白塞病性葡萄膜炎并发视网膜新生血管的临床及影像学特征分析  

Clinical and imaging characteristics of retinal neovascularization secondary to Behçet's uveitis

作　　者：陈雪琳 张雄泽 CHEN Xuelin;ZHANG Xiongze(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangzhou 510060,China)

机构地区：[1]中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州510060

出　　处：《眼科学报》2025年第2期103-112,共10页Eye Science

摘　　要：目的:探讨白塞病性葡萄膜炎(Behçet's uveitis, BU)并发视盘新生血管(neovascularization of the optic disc,NVD)和(或)视盘以外视网膜新生血管(retinal neovascularization elsewhere, NVE)的临床及影像特征。方法:回顾性分析2022年1月—2024年9月就诊的BU并发NVD和(或)NVE患者的临床资料和眼底影像学检查结果,包括眼底彩照、荧光素眼底血管造影(fluorescein fundus angiography, FFA)、光学相干断层成像(optical coherence tomography, OCT)和光学相干断层血管成像(OCT angiography, OCTA)。并分析NVD和(或)NVE面积与患眼的改良的眼后段炎症评分以及视网膜血管渗漏评分的相关性。结果:共纳入27例患者(30只眼),年龄为(27.70±12.58)岁,男女比例约为1:1。3例(11%)患者双眼并发NVD和(或)NVE;25只眼(83%)存在NVD:17只眼(57%)仅有NVD;8只眼(27%)存在NVD和NVE。仅2只眼(7%)存在视网膜无灌注区,7只眼(23%)同时发生玻璃体积血。FFA眼后段炎症评分为(20.93±4.37)分。FFA血管渗漏评分为(7.57±1.25)分。NVD和(或)NVE面积与眼后段炎症评分(rs=0.403,P=0.027)及视网膜血管渗漏评分(rs=0.518,P=0.003)均呈正相关。FFA与OCTA在检测NVD和NVE上表现完全一致(κ=1.0)。结论:BU并发NVD和(或)NVE并不罕见,以NVD为主,绝大多数与视网膜无灌注不相关,可能由BU炎症诱发。Purpose:To investigate the clinical and imaging characteristics of retinal neovascularization of the optic disc(NVD)and/or elsewhere in the retina(retinal neovascularization elsewhere,NVE)in eyes with Behçet's uveitis(BU).Methods:This retrospective analysis reviewed the clinical data and fundus imaging findings of patients diagnosed with BU complicated by NVD and/or NVE from January 2022 to September 2024.Imaging modalities included fundus photography,fluorescein fundus angiography(FFA),optical coherence tomography(OCT),and OCT angiography(OCTA).The study analyzed the correlation between the areas of NVD and/or NVE and the modified posterior segment inflammation scores,as well as retinal vascular leakage scores of the affected eyes.Results:The study included 27 patients(30 eyes)with an average age of 27.70±12.58 years and a gender ratio of approximately 1:1.Bilateral NVD and/or NVE was observed in three patients(11%);25 eyes(83%)had NVD,of which 17 eyes(57%)had only NVD and 8 eyes(27%)had both NVD and NVE.Two eyes(7%)showed areas of retinal non-perfusion,and seven eyes(23%)had concurrent vitreous hemorrhage.The average score for posterior segment inflammation on FFA was 20.93±4.37,and the average score for vascular leakage was 7.57±1.25.There was a significant positive correlation between the area of NVD and/or NVE and both the inflammation score(rs=0.403,P=0.027)and the vascular leakage score(rs=0.518,P=0.003).FFA and OCTA showed perfect agreement in detecting NVD and NVE(κ=1.0).Conclusion:NVD and/or NVE in BU are not uncommon and are predominantly presented as NVD,mostly not associated with retinal non-perfusion,likely induced by inflammatory factors related to BU.

关 键 词：白塞病性葡萄膜炎 视网膜新生血管 视盘新生血管 多模式影像 炎症 

分 类 号：R774.11[医药卫生—眼科] R770.4[医药卫生—临床医学]