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Interpretation of OCT and OCTA images from a histological approach: Clinical and experimental implications.
Progress in Retinal and Eye Research ( IF 18.6 ) Pub Date : 2020-01-03 , DOI: 10.1016/j.preteyeres.2019.100828
Nicolás Cuenca 1 , Isabel Ortuño-Lizarán 2 , Xavier Sánchez-Sáez 2 , Oksana Kutsyr 2 , Henar Albertos-Arranz 2 , Laura Fernández-Sánchez 3 , Natalia Martínez-Gil 2 , Agustina Noailles 2 , José Antonio López-Garrido 4 , Maribel López-Gálvez 5 , Pedro Lax 2 , Victoria Maneu 3 , Isabel Pinilla 6
Affiliation  

Optical coherence tomography (OCT) and OCT angiography (OCTA) have been a technological breakthrough in the diagnosis, treatment, and follow-up of many retinal diseases, thanks to its resolution and its ability to inform of the retinal state in seconds, which gives relevant information about retinal degeneration.

In this review, we present an immunohistochemical description of the human and mice retina and we correlate it with the OCT bands in health and pathological conditions. Here, we propose an interpretation of the four outer hyperreflective OCT bands with a correspondence to retinal histology: the first and innermost band as the external limiting membrane (ELM), the second band as the cone ellipsoid zone (EZ), the third band as the outer segment tips phagocytosed by the pigment epithelium (PhaZ), and the fourth band as the mitochondria in the basal portion of the RPE (RPEmitZ). The integrity of these bands would reflect the health of photoreceptors and retinal pigment epithelium.

Moreover, we describe how the vascular plexuses vary in different regions of the healthy human and mice retina, using OCTA and immunohistochemistry. In humans, four, three, two or one plexuses can be observed depending on the distance from the fovea. Also, specific structures such as vascular loops in the intermediate capillary plexus, or spider-like structures of interconnected capillaries in the deep capillary plexus are found. In mice, three vascular plexuses occupy the whole retina, except in the most peripheral retina where only two plexuses are found. These morphological issues should be considered when assessing a pathology, as some retinal diseases are associated with structural changes in blood vessels.

Therefore, the analysis of OCT bands and OCTA vascular plexuses may be complementary for the diagnosis and prognosis of retinal degenerative processes, useful to assess therapeutic approaches, and it is usually correlated to visual acuity.



中文翻译:

从组织学方法解释OCT和OCTA图像:临床和实验意义。

光学相干断层扫描(OCT)和OCT血管造影(OCTA)在许多视网膜疾病的诊断,治疗和随访中已成为一项技术突破,这要归功于其分辨率和能够在几秒钟内告知视网膜状态的能力。有关视网膜变性的相关信息。

在这篇综述中,我们介绍了人类和小鼠视网膜的免疫组织化学描述,并将其与健康和病理状况下的OCT带相关联。在这里,我们提出了四种与视网膜组织学相对应的外部超反射OCT波段的解释:第一个和最里面的波段为外部限制膜(ELM),第二个波段为圆锥椭球区(EZ),第三个波段为外段尖端被色素上皮(PhaZ)吞噬,第四条带是RPE基础部分的线粒体(RPEmitZ)。这些条带的完整性将反映感光器和视网膜色素上皮的健康状况。

此外,我们使用OCTA和免疫组织化学描述了健康人和小鼠视网膜不同区域的血管丛如何变化。在人类中,根据距中央凹的距离,可以观察到四个,三个,两个或一个神经丛。另外,还发现了特定的结构,例如中间毛细血管丛中的血管环,或深毛细血管丛中互连的毛细血管的蜘蛛状结构。在小鼠中,三个血管神经丛占据整个视网膜,除了在最周围的视网膜中,只有两个神经丛被发现。在评估病理时应考虑这些形态学问题,因为一些视网膜疾病与血管的结构变化有关。

因此,OCT谱带和OCTA血管丛的分析可能是视网膜变性过程的诊断和预后的补充,对评估治疗方法很有用,并且通常与视敏度相关。

更新日期:2020-01-03
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