息肉状脉络膜血管病变多光谱眼底成像与眼底血管造影对比观察

Comparison of Multispectral Imaging and Indocyanine Green Angiography for Detection of Polypoidal Choroidal Vasculopathy

摘要: 目的：对比观察多光谱眼底成像(Multispectral imaging, MSI)与吲哚菁绿脉络膜血管造影(ICGA)对息肉状脉络膜血管病变(Polypoidal choroidal vasculopathy, PCV)的成像特征和检出率差异比较。方法：回顾性临床病例研究。经临床确诊的PCV患者33例38眼纳入研究，所有患者均行最佳矫正视力(BCVA)，共焦激光眼底照相(SLO)，无赤光照相(red-free)，红外照相(infra-red)，光学相干断层扫描(OCT)，吲哚青绿血管造影(ICGA)与MSI检查。结果：硬性渗出的检出比率在MSI 550，600，620 nm波长段显著高于ICG造影(2=11.5; p = 0.012)。MSI各波长与无赤光照相(red-free)、红外照相、ICGA比较，浆液性视网膜色素上皮脱离(SPED)与浆液血液性色素上皮脱离(SHPED)检出率无显著性差异(2 = 4.67, p = 0.603)。视网膜下出血(SRH)采用MSI680 nm、780 nm、810 nm、850 nm波长与ICGA比较，检出率无显著性差异(2 = 3.61, p = 0.799)。MSI680 nm、780 nm、810 nm、850 nm四种波长与ICGA对于脉络膜异常血管网(BVN)和脉络膜息肉(Polyps)的检出率差异有显著性意义(2 = 10.0; p = 0.040; 2=27.96; p = 0.000)。结论：MSI可清晰显示PCV特征性SPED，SHPED，SRH图像特征，MSI可做为PCV诊断有益的影像补充。

Abstract: Objective: To compare the imaging characteristics and detection of various types lesions in polypoidal choroidal vasculopathy (PCV) with Multispectral Imaging (MSI) and indocyanine green angiography (ICGA). Methods: Retrospective cases series observational study. Total of 38 eyes among 33 patients with diagnosed PCV were enrolled in the study. All patients underwent BCVA, color fundus photography (CFP), ICGA, optical coherence tomography (OCT) and MSI. Results: The detection rate of MSI 550, 580, 620 nm wavelength was more than ICGA. There was significant difference between two methods (2 = 11.5; p = 0.012). The detection rate of serous pigmental epithelium detachment (SPED) and serous hemorrhage pigmental epithelium detachment (SHPED), subretinal hemorrhage (SRH) on MSI all wavelength and 680 - 850 nm wavelength were consistent with red free, infra-red photography and ICGA. There was no significant difference between two methods (2 = 4.67, 3.61; p = 0.603, 0.799). Branch vessel net (BVN) and polyps signal in PCV patiets were better detected at ICGA (2 = 10.0; p = 0.040; 2 = 27.96; p = 0.000). Conclusion: MSI may clearly showed imaging characteristics of SPRD, SHPED, SRH for PCV, which has good consistency with ICGA and be used to provide more information for diagnosis.