基于光学相干断层扫描及光学相干断层扫描血管成像观察白内障合并高血压患者超声乳化术后视网膜厚度及血流变化的临床研究  

Observation of changes in retinal thickness and blood flow after phacoemulsification surgery for cataract patients with hypertension using optical coherence tomography and optical coherence tomography angiography

作　　者：刘思佳 叶子[2] 李紫微 杨青华[2] 李方敏 李朝辉[2] Sijia Liu;Zi Ye;Ziwei Li;Qinghua Yang;Fangmin Li;Zhaohui Li(Master's degree 2021,Chinese People's Liberation Army Medical School,Beijing 100853,China;Department of Ophthalmology,The Third Medical Center,Chinese People's Liberation Army General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院,100853 [2]解放军总医院第三医学中心眼科医学部眼科,100853

出　　处：《中华眼科医学杂志(电子版)》2024年第5期269-275,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：国家自然科学基金项目(82101097)。

摘　　要：目的应用光学相干断层扫描(OCT)及光学相干断层扫描血管成像(OCTA)观察白内障合并高血压患者超声乳化术后视网膜厚度及血流的变化。方法收集2023年4月至2024年7月期间于解放军总医院第一医学中心确诊年龄相关性白内障拟行超声乳化白内障吸除联合人工晶体植入术的患者58例(66只眼)。依据是否确诊过高血压或有明确降压药用药史分为高血压组30例(33只眼)和非高血压组28例(33只眼)。应用Cirrus 5000-HD型OCT仪扫描获取黄斑区视网膜厚度图像。采用AngioPlex 3mm×3mm成像模式扫描获取黄斑中心凹全层视网膜厚度(CMT)、浅层毛细血管层(SVP)图像及血管灌注密度(PD)。年龄、眼轴长度、收缩压、眼压(IOP)及最佳矫正视力(BCVA)等定量资料使用Shapiro-Wilk检验分析数据的正态性,服从正态分布的数据以±s表示,不符合正态分布的数据以中位数及四分位数M(Q25,Q75)表示。组内和组间比较采用两因素重复测量方差分析,并使用Bonferonni校正法进行简单效应分析。性别和眼别等定性数据以率表示,采用卡方检验进行比较。结果高血压组术后1 d、7 d及30 d的黄斑中心区域PD、黄斑内层区域PD、黄斑完整区域PD、视盘中心区域PD、视盘内层区域PD及视盘完整区域PD分别为0.12±0.06、0.13±0.05、0.16±0.14、0.33±0.05、0.44±0.57、0.35±0.04,0.31±0.05、0.33±0.06、0.33±0.04、0.21±0.10、0.21±0.11、0.22±0.09、0.37±0.04、0.38±0.04、0.38±0.04、0.35±0.04、0.36±0.04及0.36±0.04,差异均无统计学意义(F=2.061,1.072,1.601,0.947,1.559,1.158;P>0.05)。非高血压组术后不同时间点的黄斑中心区域PD、黄斑内层区域PD及黄斑完整区域PD分别为0.10±0.04、0.12±0.05、0.12±0.05、0.33±0.05、0.36±0.04、0.34±0.05、0.30±0.05、0.33±0.04及0.31±0.05,差异均有统计学意义(F=3.084,4.462,3.705;P<0.05)。高血压组患者术后1 d、7 d及30 d的CMT分别为(242.61±19.78)μm、(246.27±22.02)�Objective To observe the changes of retinal thickness and blood flow in cataract patients with hypertension after phacoemulsification by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA).Methods A total of 58 patients(66 eyes)diagnosed with age-related cataracts and scheduled for phacoemulsification and intraocular lens implantation at the First Medical Center of PLA General Hospital from April 2023 to July 2024 were enrolled.Patients were divided into two groups based on a confirmed diagnosis of hypertension or a history of taking antihypertensive medication:the hypertension group(30 patients,33 eyes)and the non-hypertension group(28 patients,33 eyes).The Cirrus 5000-HD OCT(produced by Carl Zeiss Meditec)was used to scan and obtain images of the macular retina thickness.Using the AngioPlex 3mm×3mm imaging mode to scan and obtain central macular thickness(CMT),superficial vascular plexus(SVP),and vascular perfusion density(PD)images of the macula fovea.Age,axial length,systolic blood pressure,intraocular pressure(IOP),and bestcorrected visual acuity(BCVA)were analyzed for normality using the Shapiro-Wilk test.Data that followed a normal distribution were represented as±s,while data that did not follow a normal distribution were represented as the median and interquartile range[M(Q25,Q75)].Two-factor repeated measures ANOVA was used for intra-group and inter-group analysis,and the Bonferroni correction method was applied for simple effect analysis.Qualitative data such as gender and eye type were expressed as rates and analyzed using the chi-square test.Results The PD values of the central area of the macula,inner layer of the macula,intact area of the macula,central area of the optic disc,inner layer of the optic disc,and intact area of the optic disc in the hypertensive group at 1 day,7 days,and 30 days after surgery were 0.12±0.06,0.13±0.05,0.16±0.14,0.33±0.05,0.44±0.57,0.35±0.04,0.31±0.05,0.33±0.06,0.33±0.04,0.21±0.10,0.21±0.11,0.22±0.09,0.37±0.04,0.38±0.04,0.3

关 键 词：白内障 高血压 超声乳化术 光学相干断层扫描 光学相干断层成像血管造影 

分 类 号：R779.6[医药卫生—眼科]