光相干断层扫描血管成像与传统多模式眼底成像对渗出型老年性黄斑变性脉络膜新生血管诊断与活动性判断的对比观察  

Optical coherence tomography angiography and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization in exudative age-related macular degeneration

作　　者：孙晓丽[1] 丛春霞[1] 李立[1] 解世勇[1] 韩梅[1] 

机构地区：[1]天津医科大学眼科临床学院天津市眼科医院天津市眼科学与视觉科学重点实验室天津市眼科研究所,300020

出　　处：《中华眼底病杂志》2017年第1期10-14,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的 对比观察光相干断层扫描血管成像（OCTA）与传统多模式眼底成像对渗出型老年性黄斑变性（AMD）脉络膜新生血管（CNV）诊断与活动性判断的一致性及差异。 方法 回顾性分析渗出型AMD患者112例130只眼的临床资料。其中，男性62例71只眼，女性50例59只眼。年龄50～91岁，平均年龄（68.250±9.789）岁。所有患眼均行荧光素眼底血管造影、吲哚青绿血管造影、频域光相干断层扫描等传统多模式眼底成像以及OCTA检查。根据传统多模式眼底成像结果将患眼分为活动性CNV及非活动性CNV；根据OCTA所见血管特征将患眼分为活动性血管形态与非活动性血管形态。以传统多模式眼底成像结果为标准，分析OCTA对CNV诊断及其活动性判断的敏感性及特异性。 结果 130只眼中，传统多模式眼底成像检出CNV 109只眼，占83.8%。OCTA检出CNV 103只眼，占79.2%；其中，假阴性 7 只眼，假阳性 1 只眼。OCTA对CNV诊断的敏感性为93.6%，特异性为95.2%。两种检查模式对CNV的检出结果比较，差异无统计学意义（Youden指数=0.89，Kappa值=0.796，P=0.07）。传统多模式眼底成像检出CNV 109只眼中，活动性CNV 73只眼，占67.0%；非活动性CNV 36只眼，占33.0%。OCTA血管形态为活动性60只眼，占55.0%；非活动性49只眼，占45.0%。OCTA对CNV活动性判断的敏感性为82.2%，特异性为100.0%。两种检查模式对CNV活动性的判断结果比较，差异有统计学意义（Youden指数=0.82，Kappa值=0.753，P=0.00）。 结论 OCTA与传统多模式眼底成像对渗出型AMD CNV诊断及其活动性判断具有显著一致性。Objective To compare the consistency and difference of optical coherence tomography angiography （OCTA） and traditional multimodal fundus imaging in the diagnosis and activity evaluation of choroidal neovascularization （CNV） in exudative age-related macular degeneration （AMD）. Methods A total of 112 exudative AMD patients （130 eyes） were included in this retrospective study, 62 were men （71 eyes） and 50 were women （59 eyes）. The mean age was （68.250±9.789） years （range 50 - 91 years）. All patients were underwent traditional multimodal fundus imaging including fundus fluorescein angiography （FFA）, indocyanine green angiography （ICGA） and spectral domain optical coherence tomography （OCT）; OCTA was performed at the same time. The CNV type was divided into active and non-active according to the results of traditional multimodal fundus imaging. The vascular pattern was divided into active and non-active according to the results of OCTA. Using traditional multimodal fundus imaging as the standard, the sensitivity and specialty of OCTA was evaluated. Results In 130 eyes, CNV was visualized on traditional multimodal fundus imaging in 109 eyes （83.8%）; CNV was visualized on OCTA in 103 eyes （79.2%）, which including 7 eyes of false negative and 1 eye of false positive. The sensitivity of OCTA for CNV diagnosis was 93.6%, with specificity of 95.2%. The CNV detection rate between two methods had no significant difference （Youden index=0.89,Kappa value=0.796,P=0.07）. In 109 eyes diagnosed with CNV by traditional multimodal fundus imaging, 73 eyes （67.0%） were active CNV and 36 eyes （33.0%） were non-active CNV; the vascular pattern was active in 60 eyes （55.0%） and non-active in 49 eyes （45.0%）. The sensitivity of OCTA for the detection of active CNV was 82.2%, with specificity of 100.0%. The active CNV detection rate between two methods had no significant difference （Youden index=0.82,Kappa value=0.753,P=0.00）. Conclusion In the diagnosis and activit

关 键 词：脉络膜新生血管化/诊断 体层摄影术 光学相干 荧光素血管造影术 吲哚花青绿/诊断应用 

分 类 号：R774.5[医药卫生—眼科]