儿童系统性红斑狼疮患者黄斑区视网膜微循环的变化  

Retinal Capillary Abnormalities in Juvenile Systemic Lupus Erythematosus

作　　者：张煜 徐思思[2] 雷蕾 蔡剑秋[1] Yu Zhang;Sisi Xu;Lei Lei;Jianqiu Cai(Department of Ophthalmology,the Second Affiliated Hospital of Wenzhou Medical University&Yuying Children's Hospital,Wenzhou 325027,China;Department of Ophthalmology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Intensive Care,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]温州医科大学附属第二医院&育英儿童医院眼科,温州325027 [2]温州医科大学附属第一医院眼科,温州325015 [3]温州医科大学附属第一医院重症医学科,温州325015

出　　处：《中华眼视光学与视觉科学杂志》2023年第11期847-852,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:应用光学相干断层扫描血管成像(OCTA)分析无视网膜病变的儿童系统性红斑狼疮(JSLE)患者黄斑区视网膜及脉络膜血流的变化情况。方法:系列病例研究。随机抽取2023年1—6月温州医科大学附属第二医院儿童风湿科住院患儿中无视网膜病变的JSLE患者18例(18眼)作为JSLE组,同时纳入年龄、性别相近的眼科门诊正常儿童18例(18眼)作为对照组。采用OCTA测量以黄斑为中心4.5 mm×4.5 mm视网膜浅层视网膜毛细血管丛(SCP)、中间视网膜毛细血管丛(ICP)、深层视网膜毛细血管丛(DCP)、脉络膜毛细血管层(CC)血流密度和黄斑中心凹无血管区(FAZ)面积。使用独立样本t检验分析2组间血流密度的差异,使用Spearman相关分析各层血流密度与病程的相关性。结果:JSLE组ICP、DCP和CC血流密度较对照组明显下降(t=2.37,P=0.024;t=3.25,P=0.003;t=3.17,P=0.003),且CC血流密度与JSLE病程呈正相关(r=0.76,P<0.001)。组间SCP血流密度和FAZ面积差异均无统计学意义(均P>0.05)。结论:在无视网膜病变的JSLE患者中,OCTA可以检测到黄斑区深层视网膜和脉络膜毛细血管层血管的损伤。Objective:To evaluate the retinal and choroidal capillary alternations in patients with juvenile systemic lupus erythematosus(JSLE)using optical coherence tomography angiography(OCTA).Methods:This was a case series study.Eighteen patients(18 eyes)who were diagnosed with JSLE by the Second Affiliated Hospital of Wenzhou Medical University from January to June 2023 were included in this study as the JSLE group.Eighteen healthy children(18 eyes)of similar age and gender from the eye clinic were included as the control group.All subjects had a 4.5 mm×4.5 mm area of the macula scanned by OCTA to obtain vessel density of superficial capillary plexus(SCP),intermediate capillary plexus(ICP),deep capillary plexus(DCP),choriocapillaris(CC),and area of foveal avascular zone(FAZ).Data analysis was performed by a t test and Spearman correlation analysis.Results:The vessel density of ICP,DCP,and CC in the JSLE group were significantly lower than those in the control group(t=2.37,P=0.024;t=3.25,P=0.003;t=3.17,P=0.003,respectively).And vessel density of CC was positively correlated with the duration of the disease(r=0.76,P<0.001).There was no statistically significant difference in vessel density of SCP and area of FAZ between the two groups(all P>0.05).Conclusion:At subclinical stage,OCTA could detect damage to the deep retinal and choriocapillaris layers in patients with JSLE.

关 键 词：儿童系统性红斑狼疮 深层视网膜毛细血管丛 中间视网膜毛细血管丛 光学相干断层扫描血管成像 

分 类 号：R725.9[医药卫生—儿科] R774.1[医药卫生—临床医学]