应用OCTA分析不同分期原发性开角型青光眼患者视网膜的血流密度变化  

Analysis of the changes of retinal blood flow density in patients with different stages of primary open-angle glaucoma by OCTA

作　　者：贾飞[1,2] 刘舒静 任家平 曹靖 Jia Fei;Liu Shujing;Ren Jiaping;Cao Jing(School of Basic Medical Sciences,Zhengzhou University,Zhengzhou 450001,China;Department of Ophthalmology,Zhengzhou Second Hospital,Zhengzhou 450006,China;Wenzhou Medical College,Wenzhou 325035,China)

机构地区：[1]郑州大学基础医学院,郑州450001 [2]郑州市第二人民医院眼科,郑州450006 [3]温州医科大学,温州325035

出　　处：《中华眼外伤职业眼病杂志》2024年第1期27-32,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析应用光学相干断层扫描血管成像(OCTA)评价不同分期原发性开角型青光眼患者(POAG)视网膜血流密度的变化。方法横断面研究。纳入2023年1月至7月郑州市第二人民医院收治的POAG者94例(122眼), 根据视野平均缺损(MD)将患者分为早期组(MD≥-6 dB)30例(44眼)、中期组(-12 dB≤MD<-6 dB)35例(40眼)和晚期组(MD<-12 dB)29例(38眼)。另选取健康志愿者31名(36眼)为对照组。采用OCTA检查比较各组视盘整体血流密度(VD)、视盘旁VD及黄斑浅层VD、黄斑深层VD。采用Pearson单因素相关性分析法检验视网膜血流与视野损害的相关性。绘制视盘整体VD、视盘周围VD及黄斑浅层VD、黄斑深层VD的受试工作者曲线(ROC), 计算曲线下面积(AUC)判断诊断效能。结果 POAG早期组、中期组及晚期组视盘区整体VD及周围VD、黄斑浅层VD及深层VD均低于对照组(均P<0.05), 且从早期组至晚期组视盘区整体VD、周围VD、黄斑区浅层VD及深层VD均逐渐降低(均P<0.05)。Pearson相关性分析显示, 视盘整体VD、视盘周围VD及黄斑浅层VD、黄斑深层VD均与视野指数(VFI)呈正相关(均P<0.05)。比较AUC发现, 由高到低分别为黄斑浅层VD(AUC=0.956)、黄斑深层VD(AUC=0.912)、视盘周围VD(AUC=0.901)及视盘整体VD(AUC=0.884)。结论应用OCTA分析, 随着POAG程度加重, 视盘整体VD、视盘周围VD及黄斑浅层VD、黄斑深层VD均逐渐降低;黄斑浅层VD和深层VD可能有助于判断POAG的病情进展。Objective To analyse the changes of retinal blood flow density in patients with different stages of primary open-angle glaucoma(POAG)by optical coherence tomography angiography(OCTA).Methods This was a cross-sectional study.A total of 122 eyes of 94 patients with POAG were included from Jan.2023 to Jul.2023 in Zhengzhou Second Hospital.Based on the mean defect(MD)of visual field,all subjects were divided into the early group(MD≥-6 dB)with 30 cases(44 eyes),the middle group(-12 dB≤MD<-6 dB)with 35 cases(40 eyes),and the late group(MD<-12 dB)with 29 cases(38 eyes),then another 31 healthy volunteers(36 eyes)were selected as the control group.Overall blood flow density(VD),paratopic VD,superficial macular VD and deep macular VD were measured by OCTA and compared among all groups.Pearson single factor correlation was used to analyze the correlation between retinal blood flow VD and visual field.The ROC curves of overall VD,perioptic disc VD,superficial macular VD and deep macular VD were plotted,and area under the curve(AUC)was calculated to judge the diagnostic efficiency.Results Overall and peripheral disc VD levels in optic disk,and superficial macular VD levels and deep VD levels in the macular area in the early group,the middle group and the late group were lower than those in the control group(all P<0.05).From the early group to the late group,overall VD level,peripheral VD level and superficial VD level in optic disk,deep VD level in the macular area decreased gradually(all P<0.05).Pearson correlation analysis showed that overall disc VD,perioptic disc VD,superficial macular VD and deep macular VD were positively correlated with visual field index(VFI)(P<0.05).The sequence from the highest to the lowest was found as the following:the VD in the superficial macular layer(AUC=0.956),VD in the deep macular layer(AUC=0.912),VD around the optic disc(AUC=0.901)and VD in the whole optic disc(AUC=0.884),respectively.Conclusion With the severity of POAG,the whole disc VD,perioptic disc VD,superficial macular VD and d

关 键 词：青光眼 开角型 原发性 血管成像 光学相干断层扫描 密度 血流 区 视盘 区 黄斑 

分 类 号：R775.2[医药卫生—眼科]