早产儿视角膜血管的形态学临床量化分析
发布时间：2018-08-01 09:31
【摘要】：早产儿视网膜病变（Retinopathy of prematurity, ROP）是影响早产儿视网膜的致盲性眼病之一。ROP的附加性（plus）病变在一定程度上反映了ROP的严重性及危险性，表现为后极部视网膜血管的扩张和迂曲。本实验通过计算机软件量化血管宽度及迂曲度，探讨在ROP发展过程中视网膜血管的形态学改变。 实验所选60例共120只眼的早产儿眼底图像，均为于吉林大学白求恩第一医院新生儿科住院并行ROP筛查的早产儿眼底图像，所有筛查均为同一眼科医师应用广角数码儿童视网膜成像系统（RetCam Ⅱ）进行。其中ROP阈值期及阈值前期的早产儿30例60只眼为ROP组，另外30例60只眼为无ROP组。所选图像均为以视盘为中心的后极部视网膜图像，借助Image J软件，选取每张图像中以视盘的中心为中心，以视盘中心与黄斑距离为半径的圆形区域，并将图像分为颞上、颞下、鼻下、鼻上四个象限，，利用操作者主观选择操作和计算机软件的识别、测量及计算功能，测量最迂曲血管的迂曲度，并通过计算机软件的放大系统及血管壁描记、锐化功能描记测量每张图像中每个象限距离视盘中心1个视盘直径长度的最扩张血管的宽度，系统自动显示测量结果并均以Excel格式储存在同一表格中。测量结束后分别进行组间各象限宽度及迂曲度的比较分析，并行ROP组内统计分析视网膜血管的形态学改变。 将所得数据行统计分析可知，1.在所测量的两组早产儿眼底图像中，ROP组视网膜血管的宽度和迂曲度与无ROP组各象限分别比较均有统计学意义（P＜0.001），其中颞上象限视网膜血管的宽度及迂曲度的组间差异最显著。2.在ROP组内，颞上象限与颞下象限视网膜血管的宽度比较无统计学意义（P＞0.05），其他各象限之间的血管宽度两两比较均有统计学意义（P＜0.05）。3.在ROP组内，各象限之间的血管迂曲度两两比较均无统计学意义（P＞0.05）。 由本实验可得出如下结论：1. ROP阈值期及阈值前期的后极部视网膜血管与无ROP相比，其宽度和迂曲度在各个象限均发生了明显的改变。2. ROP颞侧后极部视网膜血管宽度的改变最明显，而后极部各个象限之间血管迂曲度的改变均无显著差异。3.早产儿眼底图像后极部视网膜血管形态变化的量化分析，能较为客观的反映ROP筛查中plus病变的判断并协助评价其严重程度。
[Abstract]:Retinopathy of premature infants (Retinopathy of prematurity, ROP) is one of the blind eye diseases of premature infants. The additional (plus) lesion of ROP reflects the severity and risk of ROP to a certain extent, which is characterized by the dilation and detour of retinal vessels in the posterior pole. The morphologic changes of retinal vessels during the development of ROP were investigated by computer software. The fundus images of 60 premature infants (120 eyes) were selected from Bethune first Hospital of Jilin University and were screened by ROP in pediatrics department of the first Hospital of Jilin University. All screening was performed by the same ophthalmologist using the wide-angle digital retina imaging system (RetCam II). Among them, 30 premature infants with ROP threshold period and 60 eyes with pre-threshold were in ROP group, and 60 eyes without ROP in 30 cases. The selected images were all posterior polar retina images with the center of the disc as the center. With the help of Image J software, the circular region with the center of the disc as the center and the distance between the center of the disc and the macula as the radius was selected for each image, and the images were divided into suprtemporal, subtemporal and subtemporal images. Under the nose and in the four quadrants above the nose, using the operator's subjective selection operation and the recognition, measurement and calculation function of the computer software, the roundness of the most circuitous vessels was measured, and the amplification system of the computer software and the vascular wall drawing were used. Sharpening function is used to measure the width of the most dilated blood vessels in each image, which is one of the diameters of each quadrant from the center of the disc. The system automatically displays the measured results and stores them in the same table in Excel format. At the end of the measurement, the width of quadrant and the degree of detour were compared and analyzed respectively, and the morphological changes of retinal vessels in ROP group were analyzed statistically. From the statistical analysis of the data row, we can see that 1. In the fundus images of preterm infants, there were significant differences in the width and tortuosity of retinal vessels between the two groups (P < 0.001), and the differences of the width and the degree of tortuosity of retinal vessels in the superior temporal quadrant were the most significant among the two groups (P < 0.001). In the ROP group, there was no significant difference in the width of retinal vessels between the superior temporal quadrant and the infratemporal quadrant (P > 0. 05), but there was significant difference between the other quadrants (P < 0. 05). In ROP group, there was no significant difference between the two quadrants (P > 0. 05). From this experiment, we can draw the following conclusion: 1. The width and tortuosity of the posterior polar retinal vessels in the ROP threshold period and prethreshold period were significantly changed in each quadrant compared with those in the absence of ROP. The change of retinal vascular width in posterior temporal pole of ROP was the most obvious, and there was no significant difference in the degree of vessel detour between the different quadrants of the posterior pole of ROP. Quantitative analysis of retinal vascular morphology after fundus imaging of preterm infants can objectively reflect the judgment of plus lesions in ROP screening and help to evaluate the severity of the lesions.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.1;R722.6
[Abstract]:Retinopathy of premature infants (Retinopathy of prematurity, ROP) is one of the blind eye diseases of premature infants. The additional (plus) lesion of ROP reflects the severity and risk of ROP to a certain extent, which is characterized by the dilation and detour of retinal vessels in the posterior pole. The morphologic changes of retinal vessels during the development of ROP were investigated by computer software. The fundus images of 60 premature infants (120 eyes) were selected from Bethune first Hospital of Jilin University and were screened by ROP in pediatrics department of the first Hospital of Jilin University. All screening was performed by the same ophthalmologist using the wide-angle digital retina imaging system (RetCam II). Among them, 30 premature infants with ROP threshold period and 60 eyes with pre-threshold were in ROP group, and 60 eyes without ROP in 30 cases. The selected images were all posterior polar retina images with the center of the disc as the center. With the help of Image J software, the circular region with the center of the disc as the center and the distance between the center of the disc and the macula as the radius was selected for each image, and the images were divided into suprtemporal, subtemporal and subtemporal images. Under the nose and in the four quadrants above the nose, using the operator's subjective selection operation and the recognition, measurement and calculation function of the computer software, the roundness of the most circuitous vessels was measured, and the amplification system of the computer software and the vascular wall drawing were used. Sharpening function is used to measure the width of the most dilated blood vessels in each image, which is one of the diameters of each quadrant from the center of the disc. The system automatically displays the measured results and stores them in the same table in Excel format. At the end of the measurement, the width of quadrant and the degree of detour were compared and analyzed respectively, and the morphological changes of retinal vessels in ROP group were analyzed statistically. From the statistical analysis of the data row, we can see that 1. In the fundus images of preterm infants, there were significant differences in the width and tortuosity of retinal vessels between the two groups (P < 0.001), and the differences of the width and the degree of tortuosity of retinal vessels in the superior temporal quadrant were the most significant among the two groups (P < 0.001). In the ROP group, there was no significant difference in the width of retinal vessels between the superior temporal quadrant and the infratemporal quadrant (P > 0. 05), but there was significant difference between the other quadrants (P < 0. 05). In ROP group, there was no significant difference between the two quadrants (P > 0. 05). From this experiment, we can draw the following conclusion: 1. The width and tortuosity of the posterior polar retinal vessels in the ROP threshold period and prethreshold period were significantly changed in each quadrant compared with those in the absence of ROP. The change of retinal vascular width in posterior temporal pole of ROP was the most obvious, and there was no significant difference in the degree of vessel detour between the different quadrants of the posterior pole of ROP. Quantitative analysis of retinal vascular morphology after fundus imaging of preterm infants can objectively reflect the judgment of plus lesions in ROP screening and help to evaluate the severity of the lesions.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.1;R722.6
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