不同病程前部缺血性视神经病变患者黄斑区血流密度及GCIPL厚度变化特征观察  

Changes of blood flow density and GCIPL thickness in macular area in patients with anterior ischemic optic neuropathy of different course

作　　者：杨敏[1] 刘爽 李珊珊 张大卫[1] YANG Min;LIU Shuang;LI Shan-shan(Department of Ophthalmology,Beijing Luhe Hospital,Capital Medical University,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院眼科,北京101100

出　　处：《临床和实验医学杂志》2025年第6期660-663,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金项目(编号:7192237)。

摘　　要：目的探讨不同病程前部缺血性视神经病变(AION)患者黄斑区血流密度及黄斑区神经节细胞内丛状层(GCIPL)厚度变化特征。方法回顾性选取自2020年5月至2024年5月首都医科大学附属北京潞河医院收治的AION患者99例作为研究对象。根据患者病程的差异将患者分为急性期组(n=33,病程≤3周)、亚急性期组(n=33,4~12周)、慢性期组(n=33,>12周)。比较3组黄斑全区域、旁中心凹、中心凹周围不同区域浅层血管黄斑区血流密度;比较3组不同象限(鼻上、鼻下、上方、下方、颞上、颞下)的GCIPL厚度和平均GCIPL厚度(GCIPLav)、最小GCIPL厚度(GCIPLmin);比较3组黄斑神经节细胞复合体与视网膜神经纤维层(PRNFL)变化[上半部分、下半部分、平均厚度、整体丢失体积(GLV)与局部丢失体积(FLV)]。结果3组患眼的黄斑全区域、旁中心凹、中心凹周围不同部位浅层血管黄斑区血流密度比较,差异均有统计学意义(P<0.05);随着病程进展,黄斑全区域、旁中心凹、中心凹周围不同区域浅层血管黄斑区血流密度逐渐降低。3组患眼的不同象限(鼻上、鼻下、上方、下方、颞上、颞下)的GCIPL厚度和GCIPLav、GCIPLmin比较,差异均有统计学意义(P<0.05);随着病程进展,鼻上、鼻下、上方、下方、颞上、颞下的GCIPL厚度和GCIPLav、GCIPLmin逐渐降低。3组患眼的PRNFL上半部分、下半部分、平均厚度、FLV、GLV比较,差异均有统计学意义(P<0.05);随着病程进展,3组的黄斑神经节细胞复合体上半部分、下半部分、平均厚度逐渐降低,FLV、GLV逐渐升高。结论随着病程进展,AION患者黄斑全区域、旁中心凹、中心凹周围不同区域浅层血管黄斑区血流密度逐渐降低,不同象限的GCIPL厚度和GCIPLav、GCIPLmin逐渐降低,PRNFL上半部分、下半部分、平均厚度逐渐降低,FLV、GLV逐渐升高。因此,可通过检测黄斑区血流密度及GCIPL厚度变化特征为AION患者临床病情�Objective To investigate the changes of blood flow density and ganglion cell and inner plexiform layer(GCIPL)thickness in macular area in patients with anterior ischemic optic neuropathy(AION)with different course.Methods A total of 99 patients with AION admitted to Beijing Luhe Hospital,Capital Medical University from May 2020 to May 2024 were retrospectively selected as the study subjects.According to the difference of course of disease,the patients were divided into the acute stage group(n=33,course of disease≤3 weeks),the subacute stage group(n=33,4-12 weeks)and the chronic stage group(n=33,>12 weeks).The blood density of the superficial vascular macular region in the whole area of macula,parafovea and perifovea of the 3 groups were compared.The GCIPL thickness,average GCIPL thickness(GCIPLav)and minimum GCIPL thickness(GCIPLmin)of the three groups in different quadrants(suprasal,subnasal,upper,lower temporal,subtemporal)were compared,and the changes of pexipapillary retinal nerve fiber layer(PRNFL)in the three groups[upper part,lower part,average thickness,focal loss volume(FLV)and ganglion loss volume(GLV)]were compared.Results There were statistically significant differences in blood flow density in the macular region,parafovea and perifovea of the three groups(P<0.05).With the progression of the disease,the blood flow density in the macular area of superficial vessels gradually decreased in the whole area of macula,parafovea and perifovea.There were statistically significant differences in GCIPL thickness,GCIPLav and GCIPLmin in different quadrants(suprasal,subnasal,upper,lower,supratemporal,infratemporal)among the three groups(P<0.05).With the progression of the disease,the thickness of GCIPL,GCIPLav and GCIPLmin in suprasal,subnasal,upper,lower,supratemporal and subtemporal were gradually reduced.There were statistically significant differences in the upper and lower parts of PRNFL,average thickness,FLV and GLV among the three groups(P<0.05).With the progression of the disease,the average thickness of

关 键 词：不同病程 前部缺血性视神经病变 黄斑区血流密度 GCIPL厚度 

分 类 号：R774.1[医药卫生—眼科]