正常眼压性青光眼患者黄斑区微循环状态与视功能改变的关系研究  

Research on the macular microcirculation status and visual function changes of normal tension glaucoma patients

作　　者：范彩媚 臧苗苗 王丽君 易澄 曾璐瑶 武天硕 李汉林[1] FAN Caimei;ZANG Miaomiao;WANG Lijun;YI Cheng;ZENG Luyao;WU Tianshuo;LI Hanlin(Department of Ophthalmology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China)

机构地区：[1]南昌大学第一附属医院眼科,江西省南昌市330006

出　　处：《眼科新进展》2024年第3期197-202,共6页Recent Advances in Ophthalmology

基　　金：江西省应用研究培育计划(编号:20212BAG70032);江西省重点研发计划(编号:20202BBGL73019);江西省卫计委科技计划项目(编号:202130275)。

摘　　要：目的 联合使用光学相干断层扫描血管成像(OCTA)和微视野计探讨正常眼压性青光眼(NTG)患者黄斑区微循环状态和视功能变化情况,并分析两者之间的相关性。方法 横断面观察性研究。收集NTG患者17例30眼作为NTG组,按病情严重程度分为轻度、中度和重度NTG组3组。选取同期年龄、性别相匹配的健康体检者13例23眼作为对照组。使用OCTA获取黄斑区浅层视网膜血管线性密度(LD)及灌注密度(PD)。使用微视野计检测黄斑区10°范围的视网膜光敏感度(RS)及2°、4°固视率。比较各组间OCTA参数及微视野计参数的差异,并分析NTG患者OCTA参数与微视野计参数之间的相关性。结果 对照组与轻度NTG组受试者之间除黄斑区中央和鼻侧的LD、PD差异均无统计学意义外,其余各区域和整体平均LD、PD在对照组和轻度、中度、重度NTG组受试者间均呈逐渐下降趋势。轻度NTG组患者黄斑区下方和颞侧区域RS均较对照组受试者降低。黄斑区各区域及整体平均RS随NTG病情分期加重而降低。在NTG组患者中,LD、PD与RS在黄斑区各区域和整体平均中均呈显著性正相关(均为P<0.05)。NTG组患者黄斑区LD、PD与P2在一定区域内呈正相关。结论 NTG患者黄斑区微循环状态及视功能均较健康人显著下降,且随病情进展而加重;NTG患者黄斑区血管密度与RS存在显著相关性。Objective To explore the changes in macular microcirculation status and visual function in patients with normal tension glaucoma(NTG)using the optical coherence tomography angiography(OCTA)and microperimeter MP-3 and analyze the correlation between the two.Methods In this cross-sectional observational study,17 NTG patients(30 eyes)were collected as the NTG group and then divided into mild,moderate and severe NTG subgroups according to the severity of the disease.During the same period,13 healthy subjects(23 eyes)with the same age and gender distribution were selected as the control group.OCTA was used to obtain linear density(LD)and perfusion density(PD)of superficial retinal vessels in the macular area.The microperimeter MP-3 was used to measure retinal sensitivity(RS)within 10°and fixation rate at 2°and 4°of the macular area.The OCTA parameters and microperimeter MP-3 parameters were compared among all groups,and the correlation between OCTA parameters and microperimeter MP-3 parameters in NTG patients was analyzed.Results There were no significant differences in LD and PD between the control group and the mild NTG subgroup in the central and nasal sides of the macula;the LD and PD in the remaining regions and overall average LD and PD showed a gradual downward trend in the control group and the mild,moderate and severe NTG subgroups.Compared with the control group,the RS of the mild NTG subgroup was lower in the inferior and temporal regions of the macular area.The RS of each region and overall average RS in the macular area decreased with the aggravation of the NTG.In the NTG group,LD and PD were significantly positively correlated with RS in each region and overall average RS in the macular area(all P<0.05).In the NTG group,LD and PD were positively correlated with P2 in some regions of the macular area.Conclusion Compared with the control group,the macular microcirculation status and visual function of NTG patients significantly decreased with the progression of the disease;there is a significant correla

关 键 词：正常眼压性青光眼 光学相干断层扫描血管成像 微视野计 血管密度 视网膜光敏感度 固视率 

分 类 号：R775[医药卫生—眼科]