OCTA观察斜视手术前后虹膜血流变化的研究  

Observation on iris vasculature by optical coherence tomography angiography after strabismus surgery

作　　者：邵婉瑜 马波[1] 季家利 赵展琳 刘嫣[1] 罗敏[1] 沈勤[1] Shao Wanyu;Ma Bo;Ji Jiali;Zhao Zhanlin;Liu Yan;Luo Min;Shen Qin(Department of Ophthalmology,Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,Shanghai,China,Department of Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院眼科上海市眼眶病眼肿瘤重点实验室,200011

出　　处：《临床眼科杂志》2021年第4期315-319,共5页Journal of Clinical Ophthalmology

摘　　要：目的通过相干光层析血管成像术(OCTA)评估斜视手术前后虹膜血流的变化,为斜视手术中眼外肌变动数目的选择以及评估是否发生眼前节缺血提供参考。方法采用横断面观察试验研究的方法,收集2019年1~3月就诊于上海交通大学医学院附属第九人民医院的34名确诊为斜视并且有手术指征的受试者,平均年龄(37.24±13.61)岁,使用OCT(Triton Prototype DRI-OCT,拓普康,日本)检查设备,每个受试者由1名训练有素的操作者对术前和术后1周的虹膜的4个象限(上,下,鼻和颞)进行扫描,选择虹膜区域后将图像导入IMAGEnet6进行分析。选取其中图像清晰的10名受试者(共12只眼)进行分析,男性和女性各5名,平均年龄(39.9±13.3)岁。结果所有患者均能采集到虹膜血管图像,虹膜颜色较浅的受试者的血管形态更清晰,成像质量相对高,选入分析的患者的四个象限术前平均灰度值96.36±24.95,术后97.08±24.05,差异无统计学意义(t=0.16,MD=0.722,P>0.05);手术直肌对应的象限术前平均灰度值95.35±22.80,术后102.81±28.61,差异无统计学意义(t=0.85,MD=7.46,P>0.05)。在手术安全范围内,术前和术后的虹膜血流变化差异无显著性。结论初步描述了用OCTA来无创性获得斜视手术前后虹膜血管的变化,该技术具有可重复性,可用于将来评估斜视患者初次或再次手术的手术量。Objective Optical coherence tomography angiography(OCTA)was used to evaluate the changes of iris blood flow before and after strabismus surgery,which provided a reference for the selection of the number of extraocular muscle changes in strabismus surgery and the evaluation of anterior segment ischemia.Methods Participants of this cross-sectional observational pilot study were enroled at the Department of Ophthalmology in Shanghai Ninth People’s Hospital from January 2019 to March 2019.Thirty-four adults(37.24±13.61years)undergoing strabismus surgery were recruited.All OCTA scans were performed using an OCTA system operating at a wavelength of 1050-nm in four quadrants(superior,inferior,nasal,and temporal).The scans were delineated into iris layers using IMAGEnet6 for analysis.Twelve eyes of 10 patients(5 males,5 females;age,39.9±13.3years)were chosen to analyze.Results It is possible to observe the iris vascular network of all adults.The patterns of vascular are less clearly visible in a highly pigmented iris.The mean gray value averaged for all quadrants was 96.36±24.95 preoperatively and 97.08±24.05 postoperatively.The difference was not statistically significant(t=0.16,MD=0.722,P>0.05).When comparing quadrants adjacent to operated muscles,the average gray value was 95.35±22.80 preoperatively and 102.81±28.61 postoperatively(t=0.85,MD=7.46,P>0.05).There was no significant difference in iris blood flow before and after operation in safe range.Conclusions We describe a new application of OCTA to obtain iris vascular noninvasively.This technique is repeatable and can be used to evaluate surgical protocols of strabismus patients in the future.

关 键 词：相干光层析血管成像术 虹膜 斜视 眼前节缺血 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]