OCT和OCTA在甲状腺相关眼病中的研究进展  

Research progress of optical coherence tomography and optical coherence tomography angiography in thyroid-associated ophthalmopathy

作　　者：郭威 李冬梅[2] Guo Wei;Li Dongmei(Department of Ophthalmology,Beijing Mentougou District Hospital,Beijing 102300,China;Beijing Tongren Hospital,Capital Medical University/Beijing Tongren Eye Center/Beijing Key Laboratory of Ophthalmology&Visual Science,Beijing 100730,China)

机构地区：[1]中国北京市门头沟区医院眼科,102300 [2]首都医科大学附属北京同仁医院、北京同仁眼科中心、眼科学与视觉科学北京市重点实验室,北京市2100730

出　　处：《国际眼科杂志》2024年第10期1576-1581,共6页International Eye Science

基　　金：国家自然科学基金面上项目(No.82071005)。

摘　　要：甲状腺相关眼病(TAO)是成年人最常见的眼眶疾病,主要特征为球后和眼眶周围软组织的炎性细胞浸润,引起眼外肌肥大、球后脂肪增多、软组织水肿以及眼眶纤维化等一系列病理改变,从而导致患者眼眶压力增高、血液回流障碍,严重者可以引起甲状腺功能障碍性视神经病变(DON),这是导致患者视力丧失的主要原因之一。TAO患者存在眼部血流动力学的异常,DON的发生与视神经缺血密切相关。因此,及早了解并监测TAO患者眼部血流的变化可能具有重要意义。光学相干断层扫描(OCT)和光学相干断层扫描血流成像(OCTA)可以获得活体视网膜、脉络膜组织结构和血管影像,具有非接触、无创伤、速度快、分辨率高的特点,现已用于研究多种眼科疾病和全身疾病对眼部血流变化的影响。迄今为止,已有众多学者应用OCT和OCTA对TAO患者的眼底微循环结构及血流进行研究,然而由于存在测量技术、混杂因素以及研究人群的差异,相关研究结果仍存在争议,且该领域尚未有相关的国内文献综述。文章主要对OCT和OCTA在TAO中的研究进展进行综述,以探讨OCT和OCTA技术在TAO中的潜在应用价值。Thyroid-associated ophthalmopathy(TAO)is the most common orbital disease in adults,characterized by inflammatory cell infiltration in the retrobulbar and periorbital soft tissues.This condition induces a series of pathological alterations including enlargement of the extraocular muscles,increased retrobulbar adipose tissue,soft tissue edema,and orbital fibrosis,resulting in elevated intraorbital pressure and impeded venous return,and in severe cases,can cause dysthyroid optic neuropathy(DON),which is one of the main causes of vision loss in patients.There are abnormalities in ocular hemodynamics in TAO patients,and the occurrence of DON is closely related to optic nerve ischemia.Therefore,it may be important to understand and monitor changes in ocular blood flow in TAO patients as early as possible.Optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)can obtain in vivo images of retinal and choroidal tissue structure and vasculature with non-contact,non-invasive,rapid,and high-resolution characteristics.They have been used to study changes in ocular blood flow in a variety of ophthalmic and systemic diseases.To date,a multitude of scholars have employed OCT and OCTA to investigate the microcirculatory structure and blood flow in the fundus of patients with TAO.However,the research results are still controversial due to differences in measurement techniques,confounding factors,and study populations,and there is no relevant domestic literature review in this field.This article reviews the research progress of OCT and OCTA in TAO,thus exploring the application value of OCT and OCTA technology in TAO.

关 键 词：甲状腺相关眼病(TAO) Graves眼病(GO) 光学相干断层扫描(OCT) 光学相干断层扫描血流成像(OCTA) 

分 类 号：R581.1[医药卫生—内分泌] R771.3[医药卫生—内科学]