屈光参差性弱视儿童治疗前后视网膜微血流状态变化及其与疗效的相关性  

Changes in retinal microbleed status before and after treatment in children with anisometropic amblyopia and their correlation with treatment effect

作　　者：陈杰 刘永华[1] 李晓燕[1] 渠晓梨 CHEN Jie;LIU Yonghua;LI Xiaoyan;QU Xiaoli(Department of Ophthalmology,Liaocheng People’s Hospital,Liaocheng 252000,Shandong Province,China;Department of Ophthalmology,the First Affiliated Hospital of Shandong First Medical University,Jinan 250000,Shandong Province,China)

机构地区：[1]聊城市人民医院眼科,山东省聊城市252000 [2]山东第一医科大学第一附属医院眼科,山东省济南市250000

出　　处：《眼科新进展》2022年第4期314-318,共5页Recent Advances in Ophthalmology

摘　　要：目的分析屈光参差性弱视儿童治疗前后视网膜微血流状态变化及其与疗效的相关性。方法选取2017年12月至2019年12月我院眼科收治的单眼屈光参差性弱视患儿150例(弱视眼150眼)作为研究对象。将屈光参差性弱视患儿的弱视眼纳入弱视眼组(150眼),非弱视眼为对侧眼组(150眼);另选取60例正常视力儿童右眼(60眼)作为正常对照组。使用OCTA对三组儿童入选眼黄斑区行3 mm×3 mm黄斑扫描及4.5 mm×4.5 mm视盘扫描,经ImageJ图像处理软件获得受试者浅层视网膜毛细血管丛血流密度(SCP)和深层视网膜毛细血管丛血流密度(DCP)、视盘及视盘旁血流密度、黄斑中心凹无灌注区(FAZ)面积和黄斑中心凹厚度(CMT)。患儿入院后均在屈光矫正、遮盖健眼的基础上对弱视眼进行视功能训练治疗,采用重复测量方差分析及配对t检验分析治疗前和治疗后3个月、6个月患儿弱视眼视网膜微血流参数、最佳矫正视力(BCVA)及立体视等差异,采用Pearson相关分析探讨视网膜微血流参数与BCVA及立体视的相关性。结果弱视眼组受试者等效球镜度均大于对侧眼组和正常对照组,且对侧眼组等效球镜度大于正常对照组(均为P<0.05);弱视眼组受试者BCVA较对侧眼组和正常对照组差(均为P<0.05);弱视眼组和对侧眼组受试者眼轴长度均短于正常对照组(均为P<0.05)。治疗前弱视眼组受试者SCP、DCP、视盘血流密度均小于对侧眼组和正常对照组(均为P<0.05);弱视眼组、对侧眼组和正常对照组受试者视盘旁血流密度、FAZ面积、CMT组间比较,差异均无统计学意义(均为P>0.05)。弱视眼组患儿治疗前SCP、DCP、视盘血流密度均低于治疗后3个月和治疗后6个月,且治疗后3个月SCP、DCP、视盘血流密度均低于治疗后6个月(均为P<0.05)。弱视眼组患儿治疗后3个月和治疗后6个月BCVA均优于治疗前,且治疗后6个月BCVA优于治疗后3个月(均为P<0.05);患儿治�Objective To investigate the changes in retinal microbleed status before and after treatment in children with anisometropic amblyopia and their correlation with the treatment effect.Methods One hundred and fifty children(150 amblyopic eyes)with monocular anisometropic amblyopia admitted to our ophthalmology department from December 2017 to December 2019 were selected.Their amblyopic eyes were included in the amblyopic eye group and their non-amblyopic eyes were included in the contralateral eye group.Sixty right eyes of 60 children with normal vision were selected into the normal control group.With optical coherence tomography angiography(OCTA),a 3 mm×3 mm macular scan and a 4.5 mm×4.5 mm optic disc scan were performed in the macular region of all selected eyes.The vessel density in superficial capillary plexus(SCP-VD),vessel density in deep capillary plexus(DCP-VD),vessel density in and around the optic disc,foveal avascular zone(FAZ)area,and central macular thickness(CMT)were obtained using ImageJ software.After admission,the children were treated with refractive correction and visual training with the healthy eye shielded.The differences in the retinal microbleed,best corrected visual acuity(BCVA)and stereopsis of amblyopic eyes before and 3 and 6 months after treatment were analyzed using repeated measures ANOVA and paired t-test,and the correlation of retinal microbleed with BCVA and stereopsis was analyzed using Pearson correlation coefficient.Results The spherical equivalent(SE)in the amblyopic eye group was greater than that in the contralateral eye group and the normal control group,and the SE in the contralateral eye group was greater than that in the normal control group(all P<0.05).BCVA(logMAR)in the amblyopic eye group was smaller than that in the contralateral eye group and the normal control group(both P<0.05).The axial length in the amblyopic and contralateral eye groups was shorter than that in the normal control group(both P<0.05).Before treatment,SCP-VD,DCP-VD,and VD in the optic disc were sm

关 键 词：屈光参差性弱视 光学相干断层扫描血管成像 浅层视网膜毛细血管丛 黄斑中心凹无灌注区 黄斑中心凹厚度 

分 类 号：R779.7[医药卫生—眼科]