正常眼压性青光眼黄斑区视网膜厚度和血管密度变化及其与视野的相关性分析  

Changes in macular retinal thickness and macular vessel density in Normal-tension glaucoma and its correlation with visual field analysis

作　　者：李汉林[1] 潘曈 仇雪梅 梁瀛 彭志优[1] 周琼[1] 裴重刚[1] LI Hanlin;PAN Tong;QIU Xuemei;LIANG Ying;PENG Zhiyou;ZHOU Qiong;PEI Chonggang(Department of Ophthalmology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China)

机构地区：[1]南昌大学第一附属医院眼科,江西省南昌市330006

出　　处：《眼科新进展》2020年第11期1060-1064,共5页Recent Advances in Ophthalmology

基　　金：江西省重点研发计划项目(编号20202BBGL73019、20171BBG70097);江西省科技支撑计划项目(编号20161BBG70164);江西省教育厅科技计划项目(编号GJJ150242);江西省卫计委科技计划项目(编号20181032、20155131);江西省学位与研究生教育教学改革项目(编号JXYJG-2019-029)。

摘　　要：目的使用光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)观察正常眼压性青光眼(normal tension glaucoma,NTG)黄斑区视网膜厚度(macular retinal thickness,MRT)和黄斑区血管密度(macular vessel density,MVD)改变,并探讨其与视野平均缺损的相关性。方法选取NTG患者20例(40眼)为NTG组,健康20人(40眼)为对照组。利用OCTA检测2组MRT和MVD,对比NTG组与对照组间的差异性,并检验NTG组黄斑区检测指标与视野平均缺损的相关性。结果NTG组与对照组受检者MRT、MVD在黄斑区中心凹、旁中心凹、上方及下方比较,差异均有统计学意义(F中心凹MRT=26.923、F旁中心凹MRT=38.176、F上方MRT=22.324、F下方MRT=39.936、F中心凹MVD=36.154、F旁中心凹MVD=45.573、F上方MVD=29.345、F下方MVD=30.267;均为P<0.01),而在颞侧和鼻侧两个象限MRT、MVD差异均无统计学意义(F颞侧MRT=2.614、F鼻侧MRT=2.497、F颞侧MVD=2.134、F鼻侧MVD=1.937;均为P>0.05);NTG组的黄斑中心凹、旁中心凹、上方及下方的MRT、MVD与视野平均缺损均具有相关性(均为P<0.01)。结论利用OCTA技术可以有效地反映NTG黄斑区形态学改变特征,且这种改变与视野平均缺损相关,从而可在疾病的早期提供无创影像学诊断支持,为尽早干预治疗提供帮助。Objective To use optical coherence tomography angiography(OCTA)to observe the changes of macular retinal thickness(MRT)and macular vessel density(MVD)in the macular area of normal-tension glaucoma,and to explore its relevance to visual field.Methods Twenty NTG patients(40 eyes)were selected as the TNG group,and 20 patients(40 eyes)of normal persons as the control group.OCTA was used to obtain the MRT and MVD in the macular area.The difference between the NTG group and the control group was statistically analyzed and the correlation between the macular area detection index and the visual field defect in the NTG group was tested.Results We obtained the MRT and MVD in the macular area of the subject by OCTA,and found that there were statistically significant difference in the MRT and MVD in the macular area at the four directions of fovea,paracentral fovea,top and bottom between the NTG group and the control group(Ffovea MRT=26.923,Fparacentral fovea MRT=38.176,Ftop MRT=22.324,Fbottom MRT=39.936,Ffovea MVD=36.154,Fparacentral MVD=45.573,Ftop MVD=29.345,Fbottom MVD=30.267;All P<0.01),but there was no statistical difference between two groups in temporal and nasal sides(Ftemporal MRT=2.614,Fnasal MRT=2.497,Ftemporal MVD=2.134,Fnasal MVD=1.937;All P>0.05).The fovea,paracentral fovea,top and bottom of the NTG group were correlated with the mean deviation of visual field(all P<0.01).Conclusion The use of OCTA technology can effectively reflect the characteristics of NTG macular morphological changes,and this change is related to visual field defect,which can provide non-invasive imaging diagnosis support in the early stage of the disease and provide help for early intervention treatment.

关 键 词：光学相干断层扫描血管成像 正常眼压性青光眼 黄斑区 视野 

分 类 号：R775[医药卫生—眼科]