视网膜静脉阻塞继发黄斑水肿患眼黄斑微血管结构与黄斑色素密度相关性分析  

Correlation analysis of macular microvascular structure and macular pigment opticaldensity in retinal vein occlusion

作　　者：丁国龙 武炳慧[1] 索琰 李婵 陆慧琴[1] 张红兵[1] 吴惠琴[1] Ding Guolong;Wu Binghui;Suo Yan;Li Chan;Lu Huiqin;Zhang Hongbing;Wu Huiqin(Ophthalmology Hospital,Xi'an No.1 Hospital,Xi'an 710002,China)

机构地区：[1]西安市第一医院眼科医院,西安710002

出　　处：《中华眼底病杂志》2022年第10期835-839,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：陕西省重点研发计划项目(2021SF-337)。

摘　　要：目的观察视网膜静脉阻塞(RVO)继发黄斑水肿(ME)患眼黄斑微血管结构和黄斑色素密度(MPOD)的变化,初步分析其相关性。方法前瞻性临床研究。2020年7月至2021年5月于西安市第一医院眼科医院检查确诊的单眼RVO继发ME(RVO-ME)患者62例62只眼纳入研究。其中,男性33例33只眼,女性29例29只眼;年龄(58.30±12.15)岁。其出现症状至就诊时病程(12.29±7.65)d。所有患眼均行最佳矫正视力(BCVA)、光相干断层扫描血管成像(OCTA)以及MPOD检测。采用标准对数视力表行BCVA检查,统计时换算为最小分辨角对数(logMAR)视力。采用OCTA仪对双眼黄斑区3 mm×3 mm范围进行扫描,测量视网膜浅层毛细血管丛(SCP)的血流密度(VD)、血管骨架密度(SD)、中心凹无血管区(FAZ)面积、黄斑中心凹厚度(CMT)。采用异色闪烁光度测量法测量MPOD。双眼通过检测37例;患眼未通过检测25例。对比观察患眼、对侧眼之间黄斑VD、SD、FAZ面积、CMT、MPOD变化。患眼、对侧眼MPOD比较采用配对t检验;FAZ面积、CMT、VD、SD、logMAR BCVA采用配对Wilcoxon符号秩和检验。黄斑VD、SD及FAZ面积、CMT与logMAR BCVA、MPOD的相关性分析均采用Spearman秩相关检验。结果与对侧眼比较,患眼黄斑VD(Z=-5.981)、SD(Z=-6.021)降低,FAZ面积增大(Z=-2.598),CMT增厚(Z=-6.206),差异均有统计学意义(P<0.05)。双眼均通过MPOD检测的37例患者,患眼MPOD值较对侧眼降低,差异有统计学意义(t=-2.930,P<0.05)。与未通过MPOD检测的患眼比较,通过MPOD检测的患眼黄斑VD(Z=-2.807)、SD(Z=-2.460)升高,FAZ面积减小(Z=-4.297),CMT降低(Z=-3.796),差异均有统计学意义(P<0.05)。相关性分析结果显示,患眼logMAR BCVA与黄斑VD、SD呈负相关(r=-0.298、-0.461,P<0.05),与FAZ面积、CMT呈正相关(r=0.487、0.789,P<0.05);患眼MPOD与logMAR BCVA呈负相关(r=-0.344,P<0.05);对侧眼MPOD与CMT呈正相关(r=0.358,P<0.05)。结论RVO-ME患眼黄斑SCP的VD、SD降低,FAZ面积扩大,CMT�Objective To observe the changes of macular microvascular structure and macular pigment density(MPOD)in eyes with macular edema(ME)secondary to retinal vein occlusion(RVO),and preliminarily analyze their correlation.Methods A prospective clinical study.A total of 62 eyes of 62 patients with monocular RVO secondary ME(RVO-ME)diagnosed in the Ophthalmology Hospital of Xi'an No.1 Hospital from July 2020 to May 2021 were included in this study.There were 33 males with 33 eyes,29 females with 29 eyes.The age was 58.30±12.15 years.The course of disease from the onset of symptoms to medical treatment was 12.29±7.65 days.All patients underwent best corrected visual acuity(BCVA),optical coherence tomography angiography(OCTA)and MPOD test.BCVA examination was performed using a standard logarithmic visual acuity chart,which was converted to logarithm of minimum angle of resolution(logMAR).The vascular density(VD),vascular skeletal density(SD),foveal avascular area(FAZ)and central macular thickness(CMT)of the superficial retinal capillary plexus(SCP)in the range of 3 mm×3 mm in the macular area of bilateral eyes were measured by OCTA.MPOD was measured by heterochromatic scintillation photometry.Bilateral eyes passed examination in 37 cases.The eyes of 25 patients failed to pass the test.The changes of macular VD,SD,FAZ area,CMT and MPOD between the affected eyes and the contralateral eyes were compared.The MPOD of the affected eye and the contralateral eye was compared by paired t test.FAZ area,CMT,VD,SD,and logMAR BCVA were tested by paired Wilcoxon signed rank sum test.Spearman rank correlation test was used to analyze the correlation between macular blood flow density(VD,SD)and foveal morphology(FAZ area,CMT)with logMAR BCVA and MPOD.Results Compared with contralateral eyes,VD(Z=-5.981)and SD(Z=-6.021)were decreased,FAZ area(Z=-2.598)and CMT(Z=-6.206)were increased,and the differences were statistically significant(P<0.05).In 37 patients who passed MPOD test in bilateral eyes,the MPOD value of the affected eye was lowe

关 键 词：视网膜静脉闭塞 黄斑水肿 体层摄影术 光学相干 局部血流 黄斑色素密度 

分 类 号：R774[医药卫生—眼科]