应用OCTA评估视神经炎急性期视网膜厚度和血流密度的变化  

Evaluation of changes of retinal thickness and vessel density in acute phase of optic neuritis patients by OCTA

作　　者：闫梅 王敏 鲁鑫 杜娟 李霞波 刘昊 侯力华 王润生 Yan Mei;Wang Min;Lu Xin;Du Juan;Li Xiabo;Liu Hao;Hou Lihua;Wang Runsheng(Department of Ophthalmology,the First People′s Hospital of Xianyang,Xianyang Eye Hospital,Xianyang 712000,China;Department of Neuro-Ophthalmology,Xi′an People′s Hospital,Xi′an 710004,China)

机构地区：[1]咸阳市第一人民医院眼科、咸阳市眼科医院,咸阳712000 [2]西安市人民医院神经眼科,西安710004

出　　处：《中华眼外伤职业眼病杂志》2024年第12期949-955,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：咸阳市重点研发项目(2020K02-102)。

摘　　要：目的应用相干光层析血管成像术(OCTA)观察视神经炎急性期患者视网膜厚度及血流密度的变化。方法横断面对照研究。纳入2020年5月至2023年5月咸阳市第一人民医院收治的视神经炎急性期患者43例(43眼)为研究组,同期性别、年龄相匹配的健康体检者30例(30眼)为正常对照组(A组)。43例视神经炎急性期患者采用流式细胞仪细胞微球凝集(CBA)法检测血液中水通道蛋白4(AQP4)抗体,根据检测结果分为:AQP4-IgG阳性组15例15眼(B组)和AQP4-IgG阴性组28例(28眼,C组)。收集所有患者最佳矫正视力(BCVA,logMAR)以及应用OCTA测量上、下、鼻、颞侧象限放射状视盘周围毛细血管(RPC)血流密度、黄斑区浅层毛细血管丛血流密度(SVD)、视盘周围神经纤维层(RNFL)厚度,以及上、下、鼻上、鼻下、颞下、颞上方位神经节细胞-内丛状层厚度(GCIPL)。结果A、B、C组入院时BCVA为0.06±0.10、0.43±0.56、0.40±0.49,总体比较差异具有统计学意义(F=6.34,P=0.003)。A、B、C组RPC血流密度上方为(19.93±1.39)%、(18.22±1.63)%、(18.55±1.46)%,下方为(20.13±1.43)%、(18.81±1.73)%、(18.83±1.91)%,鼻侧为(21.31±1.55)%、(20.00±1.65)%、(20.02±1.33)%,颞侧为(20.62±1.79)%、(19.07±1.93)%、(19.08±1.80)%,总体比较差异均具有统计学意义(F=9.43、6.68、5.29、6.39,P<0.001、P=0.002、0.007、0.003),B组、C组均比A组降低(均P<0.05)。A、B、C组黄斑SVD上方为(20.80±1.41)%、(19.09±1.69)%、(19.98±1.56)%,鼻侧为(20.04±1.41)%、(19.04±1.87)%、(19.09±1.29)%,总体比较差异具有统计学意义(F=6.28、3.60,P=0.003、0.033),B组、C组均较A组降低(均P<0.05);下方、颞侧SVD比较差异无统计学意义(均P>0.05)。A、B、C组视盘RNFL厚度上方为(119.16±13.10)、(216.73±69.46)、(204.54±58.54)μm,下方为(109.17±13.15)、(201.40±65.03)(198.64±56.76)μm,鼻侧(65.95±12.94)、(109.95±31.83)、(111.01±18.71)μm,颞侧(88.67±11.40)、(129.13±52.84)、(139.18±60.65)μm,总体Objective To observe the changes of retinal thickness and vessel density in acute phase of optic neuritis(ON)patients by optical coherent tomography angiography(OCTA).Methods This was a cross-sectional case-control study.Forty-three patients(43 eyes)in the acute phase of ON recruited from May 2020 to May 2023 in the First People′s Hospital of Xianyang City were collected as the study group,and divided into two groups based on the presence of aquaporin-4 antibody(AQP4-IgG)in their blood:an AQP4 IgG-positive ON group(group B)and an AQP4 IgG-negative ON group(group C)after selecting 30 healthy check-up participants(30 eyes)matched for gender and age during the same period as the normal control group(group A).Data collected from the healthy check-up participants and the patients with AQP4-IgG positive or negative in the acute phase of ON during their visits,including best corrected visual acuity(BCVA)and OCTA measurements,were evaluated.BCVA was converted to the logarithm of the minimum angle of resolution(logMAR).OCTA was used to measure the vessel density of radial peripapillary capillary(RPC)and retinal nerve fiber layer(RNFL)thickness in the four quadrants around the optic disc(upper,lower,nasal,and temporal).Additionally,the vessel density of the superficial capillary plexus vessel density(SVD)and the thickness of the ganglion cell-inner plexiform layer(GCIPL)were assessed in the macula.Results At admission,BCVA of group A,group B,and group C were(0.06±0.10),(0.43±0.56),and(0.40±0.49),respectively,with a statistically significant difference(F=6.34,P=0.003).The RPC vessel density in group A,group B,and group C was as follows:(19.93±1.39)%,(18.22±1.63)%,and(18.55±1.46)%in the upper quardrant;(20.13±1.43),(18.81±1.73),and(18.83±1.91)%in the temporal quardrant;(21.31±1.55)%,(20.00±1.65)%,and(20.02±1.33)%in the nasal quardrant;and(20.62±1.79)%,(19.07±1.93)%,and(19.08±1.80)%in the temporal quardrant.Overall,significant differences were found(F=9.43,6.68,5.29,6.39;P<0.001,P=0.002,0.007,0.003),with grou

关 键 词：视神经炎 体层摄影术 光学相干 视网膜血管 毛细血管 

分 类 号：R74[医药卫生—神经病学与精神病学]