特发性视网膜前膜视网膜动脉夹角变化与视力、光相干断层扫描分级的相关性研究  

Correlation study on the changes of retinal artery angle in idiopathic epiretinal membrane and its correlation with visual acuity and optical coherence tomography classification

作　　者：项子怡 毛剑波 王勤美 张正熙 陈怡静 张士安 张晓雅 钟静 沈丽君 Xiang Ziyi;Mao Jianbo;Wang Qinmei;Zhang Zhengxi;Chen Yijing;Zhang Shian;Zhang Xiaoya;Zhong Jing;Shen Lijun(The Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou,Hangzhou 310020,China;Department of Ophthalmology,Zhejiang Provincial People's Hospital,Hangzhou 310020,China)

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

出　　处：《中华眼底病杂志》2024年第3期190-195,共6页Chinese Journal of Ocular Fundus Diseases

基　　金：浙江省自然科学基金(LTGY23H120005)。

摘　　要：目的观察特发性视网膜前膜(ERM)患眼视网膜动脉角的改变,初步分析动脉角与基于光相干断层扫描(OCT)的ERM分级、视力的相关性。方法回顾性横断面临床研究。2018年11月至2023年1月于浙江省人民医院眼科及温州医科大学附属眼视光医院杭州院区检查确诊的单眼特发性ERM(IERM)患者187例187只眼(IERM组)纳入研究。将患者对侧健康眼作为对照组。所有受检眼均行最佳矫正视力(BCVA)、眼底彩色照相、谱域OCT、OCT血管成像(OCTA)检查以及眼轴长度(AL)测量。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仪测量黄斑中心凹无血管区(FAZ)面积;谱域OCT测量黄斑中心凹厚度(CMT)。参照文献中心凹内层异位的分级标准将ERM分为1~4级,分别为42、45、62、38只眼,并据此将IERM组再分为1级组、2级组、3级组、4级组。应用Image J软件在彩色眼底像上测量视网膜动脉角及1/2视网膜动脉角。多元线性回归分析BCVA与动脉角、1/2动脉角、CMT、FAZ面积、AL之间的相关性。结果与对照组比较,IERM组患眼BCVA降低(t=9.727)、CMT增厚(t=12.452),FAZ面积缩小(t=-14.329)以及动脉角(t=-9.165)、1/2动脉角(t=-9.549)减小,差异均有统计学意义(P<0.001)。随IERM分级增大,动脉角、1/2动脉角显著减小(F=21.763、12.515,P<0.001)。其中,1级组与2级组动脉角及1/2动脉角、2级组与3级组1/2动脉角比较,差异均无统计学意义(P>0.05);其余各级组间动脉角、1/2动脉角比较,差异均有统计学意义(P<0.05)。IERM组不同分级亚组间CMT、logMAR BCVA比较,差异均有统计学意义(P<0.05)。3级组与4级组之间FAZ面积比较,差异无统计学意义(P>0.05);其余各级组间FAZ面积比较,差异均有统计学意义(P<0.05)。相关性分析结果显示,动脉角减小(P=0.013)、CMT增厚(P<0.001)与BCVA降低相关。结论与健康眼比较,随ERM分级增大,动脉角显著减小;动脉角减小与IObjective To observe the change of retinal artery angle in eyes with idiopathic epiretinal membrane(ERM)and to analyze the relationship between retinal artery angle,ERM classification based on optical coherence tomography(OCT),and visual acuity.Methods A retrospective cross-sectional clinical study.A total of 187 eyes in 187 patients diagnosed with monocular idiopathic ERM(IERM group)in Department of Ophthalmology of Zhejiang Provincial People's Hospital and the Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou from November 2018 to January 2023 were included in the study.The contralateral healthy eyes were included as the control group.All patients underwent best corrected visual acuity(BCVA),fundus photography,spectral-domain OCT,OCT angiography(OCTA)and axial length(AL)measurement.BCVA examination was performed using the standard logarithmic visual acuity chart,which was converted to the logarithm of the minimum angle of resolution(logMAR)visual acuity.The foveal avascular zone(FAZ)area was measured by OCTA.The central macular thickness(CMT)was measured by spectral domain OCTaccording to the grading criteria of ectopic inner foveal layer(EIFL)was divided into stages 1 to 4 with 42,45,62,and 38 eyes,and the IERM group was subdivided into stage 1,stage 2,stage 3,and stage 4 groups accordingly.Image J was used to measure the retinal artery angle and the 1/2 retinal artery angle on fundus images.Multiple linear regression analysis was used to analyze the correlation between BCVA and artery angle,1/2 artery Angle,CMT,FAZ area and AL.Results Compared with the control group,eyes in IERM group had worse BCVA(t=9.727),thicker CMT(t=12.452),smaller FAZ area(t=-14.329),smaller artery angle(t=-9.165)and smaller 1/2 artery angle(t=-9.549).The differences were statistically significant(P<0.001).With the increase of IERM stage,the artery angle and 1/2 artery angle decreased significantly(F=21.763,12.515;P<0.001).There was no significant difference in artery angle and 1/2 artery angle between stage 1 group and

关 键 词：特发性视网膜前膜 视网膜动脉角度 眼底照相 光相干断层扫描 中心凹内层异位 

分 类 号：R774.1[医药卫生—眼科]