应用OCTA检测羟氯喹对系统性红斑狼疮患者黄斑区视网膜微血管形态的影响  

Application of OCTA in detecting the effects of hydroxychloroquine on the retinal microvasculature in patients with systemic lupus erythematosus

作　　者：吴苏名 王贺 陈基黎 郭建新 WU Suming;WANG He;CHEN Jili;GUO Jianxin(Department of Ophthalmology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院眼科,江苏省徐州市221006

出　　处：《眼科新进展》2020年第9期871-874,共4页Recent Advances in Ophthalmology

摘　　要：目的通过光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)检测羟氯喹(hydroxychloroquine,HCQ)对系统性红斑狼疮(systemic lupus erythematosus,SLE)患者黄斑区视网膜微血管形态的影响。方法回顾性病例研究。将服用HCQ的患者60例60眼纳入研究,根据HCQ视网膜毒性的服药累积时间,将患者分为高危组(服药累积时间≥5 a)和低危组(服药累积时间<5 a),所有患者均进行光学相干断层扫描(optical coherence tomography,OCT)、OCTA、自动化视野检查(auto visual field,AVF)及多焦视网膜电图(multifocal electroretinography,mfERG)检查。结果与低危组相比,高危组患者OCTA检查结果显示,视网膜浅表毛细血管丛和深部毛细血管丛血管密度均降低(均为P<0.05),而中心凹无血管区扩大(P<0.05)。HCQ累积剂量和累积时间均与FAZ参数呈正相关(均为P<0.05)。在视野测试中,与低危组相比,高危组的平均偏差增加。在mfERG检查中,高危组的中心凹及旁中心凹振幅密度较低危组均有下降(均为P<0.05)。结论OCTA通过评估视网膜微血管变化有助于检测HCQ引起的视网膜毒性。Objective To detect the effects of hydroxychloroquine(HCQ)on the retinal microvasculature in patients with systemic lupus erythematosus(SLE)by optical coherence tomography angiography(OCTA).Methods Retrospective case study.Sixty eyes of 60 patients taking HCQ were enrolled in the study.According to the cumulative time of taking HCQ,patients were divided into high-risk group(≥5 years)and low-risk group(<5 years).All patients were tested by optical coherence tomography(OCT),OCTA,auto visual field and multifocal electroretinography(mfERG).Results Compared with the low-risk group,OCTA showed that the vascular density of superficial capillary plexus(SCP)and deep capillary plexus(DCP)were significantly lower in the high-risk group(both P<0.05),and the fovea avascular zone(FAZ)was wider(P<0.05).The cumulative dose and duration of HCQ were both significantly positively correlated with parameters of FAZ(both P<0.05).In the visual field test,the mean deviation(MD)of the high-risk group was significantly increased.Compared with the low-risk group,the amplitude densities in foveal and parafoveal were significantly decreased in the high-risk group by mfERG(both P<0.05).Conclusion OCTA can be helpful in detecting retinal toxicity induced by HCQ via assessing retinal microvascular changes.

关 键 词：羟氯喹 光学相干断层扫描血管成像 视网膜毒性 视野 多焦视网膜电图 

分 类 号：R774[医药卫生—眼科]