基于OCTA分析妊娠期高血压患者产后视网膜微循环的变化  

Changes of retinal microcirculation in postnatal patients with pregnancy-induced hypertension based on OCTA

作　　者：孙鹏华 赵晓燕[3] 汤明霞 刘虎[1] Peng-Hua Sun;Xiao-Yan Zhao;Ming-Xia Tang;Hu Liu(Department of Ophthalmology,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210000,Jiangsu Province,China;Department of Ophthalmology,Taizhou Maternal and Child Health Care Center,Taizhou 225300,Jiangsu Province,China;Department of Ophthalmology,Changzhou No.2 People's Hospital of Nanjing Medical University,Changzhou 213000,Jiangsu Province,China;Taizhou People's Hospital,Taizhou 225300,Jiangsu Province,China)

机构地区：[1]南京医科大学第一附属医院眼科,中国江苏省南京市210000 [2]中国江苏省泰州市妇幼保健所眼科,225300 [3]南京医科大学附属常州第二人民医院眼科,中国江苏省常州市213000 [4]中国江苏省泰州市人民医院眼科,225300

出　　处：《国际眼科杂志》2022年第11期1861-1866,共6页International Eye Science

基　　金：江苏省科技计划项目(No.BE2020722)。

摘　　要：目的:利用光学相干断层扫描血管成像技术(OCTA)定量分析产后6mo以上妊娠期高血压综合征(PIH)患者的视网膜微循环变化。方法:分别测量19例PIH患者、23例正常妊娠女性(HPW)及19例未妊娠女性(CNPW)的屈光度、最佳矫正视力及眼轴长度,并使用OCTA测量三组视乳头及黄斑区血流参数、神经纤维层厚度和脉络膜厚度。所有妊娠患者数据均采集自分娩6mo以后。运用统计软件SPSS20.0,单因素方差分析比较三组间视网膜微循环相关参数的组间差异。结果:PIH组的黄斑区无灌注区面积(FAZ)明显大于HPW组和CNPW组(均P<0.05);三组间的黄斑区各区域视网膜浅层血管密度无差异;PIH组的视乳头各区域浅层血管密度,其中视乳头整层6mm区域、外层、下外侧、鼻外侧高于HPW组和CNPW组;视神经纤维层平均厚度三组间无差异,但PIH组的视神经颞侧纤维层厚度明显低于HPW组和CNPW组(均P<0.05);PIH组的黄斑中心区视网膜厚度明显低于HPW和CNPW(均P<0.05);中心凹下脉络膜厚度三组间无差异。结论:PIH患者产后视网膜部分区域血管密度、黄斑中心区厚度及颞侧视神经纤维层厚度与HPW及CNPW组间均存在差异,提示PIH对视网膜微循环的影响可能在产后仍持续存在。AIM:To quantitatively analyze the changes of retinal microcirculation in patients with pregnancy-induced hypertension(PIH)syndrome who have delivered after more than 6 mo by using optical coherence tomography angiography(OCTA).METHODS:In this study,a total of 19 females with PIH,23 healthy pregnant women and 19 control non pregnant women(CNPW)were recruited.Ocular examinations including diopter,best corrected visual acuity and axial length were measured,respectively.OCTA was used to measure the optic nerve head and macular blood flow parameters,nerve fiber layer and choroidal thickness of the three groups.The data of pregnant patients were collected more than 6 mo after delivery.All statistical analyses were performed in the SPSS20.0,and single factor analysis of variance was used to analyze inter-group differences of retinal microcirculation related parameters among the three groups.RESULTS:Foveal avascular zone(FAZ)of the PIH group was significantly larger than that of the HPW and CNPW groups(all P<0.05).There was no statistical difference in macular superficial capillary plexus vessel density among the three groups.The superficial capillary plexus vessel density of each region of the optic nerve head in the PIH group,among which the entire 6 mm layer,outer layer,lower lateral layer and lateral nasal,was higher than that in the HPW and CNPW groups.There was no statistical difference in the average thickness of retinal nerve fiber layer among the three groups,but the thickness of temporal retinal nerve fiber layer of PIH group was significantly thinner than that of HPW and CNPW group(all P<0.05).The central foveal thickness of PIH group was significantly thinner than that of HPW group and CNPW group(all P<0.05).There was no statistical difference in central choroid thickness among the three groups.CONCLUSION:Differences were founded in partial retinal superficial capillary plexus vessel density,central foveal thickness and temporal retinal nerve fiber layer thickness in postpartum patients with PIH compared with

关 键 词：妊娠期高血压 光学相干断层扫描血管成像技术(OCTA) 视网膜浅层毛细血管密度 

分 类 号：R714.246[医药卫生—妇产科学] R774[医药卫生—临床医学]