视网膜脱离复位术后黄斑区血流密度:基于光学相干断层扫描血管成像(OCTA)的观察  

Clinical observation of optical coherence tomography angiography in the macular vascular density after repair of retinal detachment

作　　者：焦亚 付碧波 叶波[2] 黄银花[2] 章晖[2] 贺文山 陈小玲 JIAO Ya;FU Bi-Bo;YE Bo;HUANG Yin-Hua;ZHANG Hui;HE Wen-Shan;CHEN Xiao-Ling

机构地区：[1]中南大学爱尔眼科学院,湖南省长沙市410000 [2]南昌爱尔眼科医院,江西省南昌市330000

出　　处：《眼科新进展》2018年第4期373-377,共5页Recent Advances in Ophthalmology

摘　　要：目的应用光学相干断层扫描血管成像(optical coherence tomography angiography,OCT A)检测孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)解剖复位稳定1 a黄斑区血流密度,并探讨其与最佳矫正视力(best corrected visual acuity,BCVA)的关系。方法将我院首诊为RRD并且通过玻璃体切割复位术,术后视网膜复位稳定1 a的患者42例(42眼)的患眼纳入RRD组,患眼的对侧眼纳入对照组A,同时选择健康眼42例(42眼)为对照组B。对所有入选者均行BCVA和OCTA检查。比较RRD组与各对照组各层黄斑区血流密度是否存在差异,并分析患眼BCVA与血流密度的相关性。结果三组黄斑区浅层视网膜血管丛、深层视网膜血管丛、脉络膜毛细血管层血流密度依次为:RRD组:0.422 4±0.089 3、0.483 6±0.074 8、0.527 1±0.039 0;对照组A:0.469 3±0.112 5、0.550 0±0.074 0、0.546 2±0.034 3;对照组B:0.561 9±0.053 7、0.611 2±0.035 2、0.562 6±0.0304。RRD组与对照组A、对照组B相比血流密度均较低,差异均有统计学意义(均为P<0.05)。RRD组深层视网膜血管丛、脉络膜毛细血,管层黄斑区血流密度与BCVA存在一定的正相关(r=0.629、0.654,均为P=0.000),浅层视网膜血管丛黄斑区血流密度与BCVA没有表现出相关性(P=0.103)。结论 RRD复位术后1 a患眼各层黄斑区血流密度均较低,血流量没有完全恢复,且BCVA与深层视网膜血管丛、脉络膜毛细血管层血流密度存在相关性;OCTA能客观有效地分层量化黄斑区血流状态。Objective To investigate the macular vascular density after successful repair of rhegmatogenous retinal detachment(RRD)for one year using optical coherence tomography angiography(OCTA),and discuss the correlation between the macular vascular density and visual acuity.Methods Totally 42 patients of the RRD(42 eyes),their contralateral eyes(A group)and 42 patients of the normal eyes(B group)were recruited into this study.All participants underwent examination with best corrected visual acuity(BCVA)and OCTA.The difference in macular vascular density was compared and the correlation between BCVA and the vascular density was analyzed.Results The macular vascular density of superficial layer,deep layer and choroidal capillary layer was 0.422 4±0.089 3,0.4836±0.0748,0.527 1±0.039 0 in RRD group,respectively,0.469 3±0.112 5,0.550 0±0.074 0,0.546 2±0.034 3 in A group,respectively,0.5619±0.053 7,0.611 2±0.035 2,0.562 6±0.030 4 in B group,respectively.The macular vascular density was significantly decreased in RRD group when compared with A and B groups(all P<0.05).There was a positive correlation between BCVA and the macular vascular density in the deep layer and choroidal capillaries layer(r=0.629,0.654,both P=0.000).However,there’s no correlation between the macular vascular density of superficial layer and BCVA(P=0.103).Conclusion All the macular vascular densities are decreased in patients of RRD after successful repair of retinal detachment one year later,which indicated that the blood flow does not completely recover.And there is a positive correlation between BCVA and macular vascular densities in deep layer and choroidal capillaries layer.And meanwhile,OCTA can objectively and effectively quantify the status of macular region blood flow.

关 键 词：孔源性视网膜脱离 光学相干断层扫描血管成像 黄斑区血流密度 最佳矫正视力 

分 类 号：R774.1[医药卫生—眼科]