地理性萎缩(GA)中的应用价值。方法:前瞻性纳入GA患者,使用蓝色自发荧光(FAF),en face结构性OCTOCT-A进行分析。 使用整个脉络膜切片采集OCT-A图像,获取椭圆体区(EZ),脉络膜(CH)水平和巩膜(SC)水平的en face结构性OCT图像。由三位阅读者独立测量GA扩展区域,并评估每次检查中的中心凹。结果:共纳入47GA(使用FAF测量的平均面积:8.77±5.00 mm2)眼(26例患者,平均年龄76±7岁)。所有的影像学技术的观察者和观察者间的一致性都很好(同类相关系数 [ICC]> 0.985,即使面对EZ结构的OCT显示质量一致性限制最差)。 考虑到两种成像技术之间的分析,与FAF相比,ICCOCT-A方面表现优异(ICC0.995),其次是CH水平(ICC0.992),SCICC0.986 EZ级(ICC0.973)的en face 结构性OCT 多焦和单焦GA病变之间没有检测到差异。 考虑到中心凹参与评估,FAF和所有其他影像技术之间的一致性较低。结论:与目前的成像技术相比,OCT-A是一种可靠的技术,可以方便地对GA进行可视化和量化, 关于视网膜和脉络膜层的血流信息并排除脉络膜新血管形成。)。考虑到两种成像技术之间的分析,ICCFAFICC0.995)相比在OCT-A方面表现优异,其次是CH结构OCTICC0.992),SC级别(ICC0.986)和EZ级(ICC0.973)。在多焦点和单焦点GA病变之间没有检测到差异。考虑到中心凹参与的评估,FAF和所有其他影像技术之间的协议较低。结论:OCT-A是一种可靠的技术,可以方便地对GA进行可视化和量化,可提供关于视网膜和脉络膜层的结构和血流信息,并排除脉络膜新血管形成。

Purpose:To investigate the application of optical coherence tomography angiography (OCT-A) in evaluation of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).Methods:Patients with GA were prospectively enrolled and studied with blue fundus autofluorescence (FAF), en face structural OCT, and OCT-A. OCT-A images were acquired using a slab of whole choroid, whereas en face structural OCT images were obtained at the ellipsoid zone (EZ), at the choroidal (CH) level, and at the scleral (SC) level. Three readers independently measured the GA extension areas and evaluated the foveal sparing in each examination. Intraobserver/interobserver agreements and agreement between each couple of imaging techniques were assessed.Results:A total of 47 eyes (26 patients, mean age 76 ± 7 years) with GA (mean area using FAF: 8.77 ± 5.00 mm2) were included. Intraobserver and interobserver agreement was excellent for all imaging techniques (intraclass correlation coefficient [ICC] > 0.985), even if en face EZ structural OCT revealed the poorest quality agreement limits. Considering the analysis between each couple of imaging techniques, ICC was excellent between OCT-A compared with FAF (ICC: 0.995), followed by en face structural OCT at CH level (ICC: 0.992), at SC level (ICC: 0.986), and at EZ level (ICC: 0.973). No differences were detected between multifocal and monofocal GA lesions. Considering the evaluation of foveal involvement, lower agreements were disclosed between FAF and all other imaging techniques.Conclusions:OCT-A is a reliable technique for easily visualizing and quantifying GA with the advantages, compared to current imaging techniques, of offering together both structural and blood flow information regarding retinal and choroidal layers and excluding choroidal neovascularization.


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