家族性渗出性玻璃体视网膜病变伴黄斑中心凹内层视网膜残留患眼黄斑区结构及血流改变  

The macular structure and blood flow in familial exudative vitreoretinopathy with inner retinal layer persistence

作　　者：邵伊润 毛剑波 陈怡静 方宇燕 沈丽君 Shao Yirun;Mao Jianbo;Chen Yijing;Fang Yuyan;Shen Lijun(Hangzhou Traditional Chinese Medicine Hospital,Hangzhou 310007,China;The Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou,Hangzhou 310020,China;Zhejiang Provincial People's Hospital(Affiliated People's Hospital,Hangzhou Medical College)Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]杭州市中医院眼科,杭州310007 [2]温州医科大学附属眼视光医院杭州院区,杭州310020 [3]浙江省人民医院眼科,杭州310014

出　　处：《中华眼底病杂志》2023年第7期560-564,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的对比观察早期家族性渗出性玻璃体视网膜病变(FEVR)伴或不伴黄斑中心凹内层视网膜(IRL)残留患眼的黄斑区微血管结构变化。方法回顾性临床研究。2017年至2022年于温州医科大学附属眼视光医院杭州院区及浙江省人民医院眼科检查确诊的伴或不伴IRL残留的1期FEVR患者94例94只眼和年龄、性别匹配的健康志愿者45名45只眼(正常对照组)纳入研究。依据是否伴IRL残留将患者分为IRL组、非IRL组,分别为22例22只眼、72例72只眼。受检眼均行最佳矫正视力(BCVA)、光相干断层扫描血管成像(OCTA)检查。BCVA检查采用对数视力表进行,记录时转换为最小分辨角对数(logMAR)视力。采用OCTA仪对所有受检眼黄斑区3 mm×3 mm范围进行扫描,测量其总体、中心凹、旁中心凹的视网膜浅层毛细血管丛(SCP)、深层毛细血管丛(DCP)血流密度以及黄斑中心凹无血管区(FAZ)面积、周长、非圆度指数(AI),FAZ范围300μm宽度内的血流密度(FD-300)以及黄斑中心凹厚度(CMT)。三组间参数比较采用单因素方差分析。结果与正常对照组比较,IRL组、非IRL组黄斑区3 mm×3 mm范围总体(F=10.774、4.583)、旁中心凹(F=10.433、3.912)SCP、DCP血流密度和CMT(F=171.940)均降低,差异有统计学意义(P<0.05)。三组FAZ面积(F=4.315)、AI(F=3.413)、FD-300(F=13.592)比较,差异均有统计学意义(P<0.05)。IRL组患眼BCVA最差。结论FEVR患眼黄斑区血流密度下降,CMT显著厚于正常人群。中心凹IRL残留患眼FAZ面积小且不规则,具有更差的BCVA、更低的黄斑血流密度。Objective To compared the changes of macular microvascular architecture in early stage familial exudative vitreoretinopathy(FEVR)patients with inner retinal layer(IRL)persistence and without IRL persistence.Methods A retrospective clinical study.From 2017 to 2022,94 patients with stage 1 FEVR with or without IRL residue and 45 age-and sex-matched healthy volunteers with 45 eyes(normal control group)who were confirmed by ophthalmology examination in Hangzhou Hospital of Optometry Affiliated to Wenzhou Medical University and Zhejiang Provincial People's Hospital were included in the study.According to whether there was IRL residue,the patients were divided into IRL group and non-IRL group,with 22 patients(22 eyes)and 72 patients(72 eyes),respectively.Best corrected visual acuity(BCVA)and optical coherence tomography angiography(OCTA)were performed in all eyes.Superficial vessel density(SCP)and deep vessel density(DCP)of whole image,fovea and parafovea,the area and perimeter of fovea avascular area(FAZ),A-circularity index(AI,perimeter/standard circle perimeter with equal area)and vessel density around the 300μm width of the FAZ(FD),central macular thickness(CMT)on macular 3 mm×3 mm scan on OCTA were measured.Results SCP and DCP of whole image(F=10.774,4.583)and parafovea(F=10.433,3.912),CMT(F=171.940)in IRL group and non-IRL group on macular 3 mm×3 mm scan on OCTA were significantly lower than that in normal persons(P<0.05).There were significant differences among three groups of the area of FAZ(F=4.315),AI(F=3.413),FD-300(F=13.592)(P<0.05).BCVA were worst in IRL group(P<0.05).Conclusions Blood flow density decreased in macular area of FEVR patients.CMT is significantly thicker than normal population.The FAZ area of the foveal IRL residual eyes is small and irregular,with worse BCVA and lower macular blood density.

关 键 词：家族性渗出性玻璃体视网膜病变 光相干断层扫描血管成像 局部血流 

分 类 号：R774[医药卫生—眼科]