原发性开角型青光眼视盘周围血流及黄斑结构变化的初步观察  

Preliminary observation on the changes of peripapillary blood flow and macular structure in primary open angle glaucoma

作　　者：杨子建 程瑜 姚慧萍 沈婷 刘晓庆 周瑜峰 Yang Zijian;Cheng Yu;Yao Huiping;Shen Ting;Liu Xiaoqing;Zhou Yufeng(Department of Ophthalmology,Ruijin Hospital North,Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 201800,China)

机构地区：[1]上海交通大学医学院附属瑞金医院北院眼科,201800

出　　处：《临床眼科杂志》2021年第1期5-8,共4页Journal of Clinical Ophthalmology

基　　金：上海交通大学医学院附属瑞金医院北院研究基金。

摘　　要：目的分析原发性开角型青光眼(POAG)视盘周围及黄斑区血流改变及结构改变的特点及其意义。方法2018年1月至2019年12月本院检查的确诊为POAG患者38例(71只眼),平均年龄(64.55±9.51)岁。正常对照组24例(48只眼),平均年龄(61.67±11.38)岁。应用拓普康DRI SS-OCT检查仪行相干光层析血管成像术(OCTA)检测两组视网膜神经纤维层(RNFL)厚度和视网膜神经节细胞复合体(GCC)。视盘周围扫描范围6 mm×6 mm;黄斑区测量范围包括中心凹(以黄斑中心点为中心的半径1 mm范围),旁中心凹(以黄斑中心点为中心的半径3 mm范围),分别记录上、下、颞侧和鼻侧区域。OCTA检查:OCT血流模式和二维模式测量。范围3 mm×3 mm,使用仪器自带测量分析软件选取高清晰度图片分析。POAG组与健康对照组年龄、视盘血流密度、黄斑区血流密度、RNFL厚度及GCC的比较采用独立样本t检验,分析POAG视盘周围血流参数、RNFL厚度及GCC厚度的改变及其意义。结果视盘周围血流比较,POAG组与健康对照组上方、下方、颞侧、鼻侧和中央部的血流相比,分别减少11.02%、11.07%、4.79%、9.06%和11.02%,差异有统计学意义。不同部位视盘周围RNFL厚度比较,POAG组与健康对照组上方、下方、颞侧、鼻侧和整体的RNFL厚度相比,分别减少44.71%、50.46%、4.79%、29.01%和31.61%,差异有统计学意义。不同部位GCC厚度比较,POAG组与健康对照组上方、下方、颞侧、鼻侧和中央直径1 mm的GCC厚度相比,分别减少23.69%、23.95%、22.76%、19.07%和-0.44%,中央直径1 mm的GCC厚度差异无统计差异,其余方位GCC厚度差异有统计学意义。结论青光眼视盘周围血流的改变与RNFL厚度层及黄斑旁中心凹GCC厚度的改变一致,而黄斑中心凹GCC厚度未受影响。OCT及OCTA是评估POAG视神经损伤及进展的有效方法。Objective To evaluate the changes of retinal vasculature and structure parameter in the peripapillary and macular region in primary open angle glaucoma(POAG).Methods A total of 38 POAG patients(71 eyes)with a mean age of(64.55±9.51)years at the Shanghai Ruijin hospital north from January 2018 to December 2019 were selected,and 24 age and gender matched healthy subjects(48 eyes,mean age 61.67±11.38 years)were selected as the control group.The peripapillary retinal circulation was evaluated using the optical coherence tomography angiography(OCTA)centered on the optic nerve head in 71 POAG eyes and 48 healthy control eyes.The peripapillary retinal nerve fibre layer(pRNFL)and macular ganglion cell complex(GCC)were measured using the optical coherence tomography(OCT).The 6x6mm peripapillary and 3x3mm macular areas were scanned.Age,disc vessle density,macular vessel density,REFL and GCC were compared between the two groups using t test.Results Compared with control group,superior,inferior,temporal,nasal and central vessel density of patient with PAOG reduced 11.02%,11.07%,4.79%,9.06%and 11.02%,respectively.Compared with control group,superior,inferior,temporal,nasal and total RNFL of patient with PAOG reduced 44.71%,50.46%,4.79%,29.01%and 31.61%,respectively.Compared with control group,superior,inferior,temporal,nasal and central GCC of patient with PAOG reduced 23.69%,23.95%,22.76%,19.07%and-0.44%,respectively(t=10.439,9.219,10.147,6.720 and-0.113).Conclusions The changes of the peripapillary blood flow were consistent with the changes of para-fovea GCC thickness and RNFL thickness,but the GCC thickness in the macular fovea was not affected.OCT and OCTA are effective methods to evaluate the optic nerve injury and disease progression in POAG.

关 键 词：相干光层析血管成像术 青光眼 黄斑 神经节细胞 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]