光学相干断层扫描血管造影术在治疗新生血管性年龄相关性黄斑变性中的应用——当前观点

IF 0.9 Q4 OPHTHALMOLOGY
R. Schwartz, Nicola Cronbach, H. Madi, R. Reynolds, U. Chakravarthy
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引用次数: 0

摘要

光学相干断层扫描血管造影术(OCTA)是一种相对较新的成像方式,可以对视网膜和脉络膜血管系统进行可视化。虽然传统上只有通过基于染料的成像技术(荧光素血管造影术(FA)和吲哚菁绿血管造影学(ICG))才能实现这一点,但OCTA提供了一种快速、无创的替代方案,易于重复,可用于在单次扫描中对视网膜和脉络膜血管系统成像,而无需注射染料。OCTA的另一个优点是它能够对视网膜组织的反射数据进行深度分辨评估,提供三维信息量。视网膜和脉络膜的毛细血管网从浅表毛细血管丛到脉络膜排列成形态上不同的层。在新生血管性年龄相关性黄斑变性(nAMD)的情况下,这使临床医生能够确定是否存在新生血管网络,其在视网膜/脉络膜内的相对位置,以及通过多次访问重复OCTA扫描,该网络是否正在改变。然而,目前没有单一的标准来获取或解释OCTA数据。第一台商用OCTA机器(AngioVue,Optovue,Fremont,CA)于2014年推出,基于频域OCT(SD-OCT)。后续OCTA装置基于SD-OCT或扫描源OCT(SS-OCT)。SD-OCT和SS-OCT都是傅立叶域OCT的类型,但它们的光源、波长和光电探测器不同,这导致视网膜和脉络膜内不同级别的扫描速度和成像分辨率不同。与SD-OCT扫描相比,SS-OCT的波长更长(约1050 nm,而SD-OCT的波长约840 nm)和灵敏度下降使得能够获得高分辨率OCTA成像,尤其是视网膜色素上皮下的新生血管网络。SS-OCT更快的扫描速度也允许对更大的区域进行成像。然而,不同的设备使用不同的算法来处理和分割所获取的数据,因此产生的图像存在差异。OCTA技术的不断进步和图像质量的提高导致OCTA在全球范围内越来越多地用于临床目的,特别是用于黄斑新生血管的诊断和监测[1]。在这篇文章中,我们讨论了OCTA在nAMD中的作用,以及它如何在nAMD的诊断和管理中对临床医生有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The utility of optical coherence tomography angiography in the management of neovascular age-related macular degeneration – current perspective
Optical coherence tomography angiography (OCTA) is a relatively new imaging modality that allows visualization of the retinal and choroidal vasculature. While this has traditionally only been possible through dye-based imaging techniques (fluorescein angiography (FA) and indocyanine green angiography (ICG)), OCTA offers a fast and noninvasive alternative that is readily repeatable and can be used to image the retinal and choroidal vasculature in a single scan without the need for dye injection. Another advantage of OCTA is its ability to produce depthresolved evaluation of the reflectance data from retinal tissue, providing a three-dimensional volume of information. The retinal and choroidal capillary networks are arranged into morphologically distinct layers, from the superficial capillary plexus to the choroid. In the case of neovascular age-related macular degeneration (nAMD), this enables the clinician to determine whether a neovascular network is present, its relative position within the retina/choroid and, with the use of repeated OCTA scans over multiple visits, whether this network is changing. However, there is currently no single standard for acquisition or interpretation of OCTA data. The first commercial OCTA machine (AngioVue, Optovue, Fremont, CA) was introduced in 2014 and was based on spectral domain OCT (SD-OCT). Subsequent OCTA devices have been based on either SD-OCT or swept source OCT (SS-OCT). SD-OCT and SS-OCT are both types of Fourier domain OCT but differ in their light source, wavelength, and photodetector, which results in differences in scanning speeds and resolution of imaging at the various levels within the retina and choroid. The longer wavelength of SS-OCT (~1050 nm, vs ~840 nm for SD-OCT) and reduced sensitivity rolloff enables acquisition of high-resolution OCTA imaging particularly of neovascular networks below the retinal pigment epithelium compared with SD-OCT scanning. The quicker scanning speeds of SS-OCT also allow for a larger area to be imaged. However, different devices utilize different algorithms to process and segment the data acquired, and therefore there are differences in the images produced. Continuous advances in OCTA technology and improvements in the quality of images produced have led to increasing use of OCTA globally for clinical purposes, particularly for the diagnosis and monitoring of macular neovascularization [1]. In this article, we discuss the role of OCTA in nAMD and how it can be of use to clinicians in the diagnosis and management of nAMD.
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来源期刊
Expert Review of Ophthalmology
Expert Review of Ophthalmology Health Professions-Optometry
CiteScore
1.40
自引率
0.00%
发文量
39
期刊介绍: The worldwide problem of visual impairment is set to increase, as we are seeing increased longevity in developed countries. This will produce a crisis in vision care unless concerted action is taken. The substantial value that ophthalmic interventions confer to patients with eye diseases has led to intense research efforts in this area in recent years, with corresponding improvements in treatment, ophthalmic instrumentation and surgical techniques. As a result, the future for ophthalmology holds great promise as further exciting and innovative developments unfold.
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