在诊断年龄相关性黄斑变性的早期黄斑萎缩方面，OCT B 扫描与面阵成像之间的比较。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-10-09 DOI:10.1016/j.ajo.2024.10.002

Yuxuan Cheng , Monika Fleckenstein , Marc Steffen Schmitz-Valckenberg , Jie Lu , Ziyu Liu , Gissel Herrera , Giovanni Gregori , Ruikang K. Wang , Philip J. Rosenfeld , Omer Trivizki

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引用次数: 0

摘要

目的：比较光谱域光学相干断层扫描（SD-OCT）B扫描上完全性视网膜色素上皮和外层视网膜萎缩（cRORA）和不完全性视网膜色素上皮和外层视网膜萎缩（iRORA）的分级与扫源OCT血管造影（SS-OCTA）正面图像上持续性脉络膜高透射缺损（hyperTDs）的分级：前瞻性研究数据的比较诊断分析方法：晚期非渗出性 AMD 患者当天使用 SD-OCT (Spectralis® Heidelberg, 512 × 97, ART:9) 和 SS-OCTA (PLEX® Elite 9000, Carl Zeiss Meditec, 500 × 500 angio pattern) 仪器进行 6 × 6 mm 黄斑扫描。SS-OCTA 和 SD-OCT 正面图像由位于布氏膜下 64-400 μm 处的视网膜下色素上皮层片生成。莫兰眼科中心进行了 SD-OCT B 扫描分级，包括检查邻近的 B 扫描，以诊断 cRORA 和 iRORA；巴斯康帕尔默眼科研究所和特拉维夫医学中心则进行了环面图像分级，以识别持续性脉络膜超视网膜病变：结果：cRORA 病变和持续性脉络膜过度TD 的分级结果高度一致（99.6%）。然而，有 27.4% 的 iRORA 病变被发现包含在持续性 hyperTDs 中。这一差异是由于发现 27.5% 的 iRORA 病变在 B 扫描中被诊断为最大线性水平尺寸小于 250 µm，但在全脸图像中，这些 B 扫描定义的 iRORA 病变被发现在非水平尺寸上的最大线性尺寸≥ 250 µm：本报告展示了使用全脸 OCT 成像识别 cRORA 病变的好处，并强调了在识别 iRORA 病变时，需要获取密集的光栅 B 扫描，并对相邻 B 扫描进行分级，以评估 iRORA 病变在非水平维度的全部范围。即使检查了邻近的 B 扫描，但在使用面内策略分级时，仍有 27.5% 的 iRORA 病变实际上是更大的 cRORA 病变的一部分。

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Comparison Between Optical Coherence Tomography B-scan and En Face Imaging for the Diagnosis of Early Macular Atrophy in Age-Related Macular Degeneration

PURPOSE

The gradings of complete retinal pigment epithelium (RPE) and outer retinal atrophy (cRORA) and incomplete RPE and outer retinal atrophy (iRORA) on spectral domain optical coherence tomography (SD-OCT) B-scans were compared with the grading of persistent choroidal hypertransmission defects (hyperTDs) on swept-source optical coherence tomography angiography (SS-OCTA) en face images.

DESIGN

Comparative diagnostic analysis of prospective study data.

METHODS

Patients with late nonexudative age-related macular degeneration underwent same-day 6×6-mm macular scans using both SD-OCT (Spectralis Heidelberg, 512×97, automatic real-time tracking: 9) and SS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec, 500×500 angio pattern) instruments. SS-OCTA and SD-OCT en face images were generated from a sub-RPE slab positioned 64 to 400 µm below Bruch's membrane. SD-OCT B-scan gradings, which included an inspection of neighboring B-scans for the diagnosis of cRORA and iRORA, were performed at the Moran Eye Center, and gradings of en face images to identify persistent choroidal hyperTDs were performed at the Bascom Palmer Eye Institute and Tel Aviv Medical Center.

RESULTS

There was a high degree of agreement (99.6%) between the gradings of cRORA lesions and persistent hyperTDs. However, 27.4% of iRORA lesions were found to be contained within persistent hyperTDs. This discrepancy was due to the finding that 27.5% of iRORA lesions were diagnosed as having a greatest linear horizontal dimension of <250 µm on B-scans, but on en face images, these B-scan–defined iRORA lesions were found to have the greatest linear dimensions in the nonhorizontal dimension that were ≥250 µm.

CONCLUSIONS

This report demonstrates the benefits of using en face OCT imaging to identify cRORA lesions and highlights the need to acquire dense raster B-scans with the grading neighboring B-scans when identifying iRORA lesions to assess the full extent of the iRORA lesions in the nonhorizontal dimension. Although neighboring B-scans were inspected, 27.5% of iRORA lesions were actually part of larger cRORA lesions when graded using an en face strategy.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.