INTRODUCTION:New diagnostic tools such as the retinal thickness analyzer (RTA), optical coherence tomography (OCT), and topographic angiography (TAG) were introduced into clinical ophthalmology during the last years giving the examiner new insights into anatomical and functional aspects of macular disease. In this study, advantages and disadvantages of the new imaging methods have been evaluated in patients with serous (sPED) and fibrovascular pigment epithelial detachments (fPED) secondary to age-related macular degeneration (AMD). METHODS:TAG, using fluorescein angiography (FA), provides a three-dimensional profile of the fluorescein pattern based on the analysis of a set of 32 confocal images over a depth of 4 mm. RTA and OCT provide cross-sectional images of the neurosensory retina and the retinal pigment epithelium-choriocapillary complex as well as retinal thickness data encoded in a false color map. We compared and evaluated these modalities in 15 patients with fPED and 15 patients with sPED secondary to AMD. RESULTS:In patients with classic fPED, TAG detected neovascular structures and delineated their configuration. In sPEDs, pooling of extravascular fluid was detected in a dome-shaped configuration. OCT provided detailed information on the neurosensory retina's structures but failed to detect the neovascular membrane in fPED. Mapping the retinal thickness, RTA and OCT both failed to detect the PED and showed typical algorithm error-based patterns. CONCLUSION:TAG OCT and RTA are useful imaging modalities in the evaluation of AMD cases. TAG visualizes the vascular configuration, dynamic perfusion, and leakage changes. OCT and RTA are able to complementarily document intra-, subretinal, and sub-RPE fluid accumulation secondary to CNV. However, OCT seems to be more efficient in imaging AMD-related pathologies than RTA, as this modality is often compromised by intra- or subretinal structural abnormalities. Nevertheless, all modalities may provide further valuable insight into AMD pathogenesis, enhance diagnostic quality, and improve the assessment of therapeutic effects.

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简介:最近几年,新的诊断工具,例如视网膜厚度分析仪(RTA),光学相干断层扫描(OCT)和地形血管造影(TAG)被引入临床眼科,为检查者提供了对黄斑疾病的解剖学和功能方面的新见解。在这项研究中,新的影像学方法的优缺点已经在患有年龄相关性黄斑变性(AMD)的浆液性(sPED)和纤维血管色素上皮脱离(fPED)的患者中进行了评估。
方法:TAG使用荧光素血管造影(FA),基于在4 mm深度上对一组32个共焦图像的分析,提供了荧光素图案的三维轮廓。 RTA和OCT提供了神经感觉视网膜和视网膜色素上皮-脉络膜毛细血管复合体的横截面图像,以及以伪彩色图编码的视网膜厚度数据。我们对15名fPED患者和15名sPED继发于AMD的患者进行了比较和评估。
结果:在经典fPED患者中,TAG检测出新血管结构并描绘出其构型。在sPED中,以圆顶形配置检测到了血管外积液。 OCT提供了有关神经感觉视网膜结构的详细信息,但未能检测到fPED中的新生血管膜。绘制视网膜厚度,RTA和OCT都无法检测到PED,并显示了典型的基于错误的算法模式。
结论:TAG OCT和RTA是评估AMD病例的有用影像学手段。 TAG可视化血管结构,动态灌注和渗漏变化。 OCT和RTA能够补充记录CNV继发的视网膜内,视网膜下和亚RPE液积聚。但是,OCT似乎比RTA更能有效地成像AMD相关的病变,因为这种方式通常会受到视网膜内或视网膜下结构异常的损害。尽管如此,所有方式都可能提供有关AMD发病机理的进一步有价值的见解,提高诊断质量,并改善对治疗效果的评估。

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