量化OCTA在视网膜静脉阻塞中的应用

发布时间：2018-07-31 14:28

【摘要】：[目的]应用光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA)研究视网膜静脉阻塞(Retinal vein occlusion,RVO)患者黄斑区血流灌注的变化及其与视力的关系。[方法]回顾性研究。30例单眼RVO患者纳入研究范围,患者双眼均接受OCTA检查,获得视网膜黄斑中心3×3mm大小范围的黄斑区血流密度、黄斑中心凹无血管区(foveal avascular zone,FAZ)面积、黄斑中心凹厚度,双眼均接受视力检查并获得最佳矫正视力(best-corrected visual acuity,BCVA),比较患眼与对侧眼黄斑区血流密度、FAZ面积、黄斑中心凹厚度的变化及其与视力的相关性。[结果]共30例RVO患者,其中视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)患者15例,视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)患者15例。CRVO患者患眼浅层、深层毛细血管总血流密度较对侧眼降低(浅层:43.07±4.95%vs 50.09±2.86%,P0.01;深层 45.89±4.12%vs53.29±2.62%,P0.01),且浅层、深层毛细血管血流密度与视力呈正相关(浅层:r = 0.6,P = 0.01;深层:r = 0.5,P = 0.04)。BRVO 患者患眼浅层、深层毛细血管总血流密度较对侧眼降低(浅层:45.62±3.04%vs 52.10±2.98%,P0.01;深层49.21±3.80%vs 55.52±3.33%,P0.01),与视力呈正相关(浅层:r = 0.5,P=0.02;深层:r = 0.6,P = 0.01)。患眼病变区域与患眼未病变区域、对侧眼相应病变相比浅层、深层毛细血管血流密度均下降(P0.01);患眼病变区域深层毛细血管密度与视力呈负相关(深层:r=0.4,P=0.04);患眼未病变区域与对侧眼相应区域比较深层毛细血管血流密度下降(56.86±1.95 vs 58.15±2.24,P=0.02)。CRVO、BRVO患眼浅层毛细血管 FAZ面积较对侧眼扩大(CRVO:0.515±0.26mm2 vs 0.27±0.08mm2,P0.01;BRVO:0.376±0.12mm2vs0.261±0.07mm2,P0.01),且与视力呈负相关(CRVO:r=-0.6,P = 0.02;BRVO:r=-0.5,P = 0.01)。CRVO、BRVO 患眼黄斑中心凹厚度均较对侧眼增加(CRVO:431.2±191.3mmvs235.5±18.2mm,P0.01;BRVO:373.2±188.7mm vs 243.8±13.7mm,P=0.01),且与视力呈负相关(CRVO:r =-0.7,P0.01;BRVO:r =-0.6,P = 0.01)。[结论]OCTA可做为测量RVO患者黄斑区血流灌注及FAZ面积的有效工具。与患者对侧眼相比,RVO患者患眼浅层、深层毛细血管总血流密度降低,并且血流密度降低与视力呈正相关关系,患眼浅层毛细血管FAZ面积扩大、黄斑中心凹厚度增加,与视力呈负相关关系。
[Abstract]:[objective] to study the changes of macular perfusion and its relationship with visual acuity in patients with retinal vein occlusion (Retinal vein occlusion) by optical coherence tomography (optical coherence tomography) angiography. [methods] Thirty patients with monocular RVO were included in the study. The patients underwent OCTA examination in both eyes. The macular area blood flow density and the area of (foveal avascular zone1 Faz in the 3 脳 3mm area of the central retinal macula were obtained. The thickness of macular fovea was examined in both eyes and the best corrected visual acuity (BCVA) was obtained. The area of blood flow in macular area and the thickness of fovea macula were compared between the affected eyes and the contralateral eyes and the correlation between the thickness of macular fovea and visual acuity was compared. [results] there were 30 patients with RVO, including 15 patients with central retinal vein occlusion (central retinal vein occlusion) and 15 patients with retinal branch vein occlusion (branch retinal vein occlusion BRVO). The total blood flow density of the deep capillary was lower than that of the contralateral eye (43.07 卤4.95%vs 50.09 卤2.86 P0.01 in the shallow layer; 45.89 卤2.62 卤2.62 P0.01 in the deep layer), and there was a positive correlation between the blood density of the capillary in the deep layer and the visual acuity (superficial: r = 0.6 P = 0.01; in the deep layer: r = 0.5, P = 0.04). The total blood flow density of the deep capillary was lower than that of the contralateral eye (45.62 卤3.04%vs 52.10 卤2.98 P0.01 in the superficial layer and 49.21 卤3.80%vs 55.52 卤3.33P0.01 in the deep layer), which was positively correlated with the visual acuity (superficial: r = 0.5P < 0.01; deep layer: r = 0.6 P = 0.01). The lesion area of the affected eye was higher than that of the non-diseased area of the affected eye, and the corresponding lesion of the contralateral eye was lower than that of the normal eye. The blood density of deep capillary decreased (P0.01), the density of deep capillary decreased negatively with visual acuity in the lesion area of the affected eye (P 0.04), and the blood density of the deep capillary decreased in the unaffected area compared with the corresponding area of the contralateral eye (56.86 卤1.95 vs 56.86 卤1.95). 58.15卤2.24,P=0.02).CRVO,BRVO鎮ｇ溂娴呭眰姣涚粏琛，

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