虹膜吲哚青绿血管造影观察不同斜视患者眼前节血液供应的特征  

Application of indocyanine green iris angiography in the evaluation of anterior segment blood supply in different strabismus patients

作　　者：丁娟[1] 李月平 丛春霞 陈丽萍 段红涛[1] 赵堪兴[1] 张伟[1] Ding Juan;Li Yueping;Cong Chunxia;Chen Liping;Duan Hongtao;Zhao Kanxing;Zhang Wei(Tianjin Eye Hospital,Nankai University Affiliated Eye Hospital,Clinical College of Ophthalmology of Tianjin Medical University,Tianjin Eye Institute,Tianjin Key Laboratory of Ophthalmology and Vision Science,Tianjin 300020,China)

机构地区：[1]天津市眼科医院,南开大学附属眼科医院,天津医科大学眼科临床学院,天津市眼科研究所,天津市眼科学与视觉科学重点实验室,天津300020

出　　处：《中华眼科杂志》2022年第7期535-541,共7页Chinese Journal of Ophthalmology

基　　金：天津市重点研发计划科技支撑重点项目(19YFZCSY00990);天津眼科医院基金面上项目(YKYB2006)。

摘　　要：目的探讨不同斜视患者眼前节血液供应的变化。方法横断面研究。收集2016年11月至2021年12月在天津市眼科医院接受虹膜吲哚青绿血管造影(ICGA)的16例(16只眼)斜视患者,按是否存在眼外肌直肌损伤以及直肌手术史分为2个组。所有患者均进行常规眼科检查和眼肌检查,并行ICGA检查,通过眼前节照相机获得图像,记录前臂-虹膜循环时间、虹膜充盈完成时间、开始消退时间、消退完成时间等指标。采用独立样本t检验或Mann-WhitneyU检验,对比2个组虹膜灌注情况,采用Pearson及Spearman相关性检验,分析前臂-虹膜循环时间、虹膜充盈完成时间与年龄、病程的关系。结果16例患者中男性10例,女性6例;年龄(49.2±13.2)岁,病程2~31个月。眼外肌无损伤组7例,眼外肌损伤或手术组9例,2个组年龄、病程差异无统计学意义(均P>0.05)。眼外肌无损伤组与眼外肌损伤或手术组前臂-虹膜循环的时间[M(Q1,Q3)]分别为18(18,21)、22(20,24)s,虹膜充盈完成时间分别为(13.86±1.95)、(12.22±3.60)s,2个组间差异均无统计学意义(均P>0.05)。相关性分析显示,前臂-虹膜循环时间与年龄、病程不相关(r=-0.033、-0.079,均P>0.05);虹膜充盈完成时间与年龄、病程不相关(r=0.057、-0.119,均P>0.05)。矩阵散点图显示,眼外肌损伤或手术组中,年龄高于总体平均数(49.2岁)且前臂-虹膜循环时间达中位数(20 s)以上患者有3例(2例合并垂直肌肉损伤),病程大于6个月且前臂-虹膜循环时间达中位数以上患者有3例(均合并垂直肌肉损伤),均大于眼外肌无损伤组(各1例)。结论ICGA显示,病程2个月以上眼外肌损伤或有手术史的斜视患者眼前节血液供应与眼外肌无损伤斜视患者无差别,年龄及病程与眼前节虹膜血管再灌注无相关性,垂直眼外肌受累对眼前节血液供应影响较大。Objective To evaluate the perfusion features of the anterior segment in patients with different types of strabismus.Methods A cross-sectional study.Sixteen strabismus patients(16 eyes)who received the examination of iris indocyanine green angiography(ICGA)in Tianjin Eye Hospital from November 2016 to December 2021 were enrolled and divided into two groups according to whether they had a history of extraocular muscle injury/rectus muscle surgery.All patients underwent routine ophthalmic examinations.Angiographic images were obtained by the anterior segment camera,and indicators such as arm to iris circulation time,whole iris filling time,regression onset time,and complete regression time were recorded.The independent sample t test or Mann-Whitney U test was used to compare iris perfusion aspects of the two groups,and the Pearson/Spearman correlation tests was used to analyze the correlation of arm to iris circulation time and whole iris filling time with age and course of strabismus.Results Among the 16 patients,there were 10 males and 6 females.The mean age was(49.2±13.2)years,and the course of strabismus ranged from 2 to 31 months.There were 7 patients in the group of without extraocualr muscle injury and 9 patients in the extraocular muscle injury/surgery group.There was no significant difference in age and course of strabismus between the two groups(both P>0.05).The arm to iris circulation time[M(Q1,Q3)]of the group without extraocular muscle injury and the group with extraocular muscle injury/surgery were 18(18,21)and 22(20,24)s,respectively.The average whole iris filling time was(13.86±1.95)and(12.22±3.60)s,respectively.There was no statistical significance between the two groups(both P>0.05).Correlation analysis showed that arm to iris circulation time was not correlated with age and course of strabismus(r=-0.033,-0.079;both P>0.05).And the whole iris filling time was not correlated with age and course of disease(r=0.057,-0.119;both P>0.05).The matrix scatter plots showed that in the group of extraocular

关 键 词：斜视 眼前半段 虹膜 血管造影术 吲哚花青绿 

分 类 号：R777.41[医药卫生—眼科]