中华眼底病杂志

中华眼底病杂志

视网膜分支静脉阻塞黄斑水肿程度对黄斑中心凹无血管区量化分析的影响

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目的 观察并分析视网膜分支静脉阻塞(BRVO)不同程度黄斑水肿对黄斑中心凹无血管区(FAZ)面积的影响及其相关性。 方法 2016年11月至2018年5月在天津医科大学眼科医院检查确诊的BRVO患者72例75只眼纳入研究。其中,男性40例42只眼,女性32例33只眼;平均年龄(56.00±9.96)岁。均行BCVA、眼压、裂隙灯显微镜联合前置镜、眼底彩色照相、OCT血管成像(OCTA)检查。根据黄斑水肿程度将患者分为M300组[中心凹视网膜厚度(CRT)≥300 μm]、L300组(CRT<300 μm),分别为38例39只眼和34例36只眼。采用OCTA仪对黄斑区3 mm×3 mm范围进行扫描,测量患眼黄斑FAZ面积、周长(PERIM)、非圆度指数(AI)以及FAZ范围300 μm宽度内的血流密度(FD-300),CRT,中心凹浅层视网膜血流密度(SFVD)、深层视网膜血流密度(DFVD),BRVO病灶所在区域浅层半侧视网膜血流密度(SHVD)、深层半侧视网膜血管密度(DHVD)。组内FAZ面积与其他参数间的相关性分析行Spearman检验。 结果 M300组、L300组患眼FAZ面积分别为(0.388±0.166)、(0.596±0.512)mm2。Spearman相关性分析结果显示,M300组患眼FAZ面积与PERIM、AI呈明显正相关(r=0.932、0.591,P=0.000、0.000);与SFVD、DFVD、SHVD呈明显负相关(r=−0.490、−0.429、−0.339,P=0.002、0.006、0.035),与FD-300、CRT、DHVD无明显负相关(r=−0.129、−0.053,−0.400,P=0.435、0.749、0.395)。L300组患眼FAZ面积与PERIM、AI呈明显正相关(r=0.887、0.633,P=0.000、0.000),与FD-300无明显正相关(r=0.093,P=0.590);与CRT、SFVD、DFVD、SHVD、DHVD呈明显负相关(r=−0.413、−0.643、−0.630、−0.370、−0.411,P=0.012、0.000、0.000、0.026、0.013)。 结论 BRVO不同程度黄斑水肿其FAZ面积不同,黄斑水肿程度越重,FAZ面积越小;FAZ面积与PERIM、AI呈明显正相关;与SFVD、DFVD、SHVD呈明显负相关。

Objective To observe the effect of different macular edema on the area of foveal avascular zone (FAZ) and its correlation in eyes with branch retinal vein occlusion (BRVO). Methods A total of 72 patients (75 eyes) diagnosed with BRVO were included in the study. There were 40 patients males (42 eyes) and 32 females (33 eyes), with the mean age of (56.00±9.96) years. All the eyes were examined by BCVA, intraocular pressure, slit lamp microscope combined with preset lens, fundus color photography and optical coherence tomography angiography (OCTA). BRVO patients were divided into two groups according to the degree of macular edema: group M300 that was CRT ≥300 μm (38 patients, 39 eyes) and group L300 that was CRT<300 μm (34 patients, 36 eyes). The macular angiography scan protocol covered a 3 mm×3 mm area. The parameters of macular were measured by the built-in measurement software of the system: (1) area of FAZ, perimeter of FAZ (PERIM), avascular index of FAZ (AI), vascular density within a width of 300 μm around the FAZ region (FD-300); (2) central retinal thickness (CRT); (3) vascular density (VD): the superficial central fovea vascular density (SFVD), the deep central fovea vascular density (DFVD), the superficial hemi-macular vascular density (SHVD), the deep hemi-macular vascular density (DHVD). Spearman test was used to test the correlation between FAZ area and other parameters in each group. Results The FAZ area in group M300 and L300 were 0.388±0.166 mm2 and 0.596±0.512 mm2, respectively. The results of Spearman test showed that the FAZ area of group M300 was positively correlated with PERIM and AI (r=0.932, 0.591; P=0.000, 0.000), negatively correlated with SFVD, DFVD and SHVD (r=−0.490, −0.429, −0.339; P=0.002, 0.006, 0.035). But there was no significant negative correlation between FAZ area and FD-300, CRT, DHVD in group M300 (r=−0.129, −0.053, −0.400; P=0.435, 0.749, 0.395). The FAZ area in group L300 was positively correlated with PERIM and AI (r=0.887, 0.633; P=0.000, 0.000), negatively correlated with SFVD, DFVD, SHVD and DHVD (r=−0.413, −0.643, −0.630, −0.370, −0.411; P=0.012, 0.000, 0.000, 0.026, 0.013). But there was no significant positive correlation between FAZ area and FD-300 in group L300 (r=0.093, P=0.590). Conclusion FAZ area varies with the degree of macular edema. The degree of macular edema is higher, the FAZ area is smaller. FAZ area is positively correlated with PERIM and AI significantly, and negatively correlated with SFVD, DFVD and SHVD.

关键词: 视网膜静脉闭塞; 黄斑水肿; 黄斑中心凹无血管区; 体层摄影术,光学相干

Key words: Retinal vein occlusion; Macular edema; Foveal avascular zone; Tomography, optical coherence

引用本文: 王林妮, 于荣国, 杨锦, 胡立影, 宫雪, 陈璐, 李志清, 李筱荣. 视网膜分支静脉阻塞黄斑水肿程度对黄斑中心凹无血管区量化分析的影响. 中华眼底病杂志, 2019, 35(1): 20-24. doi: 10.3760/cma.j.issn.1005-1015.2019.01.005 复制

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