急性中心性浆液性脉络膜视网膜病变患者视网膜和脉络膜微血管结构的改变  

Changes in retinal and choroidal microvascular structure in patients with acute central serous chorioretinopathy

作　　者：丁国龙 武炳慧[1] 巨欣 李婵 李英英 陆慧琴[1] Ding Guolong;Wu Binghui;Ju Xin;Li Chan;Li Yingying;Lu Huiqin(Department of Ophthalmology,Xi′an First Hospital,the First Affiliated Hospital of Northwest University,Xi′an 710002,China)

机构地区：[1]西安市第一医院,西北大学附属第一医院眼科,西安710002

出　　处：《中国医师杂志》2024年第5期667-672,共6页Journal of Chinese Physician

基　　金：陕西省社发项目(2022SF-312)。

摘　　要：目的分析单眼急性中心性浆液性脉络膜视网膜病变(CSC)患者黄斑区视网膜及脉络膜微血管结构的变化,以及视网膜下积液(SRF)体积的影响因素。方法前瞻性选取2023年1月至10月于西安市第一医院眼科检查确诊的37例单眼急性CSC患者纳入本研究,患眼为A组,对侧眼为B组。选取同期30例年龄、性别匹配的正常人的右眼为正常眼组(C组)。采用扫频源光学相干断层扫描血管成像(SS-OCTA)对受检眼黄斑区6 mm×6 mm范围进行扫描。应用自带软件分析并记录黄斑区0~1 mm、0~3 mm、0~6 mm的视网膜浅层毛细血管丛(SCP)及深层毛细血管丛(DCP)的血管密度(VD)、灌注面积(PA)、视网膜厚度(RT)、脉络膜厚度(CT)以及脉络膜大中血管层的脉络膜血管容积(CVV)和脉络膜血管指数(CVI),同时记录患眼组SRF体积。对比三组VD、PA、RT、CT、CVV及CVI的变化。采用Spearman秩相关检验分析SRF体积与微血管结构参数的相关性。结果(1)在黄斑区0~6 mm范围内,患眼组与对侧眼组SCP的VD、PA比较差异无统计学意义(均P>0.05);患眼组及对侧眼组SCP的VD、PA均低于正常眼组,差异均有统计学意义(均P<0.05);患眼组DCP的VD、PA均低于对侧眼组,差异有统计学意义(均P<0.05)。在黄斑区0~3 mm范围内,患眼组及对侧眼组DCP的VD、PA均低于正常眼组,差异均有统计学意义(均P<0.05)。患眼组RT高于对侧眼组,对侧眼组RT高于正常眼组,差异均有统计学意义(均P<0.05)。(2)在黄斑区0~6 mm范围内,患眼组CT高于对侧眼组,对侧眼组CT高于正常眼组,差异均有统计学意义(均P<0.05)。患眼组、对侧眼组脉络膜大中血管CVV、CVI差异无统计学意义(均P>0.05);患眼组及对侧眼组脉络膜大中血管CVV、CVI均高于正常眼组,差异均有统计学意义(均P<0.05)。(3)SRF体积与黄斑区0~3 mm范围内DCP的VD呈负相关(P<0.05),与0~6 mm范围内CT呈正相关(P<0.05)。结论急性CSC是一种双眼脉络膜疾病,脉络�Objective To analyze the changes in the retinal and choroidal microvascular structures in the macular region of patients with acute central serous chorioretinopathy(CSC),as well as the influencing factors of subretinal fluid(SRF)volume.Methods A prospective selection of 37 patients with monocular acute CSC diagnosed by ophthalmology examination at the Xi′an First Hospital from January to October 2023 was conducted.The affected eye group was Group A,and the contralateral eye was Group B.The right eye of 30 age and gender matched normal individuals during the same period was selected as the normal eye group(group C).The scanning frequency source optical coherence tomography(SS-OCTA)was used to scan the macular area of the tested eye within a range of 6 mm×6 mm.We analyzed and recorded the vascular density(VD),perfusion area(PA),retinal thickness(RT),choroidal thickness(CT),as well as choroidal vascular volume(CVV)and choroidal vascular index(CVI)of the superficial and deep retinal capillary plexus(SCP)and deep retinal capillary plexus(DCP)in the macular area of 0-1 mm,0-3 mm,and 0-6 mm using our own software.At the same time,we recorded the volume of SRF in the affected eye group.We compared the changes in VD,PA,RT,CT,CVV,and CVI among three groups.The Spearman rank correlation test was used to analyze the correlation between SRF volume and microvascular structural parameters.Results(1)There was no statistically significant difference in VD and PA of SCP between the affected eye group and the contralateral eye group within the range of 0-6 mm in the macular area(all P>0.05);The VD and PA of SCP in the affected eye group and the contralateral eye group were lower than those in the normal eye group,and the differences were statistically significant(all P<0.05);The VD and PA of DCP in the affected eye group were lower than those in the contralateral eye group,and the difference was statistically significant(all P<0.05).Within the range of 0-3 mm in the macular area,the VD and PA of DCP in the affected eye group and

关 键 词：中心性浆液性脉络膜视网膜病变 视网膜下积液 脉络膜血管指数 微血管密度 

分 类 号：R774.1[医药卫生—眼科]