Asymmetric choroidal vascular pattern in tilted disc syndrome.

IF 2.4 3区 医学 Q2 OPHTHALMOLOGY
Kyosuke Nonaka, Ichiro Maruko, Mizuha Kakehashi, Moeko Kawai, Taiji Hasegawa, Tomohiro Iida
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引用次数: 0

Abstract

Purpose: To observe the choroidal vasculature in patients with tilted disc syndrome (TDS) using en face optical coherence tomography (OCT) and to evaluate the symmetry of the choroidal vascular pattern in the macular area.

Methods: En face OCT was performed using a Plex Elite 9000 (Zeiss) with a 12 × 12 mm image of the macula, which was flattened with retinal pigment epithelium and segmented into choroidal layers. The middle/large choroidal vessels were evaluated for vertical symmetry qualitatively by the retina specialist coauthors and quantitatively by binarization analysis of choroidal vessel density and mean vessel diameter.

Results: The 2 cases and 4 eyes (19.0%) that were difficult to segment due to the severe slope of the macular area were excluded. Of the 17 eyes in the remaining 13 cases, asymmetric middle/large choroidal vessels were observed in all eyes. Vessel density (P = 0.01) and mean vessel diameter (P < 0.01) of the choroidal middle/large vessels were significantly higher in the superior than in the inferior choroidal segmentation. Serous retinal detachment was observed in 4 eyes, all asymmetric cases.

Conclusion: Vertical asymmetry of the middle and large choroidal vessels is observed in most TDS patients. Circulatory imbalance due to choroidal vascular abnormalities in TDS may be one of the causes of serous retinal detachment.

Key messages: What is known: Tilted disc syndrome is the congenital disease with ocular morphologic abnormalities associated with incomplete closure of the embryonic fissure of the eye at the inferior optic nerve head  Vertical cross-sectional optical coherence tomography images revealed that the choroid above the macula in tilted disc syndrome is relatively thickened, whereas the choroid within the inferior staphyloma is thinning.

What is new:   Evaluation of choroidal vascularity in tilted disc syndrome by en face optical coherence tomography revealed qualitatively and quantitatively highly dense choroidal vessels in the superior region, with larger diameter choroidal vessels than in the inferior region, and vertical asymmetry with an upward predominance.  Choroidal circulatory imbalance due to vertical asymmetry of the choroidal vessels may be one of the causes of serous retinal detachment in tilted disc syndrome.

倾斜椎间盘综合征的非对称脉络膜血管模式。
目的:使用正面光学相干断层扫描(OCT)观察倾斜盘综合征(TDS)患者的脉络膜血管,并评估黄斑区脉络膜血管形态的对称性:使用 Plex Elite 9000(蔡司)进行正面光学相干断层扫描,获得 12 × 12 毫米的黄斑图像,将黄斑与视网膜色素上皮压平并分割成脉络膜层。视网膜专家共同作者对中/大脉络膜血管的垂直对称性进行了定性评估,并对脉络膜血管密度和平均血管直径进行了二值化定量分析:排除了因黄斑区严重倾斜而难以分割的 2 例和 4 眼(19.0%)。在其余 13 个病例的 17 只眼睛中,所有眼睛都观察到了不对称的中/大脉络膜血管。血管密度(P = 0.01)和平均血管直径(P = 0.01)均为正常:大多数 TDS 患者的脉络膜中血管和大血管垂直方向不对称。TDS 中脉络膜血管异常导致的循环失衡可能是浆液性视网膜脱离的原因之一:已知:倾斜视盘综合征是一种先天性眼部形态异常疾病,与视神经下端眼球胚胎裂孔未完全闭合有关。垂直横断面光学相干断层扫描图像显示,倾斜视盘综合征患者黄斑上方的脉络膜相对增厚,而下葡萄状瘤内的脉络膜变薄。新发现:通过正面光学相干断层扫描对倾斜椎间盘综合征的脉络膜血管进行评估,发现上部区域的脉络膜血管在质和量上都高度密集,脉络膜血管直径大于下部区域,而且垂直方向不对称,以向上为主。 脉络膜血管垂直不对称导致的脉络膜循环失衡可能是倾斜视盘综合征浆液性视网膜脱离的原因之一。
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来源期刊
CiteScore
5.40
自引率
7.40%
发文量
398
审稿时长
3 months
期刊介绍: Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.
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