光学相干断层扫描血管成像术(OCTA)及共聚焦激光检眼镜(cSLO)眼底成像对脉络膜破裂伤患者检查的临床价值  

Clinical value of optical coherence tomography angiography(OCTA) and confocal scanning laser ophthalmoscope(cSLO) in the examination of patients with choroid rupture

作　　者：鲍宁 蒋正轩 陶黎明 BAO Ning;JIANG Zheng-Xuan;TAO Li-Ming

机构地区：[1]安徽医科大学第二附属医院

出　　处：《眼科新进展》2019年第10期941-944,共4页Recent Advances in Ophthalmology

基　　金：安徽省优秀青年人才支持计划项目资助(编号:gxyqzd2017033)~~

摘　　要：目的探讨光学相干断层扫描血管成像术(optical coherence tomography angiography,OCTA)及共聚焦激光检眼镜(confocal scanning laser ophthalmoscope cSLO)眼底成像对脉络膜破裂伤患者检查的临床价值。方法收集2017年6月至2018年6月在安徽医科大学第二附属医院门诊就诊的脉络膜破裂伤患者12例12眼的资料。应用cSLO和OCTA对患者进行视网膜脉络膜成像,获取图像后重点分析视网膜无血流层(avascular complex,AC)、脉络膜毛细血管层(choriocapillaris,CC)及脉络膜层,以AC、CC层出现异常血管影像为继发脉络膜新生血管的依据。结果分析收集的图像可以发现脉络膜破裂伤多呈现与视盘平行的条形病灶(10眼);部分病例伴有新生血管(7眼),多位于AC层,CC层少见。在OCTA图像中视网膜色素上皮断裂最大直径为(1158.8±364.0)μm,cSLO红光眼底成像处相应位置病变边缘距离为(1184.3±350.2)μm,两者比较差异无统计学意义(t=0.43,P>0.05),OCTA与cSLO眼底成像对视网膜色素上皮损伤的检查结果一致。cSLO红光眼底成像中标识视网膜色素上皮病变面积为(2.83±0.77)mm^2,OCTA显示的CC层中标识出脉络膜毛细血管缺损面积为(3.63±1.02)mm^2,两者比较差异有统计学意义(t=1.71,P<0.05)。7例患者损伤区内AC层出现异常血管影像,其中6例行玻璃体内注射抗血管内皮生长因子药物治疗,新生血管明显消退,但患者视力提高不明显。结论OCTA与cSLO眼底成像可以准确地反映外伤致脉络膜破裂伤情况,能够指导治疗,由于是无创检查,在随访过程中存在优势。Objective To evaluate the clinical value of optical coherence tomography angiography(OCTA)and confocal scanning laser ophthalmoscope(cSLO)in patients with choroid rupture.Methods Totally 12 patients(12 eyes)of choroid rupture were collected from June 2017 to June 2018 in the outpatient department of the Second Affiliated Hospital of Anhui Medical University.OCTA and cSLO were used for retinal choroid imaging.After image acquisition,avascular complex(AC)layer,choroid capillaries(CC)layer and choroid layer were analyzed.Abnormal angiogram in AC and CC layers was the basis of secondary choroid neovascularization.Results The collected images showed that striated lesions parallel to optic disc presented in choroid rupture injury(10 eyes).Some patients(7 eyes)were associated with neovascularization,mostly in AC layer,but rarely in CC layer.In OCTA images,the maximum diameter of pigment epithelial fracture was(1158.8±364.0)μm,and the lesion edge distance at the corresponding position of cSLO red fundus imaging was(1184.3±350.2)μm,and there was no statistical difference between them(t=0.43,P>0.05).The results of OCTA were consistent with those of cSLO fundus imaging on the injury of pigment epithelium.The area of retinal pigment epithelial lesion identified in cSLO red fundus imaging was(2.83±0.77)mm^2,and the area of choroid capillary defect identified in CC layer shown in OCTA was(3.63±1.02)mm^2,and there was statistical difference between them(t=1.71,P<0.05).Abnormal vascular images were found in AC layer of injury area in 7 patients,among which 6 patients were treated with anti-vascular endothelial growth factor(VEGF),and the neovascularization subsided significantly,but the visual acuity of these patients did not significantly improve.Conclusion cSLO and OCTA fundus imaging can accurately reflect the situation of chorioretinal damage caused by trauma and can guide the treatment.As they are non-invasive examinations,they have advantages in the follow-up.

关 键 词：脉络膜破裂 外伤 共聚焦激光检眼镜 光学相干断层扫描 

分 类 号：R773.4[医药卫生—眼科]