不同水平斜视手术方式对黄斑区血流密度变化及FAZ面积的影响  

Effect of different horizontal strabismus surgery methods on macular blood flow density and FAZ area

作　　者：王纹姬[1] 赵洪超[1] 曾颖[1] 陈艳芳[1] 杨卉[1] Wang Wen-ji;Zhao Hong-chao;Zeng Ying(Department of Ophthalmology,Yuxi People's Hospital,Yuxi 653100,China)

机构地区：[1]玉溪市人民医院眼科,653100

出　　处：《中国斜视与小儿眼科杂志》2024年第3期11-14,F0004,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：国家自然科学基金(81970844,82371093)。

摘　　要：目的利用光学相干断层扫描血管成像技术评价不同水平斜视手术后黄斑区血流密度变化及对黄斑中心凹无血流区(FAZ)面积大小的影响。方法本研究前瞻性纳入水平斜视手术患者56例(112眼),分为A(非手术眼对照组)、B(单眼一条直肌手术)、C(单眼两条直肌手术)、D(一条外直肌手术)及F(一条内直肌手术)组,比较不同水平斜视在术前、术后1天、术后1周和术后1月分别采用以黄斑中心凹为中心3×3mm扫描模式评估黄斑微血管,自动分析浅层毛细血管丛(SCP)血流密度(VD)及FAZ的变化。结果与手术前相比,术后1天黄斑区颞侧血流密度显著升高(t=2.34,P=0.04)。C组术后1天SCP%为(42.29±12.19)%,显著高于A组(41.38±11.49)%和B组(41.19±11.97)%,差异具有统计学意义(P<0.05);C组术后1天黄斑区颞侧血流密度(50.26±4.49)%,显著高于A组(47.61±3.53)%和B组(48.22±3.29)%,也显著高于其术前(48.27±3.23)%,差异具有统计学意义(P<0.05)。结论斜视手术可能在术后早期引起视网膜微循环的短暂改变,单眼手术行两条直肌者术后黄斑区血流密度增加明显,特别是在颞侧区。Objective To evaluate the changes of blood flow density(VD)and the area of no blood perfusion zone(FAZ)in the macular area after different levels of rectus muscle surgery using optical coherence tomography angiography.Method This study prospectively included 56 patients(112 eyes)who received horizontal strabismus surgery,including group A(unoperated control group),group B(operated on one rectus muscle in one eye),group C(operated on two rectus muscles in one eye),group D(operated on only one external rectus muscle)and group F(operated on only one internal rectus muscle).Macular microvessels were evaluated with 3×3mm scanning mode centered on macular fovea before surgery,1 day after surgery,1 week after surgery and 1 month after surgery,and the changes of VD and FAZ of superficial capillary plexus were automatically analyzed.Result Compared with before surgery,the blood density in the temporal side was significantly increased 1 day after surgery(t=2.34,P=0.04).The SCP%of group C was(42.29±12.19)%,which was significantly higher than that of group A(41.38±11.49)%and group B(41.19±11.97)%,and the difference was statistically significant 1 day after surgery(P<0.05).The temporal blood flow density(50.26±4.49)%of group C was significantly higher than that of group A(47.61±3.53)%and group B(48.22±3.29)%1 day after surgery and was also significantly higher than that of group C before surgery(48.27±3.23)%,the difference was statistically significant(P<0.05).Conclusion Strabismus surgery may cause transient changes in retinal microcirculation in the early postoperative period,and the postoperative blood flow density increases significantly in patients with both rectus muscles in one eye,especially in the temporal region.

关 键 词：斜视 黄斑 光学相干断层扫描血管成像 血流密度 

分 类 号：R779.6[医药卫生—眼科]