基于Python语言开发的荧光检测系统定量分析吲哚菁绿在黄斑前膜剥除术后眼内分布特点的临床观察  

Clinical observation of the intraocular distribution characteristics of indocyanine green after epiretinal membrane peeling using a fluorescence detection system developed in Python

作　　者：张韵 张可人 高昇[1] 张美霞[1] Zhang Yun;Zhang Keren;Gao Sheng;Zhang Meixia(Department of Ophthalmology,West China Hospital of Sichuan University,Chengdu 610041,China;Department of Ophthalmology,People′s Hospital of Chongqing Liang Jiang New Area,Chongqing 401121,China)

机构地区：[1]四川大学华西医院眼科,成都610041 [2]重庆两江新区人民医院眼科,重庆401121

出　　处：《中华眼科杂志》2024年第3期242-249,共8页Chinese Journal of Ophthalmology

基　　金：四川省科学技术厅项目(2022NSFSC1288)。

摘　　要：目的探讨基于Python语言开发的吲哚菁绿(ICG)荧光面积检测系统观察并定量分析ICG在黄斑前膜剥除术后眼内分布特点及代谢规律的作用和优势。方法前瞻性病例系列研究。纳入2019年3月至2021年3月在四川大学华西医院眼科行玻璃体切除术的特发性黄斑前膜患者,术中使用ICG染色后剥除黄斑前膜和内界膜。患者术前及术后1周、1个月、3个月、6个月及12个月随访时均行最佳矫正视力、眼压、眼底照相、近红外眼底成像术(NIR-FF)和相干光层析成像术(OCT)检查。开发基于Python语言编程ICG眼内代谢过程检测系统测量NIR-FF的眼内ICG荧光残留面积,预测ICG代谢规律方程式,与术后视力和视盘旁视网膜神经纤维层厚度进行相关性分析。结果共纳入患者64例(64只眼),年龄为(64.6±8.4)岁,其中男性25例(39.1%),女性39例(60.9%)。NIR-FF图像显示患者术前无ICG强荧光影像,术后1周出现后极部呈弥漫ICG强荧光,内界膜剥除区域呈现环形弱荧光,随时间延长可见ICG强荧光沿血管弓及神经纤维走行并逐渐向视盘方向消退,直至1年时在视盘处仍可见ICG残留荧光。基于Python语言开发的ICG荧光面积检测系统可测量眼内ICG残留面积,并通过线性回归分析构建方程式预测术后12个月ICG残留面积=0.22×术后6个月ICG残留面积(R2=16%,P=0.002)。除术后1个月ICG残留面积与术后视力呈负相关(P=0.017,r=-0.195)外,其余随访时间眼内ICG荧光残留面积与术后视力预后和视盘旁神经纤维层厚度均无相关性(均P>0.05)。结论特发性黄斑前膜患者采用ICG染色剥除内界膜后ICG在眼内的特征性代谢过程,表现为ICG强荧光沿血管弓及神经纤维走行,随时间延长逐渐向视盘汇集。基于Python语言开发的ICG荧光面积检测系统能够清晰显示ICG在黄斑前膜剥除术后的眼内分布特点,可用作预测ICG眼内代谢规律的工具。Objective To utilize a Python-based fluorescence area detection system to observe and quantitatively analyze the intraocular distribution characteristics and metabolic patterns of Indocyanine Green(ICG)following epiretinal membrane peeling.Methods A prospective case series study was conducted on patients with idiopathic epiretinal membrane undergoing vitrectomy at West China Hospital of Sichuan University from March 2019 to March 2021.ICG staining was applied during surgery for peeling the epiretinal membrane and internal limiting membrane.Patients were followed up at 1 week,1 month,3 months,6 months,and 12 months postoperatively,with assessments including best-corrected visual acuity,intraocular pressure,fundus photography,near-infrared fundus fluorescence imaging(NIR-FF),and optical coherence tomography(OCT).A Python-based ICG intraocular metabolism detection system was developed to measure the residual area of ICG fluorescence on NIR-FF,predict the ICG metabolic pattern equation,and correlate it with postoperative visual acuity and peripapillary retinal nerve fiber layer thickness.Results A total of 64 patients(64 eyes)were included,with an average age of 64.6±8.4 years,including 25 males(39.1%)and 39 females(60.9%).Preoperative NIR-FF images showed no ICG strong fluorescence.At 1 week postoperatively,diffuse ICG strong fluorescence appeared in the posterior pole,and the internal limiting membrane removal area exhibited a ring-like weak fluorescence.Over time,ICG strong fluorescence was observed along the vascular arch and nerve fiber trajectory,gradually diminishing toward the optic disc,with residual ICG fluorescence still visible at the optic disc at 1 year.The Python-based ICG fluorescence area detection system effectively measured intraocular residual ICG area.A predictive equation for the 12-month residual ICG area was constructed through linear regression analysis(Residual ICG area=0.22×Residual ICG area at 6 months,R2=16%,P=0.002).Except for a negative correlation between the ICG residual area at 1 m

关 键 词：吲哚花青绿 视网膜外膜 计算生物学 编程语言 谱学 近红外线 体层摄影术 光学相干 

分 类 号：R779.6[医药卫生—眼科]