中华眼底病杂志

中华眼底病杂志

特发性黄斑裂孔患眼黄斑中心凹下脉络膜厚度及毛细血管血流面积的频域光相干断层扫描观察

查看全文

目的观察特发性黄斑裂孔(IMH)患眼黄斑中心凹下脉络膜厚度(SFCT)和脉络膜毛细血管血流面积(CBFA)。方法前瞻性临床研究。临床检查确诊的单眼IMH患者32例(病例组)纳入研究。将病例组患者的患眼、对侧眼分别设为A、B组,均为32只眼。选取年龄、性别相匹配的正常人32名32只眼作为正常对照组(C组)。病例组32只眼中,Ⅱ、Ⅲ、Ⅳ期裂孔分别为4、17、11只眼。病例组、C组受检者之间平均年龄(t=0.865)、性别构成比(χ2=0.000)比较,差异均无统计学意义(P>0.05);A、B、C组受检眼之间屈光度(F=0.957)、眼轴长度(F=0.562)比较,差异无统计学意义(P>0.05)。采用频域光相干断层扫描(OCT)增强深度成像技术和OCT血管成像测量受检眼SFCT和CBFA。采用Kruskal-Wallis单向评秩方差分析和非参数检验比较三组受检眼之间SFCT、CBFA的差异。结果A、B、C组受检眼平均SFCT分别为(182.53±64.52)、(199.21±73.07)、(254.21± 56.85) μm。A、B组受检眼黄斑SFCT较C组明显变薄,差异有统计学意义(Z=−4.362、−3.190,P<0.05);A、B组受检眼之间SFCT比较,差异无统计学意义(Z=−1.171,P>0.05)。A、B、C组受检眼CBFA分别(5.09±0.31)、(5.41±0.20)、(5.39±0.15)mm2。A组患眼CBFA明显小于B、C组,差异有统计学意义(Z=−4.467、−4.048, P<0.05);B、C组受检眼之间CBFA比较,差异无统计学意义(Z=0.420,P>0.05)。结论IMH患眼黄斑中心凹下脉络膜薄,脉络膜毛细血管密度减少。

ObjectiveTo observe the subfoveal choroidal thickness (SFCT) and choriocapillary blood flow area (CBFA) in the patients with idiopathic macular hole (IMH).MethodsThis is a prospective clinical study. Thirty-two patients with unilateral IMH (4 in stage 2, 17 in stage 3, 11 in stage 4) and 32 age- and sex-matched normal controls were enrolled in this study. All eyes were divided into three groups, including group A (32 affected eyes), group B (32 fellow eyes) and group C (32 normal eyes of controls). There was no significant difference in age (t=0.865) and gender (χ2=0.000) in IMH patients versus normal control subjects (P>0.05). There was no significant difference in refraction (F=0.957) and ocular axial length (F=0.562) between group A, B and C. The SFCT was detected by enhanced depth imaging of spectral-domain optical coherence tomography (OCT). The CBFA was detected by OCT angiography. The differences of SFCT and CBFA in three groups were analyzed by Kruskal-Wallis and non-parametric test.ResultsThe mean SFCT was (182.53±64.52) μm in group A, (199.21±73.07) μm in group B and (254.21±56.85) μm in group C respectively. The SFCT was thinner in group A and B than that in group C (Z=−4.362, −3.190; P<0.05), but was the same in group A and B (Z=−1.171, P>0.05). The mean CBFA was (5.09±0.31) mm2 in group A, (5.41±0.20) mm2 in group B and (5.39±0.15) mm2 in group C respectively. The CBFA was reduced in group A than that in group B and C (Z=−4.467, −4.048; P<0.05), but was same in group B and C (Z=0.420, P>0.05).ConclusionSFCT and CBFA are both reduced in IMH eyes.

关键词: 视网膜穿孔/诊断; 体层摄影术,光学相干; 诊断显像

Key words: Retinal perforations/diagnosis; Tomography, optical coherence; Diagnostic imaging

引用本文: 林秋蓉, 高敏, 刘海芸. 特发性黄斑裂孔患眼黄斑中心凹下脉络膜厚度及毛细血管血流面积的频域光相干断层扫描观察. 中华眼底病杂志, 2017, 33(4): 396-399. doi: 10.3760/cma.j.issn.1005-1015.2017.04.016 复制

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. Gass JD. Idiopathic senile macular hole: its early stages and pathogenesis[J]. Arch Ophthalmol, 1988, 106(5): 629-639.
2. Kelkar AS, Bhanushali DR, Kelkar JA, et al. Spontaneous closure of a full-thickness stage 2 idiopathic macular hole without posterior vitreous detachment[J]. Case Rep Ophthalmol, 2013, 4(3): 188-191. DOI: 10.1159/000356125.
3. Aras C, Ocakoglu O, Akova N. Foveolar choroidal blood flow in idiopathic macular hole[J]. Int Ophthalmol, 2004, 25(4): 225-231.
4. Schaal KB, Pollithy S, Dithmar S. Is choroidal thickness of importance in idiopathic macular hole?[J]. Ophthalmologe, 2012, 109(4): 364-368. DOI: 10.1007/s00347-012-2529-8.
5. Reibaldi M, Boscia F, Avitabile T, et al. Enhanced depth imaging optical coherence tomography of the choroid in idiopathic macular hole: a cross-sectional prospective study[J]. Am J Ophthalmol, 2011, 151(1): 112-117. DOI: 10.1016/j.ajo.2010.07.004.
6. Gass JD. Reappraisal of biomicroscopic classification of stages of development of a macular hole[J]. Am J Ophthalmol, 1995, 119(6): 752-759.
7. Branchini L, Regatieri CV, Flores-Moreno I, et al. Reproducibility of choroidal thickness measurements across three spectral domain optical coherence tomography systems[J]. Ophthalmology, 2012, 119(1): 119-123. DOI: 10.1016/j.ophtha.2011.07.002.
8. Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes[J]. Am J Ophthalmol, 2009, 147(5): 811-815. DOI: 10.1016/j.ajo.2008.12.008.
9. 梁安怡, 曹丹, 张良. 脉络膜厚度与糖尿病视网膜病变相关性研究现状[J]. 中华眼底病杂志, 2017, 33(3): 315-318. DOI: 10.3760/cma.j.issn.1005-1015.2017.03.Liang AY, Cao D, Zhang L. The correlation between choroidal thickness and diabetic retinopathy[J]. Chin J Ocul Fundus Dis, 2017, 33(3): 315-318. DOI: 10.3760/cma.j.issn.1005-1015.2017.03.
10. Wei WB, Xu L, Jonas JB, et al. Subfoveal choroidal thickness: the Beijing Eye Study[J]. Ophthalmology, 2013, 120(1): 175-180. DOI: 10.1016/j.Ophtha.2012.07.048.
11. Zeng J, Li J, Liu R, et al. Choroidal thickness in both eyes of patients with unilateral idiopathic macular hole[J]. Ophthalmology, 2012, 119(11): 2328-2333. DOI: 10.1016/j.ophtha.2012.06.008.
12. 陈迪, 李略, 杨治坤, 等. 频域光学相干断层扫描观察特发性黄斑裂孔患者脉络膜厚度[J]. 协和医学杂志, 2013, 4(2): 113-117. DOI: 10.3969/j.issn.1674-9081.2013.02.006.Chen D, Li L, Yang ZK, et al. Spectral-domain optical coherence tomography findings of choroidal thickness in eyes of patients with idiopathic macular holes[J]. Medical Journal of Peking Union Medical College Hospital, 2013, 4(2): 113-117. DOI: 10.3969/j.issn.1674-9081.2013.02.006.
13. Karkhaneh R, Nikbakht M, Bazvand F, et al. Choroidal thickness in idiopathic macular hole[J]. J Curr Ophthalmol, 2016, 29(1): 45-49. DOI: 10.1016/j.joco.2016.08.005.
14. Kim M, Kim SS, Kwon HJ, et al. Association between choroidal thickness and ocular perfusion pressure in young, healthy subjects: enhanced depth imaging optical coherence tomography study[J]. Invest Ophthalmol Vis Sci, 2012, 53(12): 7710-7717. DOI: 10.1167/iovs.12-10464.
15. Kiel JW, van Heuven WA. Ocular perfusion pressure and choroidal blood flow in the rabbit[J]. Invest Ophthalmol Vis Sci, 1995, 36(3): 579-585.
16. Lovasik JV, Kergoat H, Riva CE, et al. Choroidal blood flow during exercise-induced changes in the ocular perfusion pressure[J]. Invest Ophthalmol Vis Sci, 2003, 44(5): 2126-2132.
17. 王敏. 利用光相干断层扫描血管成像技术优势, 提升视网膜脉络膜血管疾病认知水平[J]. 中华眼底病杂志, 2016, 32(4): 349-352. DOI: 10.3760/cma.j.issn.1005-1015.2016.04.003.Wang M. Evaluating retinal and choroidal vascular diseases with optical coherence tomography angiography[J]. Chin J Ocul Fundus Dis, 2016, 32(4): 349-352. DOI: 10.3760/cma.j.issn.1005-1015.2016.04.003.