分频辐去相干影像OCT技术对脉络膜新生血管的定量分析  

Quantitative analysis of choroidal neovascularization by split spectrum amplitude decorrelation angiography OCT

作　　者：霍妍佼[1] 杨丽红[1] 魏文斌[1] 

机构地区：[1]首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室,100730

出　　处：《中华实验眼科杂志》2015年第12期1126-1130,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（81272981）;北京市自然科学基金项目（7151003、7112031）;北京市医院管理局临床医学发展专项经费项目（ZYLX201307）

摘　　要：背景脉络膜新生血管（CNV）是多种眼底病变视力损害的主要原因，传统的CNV检测和评价方法主要依靠眼底血管造影术，但为有创检查方法。分频辐去相干影像（SSADA）OCT可快速获得清晰的血管信号，但SSADA—OCT对CNV的检测价值尚不清楚。目的利用SSADA—OCT检测并定量分析CNV的血流信息，评价其在眼科临床的应用价值。方法纳入2014年6—8月于首都医科大学附属同仁医院眼科中心确诊的单眼CNV患者13例，应用高速频域OCT系统扫描黄斑中心6mm×6mm区域，最终得到SSADA—OCT血流图像。应用Photoshop软件分别在视网膜和脉络膜层面上测量CNV面积并计算平均灰度值。结果SSADA—OCT可显示视网膜内界膜层、内丛状层、视网膜色素上皮（RPE）层及脉络膜层面血流情况。不同病因CNV患者的SSADA—OCT表现均呈黄斑区边界清楚的团状高反射信号。13例CNV患者患眼平均CNV面积为（0．15±0．09）mm^2，平均灰度值为75．40±32．35，对侧眼选择黄斑中心300μm的区域进行测量，平均灰度值为26．99±22．87，患眼CNV平均灰度值明显高于对侧眼，差异有统计学意义（t=6．946，P〈0．001）。结论OCT血管影像技术是一种快速、非侵人的视网膜及脉络膜血流观察技术，可对CNV的面积和活动性进行定量分析。Background Choroidal neovascularization （CNV） is a major cause of visual loss in many fundus diseases. Fundus angiography （FA） is essential for the diagnosis,location and treatment of CNV. However, FA is an invasive examination method. Split spectrum amplitude deeorrelation angiography （SSADA） OCT can quickly and clearly provide vascular signals. However, whether SSADA-OCT is feasible in the evaluation of CNV remains unclear. Objective This study was to detect and quantify CNV using OCT angiography. Methods Thirteen patients with unilateral CNV were included in Beijing Tongren Eye Center from June 2014 to August 2014. All affected eyes of the subjects were scanned with a high-speed frequency domain OCT. The SSADA-OCT images were obtained by scanning of macula covered 6 mm×6 mm area. The CNV area and grey scale were computed from the en face OCT images of retinal layer and choroidal layer. This study followed the Helsinki Declaration and was approved by the Ethics Committee of Beijing Tongren Hospital, and written informed consent was obtain from each patient prior to any medical examination. Results SSADA-OCT angiogram revealed CNV area and location confirmed by fluorescein angiography,and the CNV blood flow information of internal limiting membrane,inner plexiform layer,retinal pigment epithelium,and choroid was exhibited by OCT angiography. All CNVs with different causes showed the well defined and hyperreflected signal in macular region. The average CNV area was （0. 15 ±0. 09）mm^2 , and the average grey scale of CNV was 75.40±32.35 in the affected eyes,and that in the contralateral eyes was 26.99±22.87 in the 300 μm area,showing significant elevation in gray scale in the affected eyes compared with the contralateral eyes （t = 6. 946, P〈0. 001 ）. Conclusions OCT angiography is a noninvasive observation technique of retinal and choroidal blood flow. It can provide quantitative information and detailed images of CNV.

关 键 词：光学相干断层扫描/方法 脉络膜新生血管/诊断 荧光素血管造影 分频辐去相干影像技术 视网膜 黄斑 

分 类 号：R773.4[医药卫生—眼科]