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Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians
摘要： Purpose: To investigate myopic choroidal neovascularization (mCNV) by fluorescein angiography (FA), spectral-domain optical coherence tomography (SD-OCT), near-infrared (NIR) reflectance, and autofluorescence (AF). Methods: This retrospective study included 65 eyes of 62 Caucasian patients with a mean age of 66.72 years (95% confidence interval [CI] 63–70 years) and a mean refraction of -9.72 diopters (95% CI -8.74 to -10.70 diopters). Results: Most of the mCNV cases were foveal-juxtafoveal (60/65, 92.3%), with thickening of the corresponding retina (62/65, 95.3%) and leakage on FA (44/65, 67.6%). No retinal fluid was detectable in 32 (49.2%) eyes and there was no hemorrhage in 25 (38.4%) eyes. Papillary chorioretinal atrophy was evident in 58 (89.2%), a shadowing effect in 48 (73.8%), and an epiretinal membrane in 38 (58.4%) eyes. If an area of macular chorioretinal atrophy was present, mCNV frequently developed adjacent to it and was hyperfluorescent rather than with leakage (P<0.001). In eyes with edema or hemorrhage, hyper-reflective foci were more frequent (P<0.005). NIR and AF features were indeterminable in 19 (29.2%) and 27 (41.5%) eyes, respectively. The predominant feature was black or grayish on NIR (34/65, 52.3%) and patchy (hypo- and hyperfluorescence was observed) on AF (25/65, 38.4%). FA and SD-OCT correctly detected mCNV in 49 (75.3%) and 48 (73.8%) eyes, respectively, whereas NIR and AF exhibited limited diagnostic sensitivity. Doubtful diagnosis was associated with hyperfluorescent mCNV (P<0.001), absence of retinal fluid and epiretinal membrane (P<0.05), and presence of macular chorioretinal atrophy (P<0.01). Conclusion: Tomographic, angiographic, AF, and NIR features of mCNV are described in this study. Combination of SD-OCT and FA is recommendable for diagnosis.
关键词： fluorescein angiography,pathologic myopia,myopic neovascularization,SD-OCT,CNV,imaging
更新于2025-09-04 15:30:14
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Effectiveness of Glaucoma Diagnostic Parameters from Spectral Domain-Optical Coherence Tomography of Myopic Patients
摘要： 目的：目前频域光学相干成像（SD?OCT）可作为青光眼诊断的新工具。因此本文评价了SD?OCT所提供的青光眼诊断参数在不同屈光度近视患者中的诊断能力。 方法：横断面研究。共有248例受试者（248眼）入选。包括早期开角型青光眼组51，正常人组79例（±0.50D之内），低度近视组47例（?0.50 D to ?3.00 D（不包括）），中度近视组43例（?3.00 D to ?6.00 D（不包括）），高度近视组28例（≤?6.00 D）。所有受试者均行眼科常规检查及Humphrey 视野计、SD?OCT检查，将OCT检查所获得的视网膜神经纤维层(RNFL)和节细胞复合体（GCC））的相关参数进行统计学分析，分别绘制受试者操作曲线（ROC）并计算曲线下面积（AUC）。 结果：AUC结果如下：正常人、低度近视眼组的AUC最佳参数均为下方、颞下方RNFL厚度（AUC均﹥0.94），而中度近视、高度近视组的最佳参数均为颞下方参数（AUC分别为0.926，0.896），而中度近视组下方参数的AUC较?。?.864）排在所有RNFL参数的第15位。对文献中公认的诊断青光眼能力强的参数（下方、颞下方、颞上方）进行进一步分析，当灵敏度为85%时，这些参数在正视眼、低度近视眼组的特异度较高，均大于80%，而在中度近视、高度近视组特异度均较低，约在20%～60%。根据机器数据库所得绿色部分在高度近视组也较其他组少（P < 0.05）。 结论：SD?OCT的青光眼诊断参数在应用于中高度近视眼时的诊断能力较弱，特异度明显偏低，对中高度近视者进行青光眼的诊断时需综合分析。同时建议SD?OCT的正常人数据库应针对不同屈光度进行补充完善。
关键词： Glaucoma,Retina,Myopia,Nerve Fibers,Open Angle
更新于2025-09-04 15:30:14