behÇet葡萄膜炎的光学相干断层扫描与血管造影

Diana Silva, Ana Sofia Lopes, Luísa Colaço, M. Lisboa, Sara Pinto, M. Bernardo, Filomena Silva, I. Prieto
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摘要

目的:隐性葡萄膜炎是视网膜血管炎的一个原因,荧光素血管造影是诊断的金标准检查。光学相干断层扫描血管造影(OCT-A)是一种非侵入性检查,可以高分辨率地分析黄斑视网膜循环,因此对这些患者可能是一种有用的诊断检查。材料和方法:对我院8例behaperet葡萄膜炎患者的14只眼进行OCT A (AngioPlex®,蔡司)检查。评估黄斑形态、中央凹无血管区面积、周长和圆度,以及黄斑中央、内部和整体血管密度。我们将结果与健康对照进行了比较。结果:患者亚组平均视力为0.84±0.25,既往有3眼荧光素血管造影诊断为视网膜血管炎。形态学上我们发现8只眼的浅、深毛细血管丛衰减,其中1只眼的视网膜内部层也在局部区域出现萎缩。在中央凹无血管区,其面积和周长没有统计学意义上的变化(p=0.804和p=0.380),尽管我们确实发现其圆度有显著变化(p=0.027)。黄斑内部(p=0.023)和整体(p=0.028)的血管密度显著改变。结论:我们发现behet葡萄膜炎患者的黄斑微循环发生了变化,即使没有血管造影改变。为了了解这些变化的临床意义,未来有必要对更多的患者进行研究。
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OPTICAL COHERENCE TOMOGRAPHY WITH ANGIOGRAPHY IN BEHÇET UVEITIS
Purpose: Behçet uveitis is a cause of retinal vasculitis, with fluorescein angiography being the gold-standard diagnostic exam. Optical coherence tomography with angiography (OCT-A) is a non-invasive exam that analyzes macular retinal circulation with high resolution, and therefore, could be a useful diagnostic exam in these patients.Material and methods: Analysis of 14 eyes of 8 patients with Behçet uveitis from our institution that were examined by OCT A (AngioPlex®, Zeiss). Macular morphology, area, perimeter and circularity of the foveal avascular zone, as well as central internal and global macular vascular density were evaluated. We compared our results with healthy controls.Results: Mean visual acuity in the patient’s subgroup was 0,84±0,25 and 3 eyes had previous diagnosis of retinal vasculitis with fluorescein angiography. Morphologically we found attenuation of the superficial and deep capillary plexus in 8 eyes, and in 1 of these eyes atrophy of the internal retinal layers was also found in a localized territory. In the foveal avascular area, no statistically significant changes were observed in its area and perimeter (p=0.804 and p=0.380 respectively), although we did find significant changes in its circularity (p=0.027). Vascular density was significantly altered in the internal (p=0.023) and global (p=0.028) macular parameters.Conclusion: We found changes in the macular microcirculation in patients with Behçet uveitis, even in the absence of angiographic changes. Future studies with more patients are necessary to understand the clinical significance of these changes.
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