高度近视脉络膜新生血管光相干断层扫描血管成像特征及黄斑区脉络膜毛细血管密度分析  

Characteristics of highly myopic choroidal neovascularization by optical coherence tomography angiography and analysis of macular choriocapillaris density

作　　者：邵蕾 董力 张川 周文达 魏文斌 Shao Lei;Dong Li;Zhang Chuan;Zhou Wenda;Wei Wenbin(Beijing Tongren Eye Center,Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment,Beijing Ophtahlmology&Visual Sciences Key Laboratory,Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,眼内肿瘤诊治研究北京市重点实验室,北京市眼科学与视觉科学重点实验室,医学人工智能研究与验证工信部重点实验室,100730

出　　处：《中华眼底病杂志》2021年第12期920-925,共6页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金(82000916);北京市医管局"青苗"计划(QML20180204);北京市优秀人才项目青年骨干基金(2018000021469G207);东城区优秀人才培养资助项目(2020-dchrcpyzz-42);首都医科大学附属北京同仁医院青年拔尖人才项目(2018-YJJ-ZZL-045)。

摘　　要：目的观察高度近视脉络膜新生血管(mCNV)患眼光相干断层扫描血管成像(OCTA)影像特征及黄斑区脉络膜毛细血管密度(CCD)变化。方法病例对照研究。2018年1月至2020年10月于首都医科大学附属北京同仁医院眼科检查确诊的mCNV患者50例50只眼(mCNV组)纳入研究。其中,男性18例,女性32例;年龄(42.11±11.66)岁。选取近视屈光度(≥6.00 D)与mCNV组匹配的眼底正常者50例50只眼作为单纯高度近视组,正常志愿者(屈光度-0.25~0.25 D)50名50只眼作为正常对照组。三组患者间年龄(F=0.028)、性别构成比(χ^(2)=0.136)比较,差异均无统计学意义(P>0.05);最佳矫正视力比较,差异有统计学意义(F=14.762,P=0.004)。mCNV组、单纯高度近视组受检眼屈光度(t=-0.273)、眼轴长度(t=0.312)比较,差异无统计意义(P>0.05)。采用OCTA仪测量受检眼CCD。三组间计量资料比较采用方差分析;分类变量比较行χ^(2)检验。mCNV患者患眼与对侧眼CCD比较行配对t检验。结果mCNV组50只眼中,Ⅰ型、Ⅱ型、混合型脉络膜新生血管(CNV)分别为12(24%,12/50)、34(68%,34/50)、4(8%,4/50)只眼。病灶处对应OCTA横断面像可见边界清晰的"花团"样强血流信号。其中,焦点状、丝条状、团网状分别为6(12%,6/50)、8(11%,8/50)、36(72%,36/50)只眼。mCNV组、单纯高度近视组、正常对照组受检眼CCD分别为(57.39±3.24)%、(59.33±2.23)%、(61.87±1.62)%。mCNV组患眼CCD显著低于单纯高度近视组(P=0.030)、正常对照组(P<0.001)。mCNV组患眼、对侧眼CCD分别为(57.39±3.24)%、(59.82±3.94)%;患眼、对侧眼CCD比较,差异无统计学意义(t=-0.496,P=0.100)。Ⅰ型、Ⅱ型、混合型CNV患眼CCD分别为(57.38±3.31)%、(57.39±2.83)%、(57.36±4.21)%。不同CNV分型者CCD(F=1.476)、年龄(F=0.274)、性别构成比(χ^(2)=0.825)、屈光度(F=0.348)比较,差异均无统计学意义(P>0.05)。结论mCNV多为Ⅱ型,OCTA表现为异常网状血管的"花团"样外观;CCD显著降低,且呈�Objective To observe the imaging characteristics of optical coherence tomography angiography(OCTA)and the changes of choroidal capillary density(CCD)in the eyes of patients with high myopia choroidal neovascularization(mCNV).Methods A case-control study.From January 2018 to October 2020,50 cases of mCNV patients with 50 eyes(mCNV group)were included in the study.There were 18 males and 32 females;their age was 42.11±11.66 years old.Fifty eyes of 50 patients with normal fundus with matching myopia refractive power(≥6.00 D)were selected as the simple high myopia group,and 50 normal volunteers(refractive power-0.25-0.25 D)while 50 eyes were selected as the normal control group.There was no statistically significant difference in age(F=0.028)and gender composition ratio(χ^(2)=0.136)among the three groups of patients(P>0.05);the difference in best corrected visual acuity was statistically significant(F=14.762,P=0.004).Compared with mCNV group and pure high myopia group,the refractive index(t=-0.273)and axial length(t=0.312)of the examined eyes were not statistically significant(P>0.05).OCTA instrument was used to measure the CCD in the macular area of the examined eye.Analysis of variance was used for comparison of measurement data among the three groups;χ^(2) test was used for comparison of categorical variables.The paired t test was performed to compare the CCD of the mCNV patient's eye and the contralateral eye.Results Among the 50 eyes in the mCNV group,Ⅰ,Ⅱ,and mixed choroidal neovascularization(CNV)were 12(24%,12/50),34(68%,34/50),and 4(8%,4/50)eyes,respectively.Corresponding to the OCTA cross-sectional image of the lesion,there was a clear"flower cluster"-like strong blood flow signal.Among them,the focal shape,the filament shape,and the group net shape were 6(12%,6/50),8(11%,8/50),and 36(72%,36/50)eyes,respectively.The CCD of the eyes in the mCNV group,the pure high myopia group,and the normal control group were(57.39±3.24)%,(59.33±2.23)%,and(61.87±1.62)%,respectively.The CCD of the eyes in the mCNV

关 键 词：近视 脉络膜新生血管化 体层摄影术 光学相干 局部血流 

分 类 号：R778.11[医药卫生—眼科]