目的：应用光学相干断层扫描血管成像技术(OCTA)测量视网膜静脉阻塞(RVO)患者黄斑区血流密度、黄斑中心凹无血管区(FAZ)面积和黄斑中心凹视网膜厚度。方法：选取RVO患者30例30眼，视网膜中央静脉阻塞(CRVO)和视网膜分支静脉阻塞(BRVO)患者各15例，双眼接受OCTA检查，获取黄斑中心3mm×3mm大小范围的血流密度、FAZ面积、黄斑中心凹视网膜厚度，以及双眼最佳矫正视力(BCVA)。比较患眼与健眼上述指标的变化及其与BCVA的相关性。结果：CRVO患者患眼黄斑区视网膜浅层毛细血管网(SVN)、深层毛细血管网(DVN)总血流密度较健眼降低[SVN：(43.07±4.95)% vs(50.09±2.86)%，DVN：(45.89±4.12)% vs(53.29±2.62)%，均P<0.01]，与BCVA呈负相关(rs=-0.6、-0.5，均P<0.05)。BRVO患者患眼SVN、DVN总血流密度较健眼降低[SVN：(45.62±3.04)% vs(52.10±2.98%)，DVN：(49.21±3.80)% vs(55.52±3.33%)，均P<0.01]，与BCVA呈负相关(rs=-0.5、-0.5，均P<0.05)。BRVO患眼病变区域与患眼未病变区域、健眼对应区域比较，SVN、DVN血流密度均下降(均P<0.01)； 患眼未病变区域DVN血流密度较健眼相应区域下降[(56.86±1.95)% vs(58.15±2.24)%， P=0.02]； 患眼病变区域DVN血流密度与BCVA呈负相关(rs=-0.6，P=0.01)。CRVO、BRVO患眼SVN的FAZ面积较健眼明显扩大(CRVO：0.515±0.26mm2 vs 0.27±0.08mm2，P<0.01； BRVO：0.376±0.12mm2 vs 0.261±0.07mm2，P<0.01)，且均与BCVA呈正相关(CRVO：rs=0.6，P=0.01； BRVO：rs=0.5，P=0.01)。CRVO、BRVO患眼黄斑中心凹视网膜厚度均较健眼增加(CRVO：431.2±191.3μm vs 235.5±18.2μm，P<0.01； BRVO：373.2±188.7μm vs 233.8±13.7μm，P=0.01)，均与BCVA呈正相关(CRVO：rs=0.9，P=0.01； BRVO：rs=0.6，P=0.01)。结论：OCTA可作为测量RVO患者黄斑区血流密度、FAZ面积及黄斑中心凹视网膜厚度的有效工具。

AIM: To use optical coherence tomography angiography(OCTA)in measuring the macular vascular density, foveal avascular zone(FAZ)area and the macular retinal thickness in patients with retinal vein occlusion(RVO).METHODS: Totally 30 patients(30 eyes)with unilateral RVO were enrolled. Fifteen patients with central retinal vein occlusion(CRVO)and 15 patients with branch retinal vein occlusion(BRVO), OCTA was performed on both eyes. Macular vascular density in the 3mm×3mm range, FAZ area, foveal thickness and best-corrected visual acuity(BCVA)were measured. The changes of vascular density, FAZ area, foveal thickness and its correlation with BCVA were compared between the eyes and the fellow eyes.RESULTS: In eyes with CRVO the overall vascular density measured in the entire scan was lower compared to fellow eyes in both the superficial [SVN:(43.07±4.95)% vs (50.09±2.86)%; P<0.01)]and [DVN:(45.89±4.12)% vs(53.29±2.62)%; P<0.01]. And a negative correlation was found between the visual acuity and the overall density in superficial(rs= -0.6, P<0.05)and deep(rs= -0.5, P<0.05)networks. In eyes with BRVO the overall vascular density measured in the entire scan was lower compared to fellow eyes in both the superficial [(45.62±3.04)% vs(52.10±2.98)%; P<0.01] and deep [(49.21±3.80%)vs(55.52±3.33)%; P<0.01] networks. And a negative correlation was found between the visual acuity and the overall density in superficial(rs= -0.5, P<0.05)and deep(rs= -0.5, P<0.05)networks. In both networks, the density was lower in the affected BRVO sector compared to the unaffected sector in the same eye and in the fellow eye(P<0.01). And the vascular density in the affected BRVO sector correlated negatively with visual acuity in the deep network(rs= -0.6, P=0.01). In the deep network, the density was lower in the unaffected sector of the BRVO eye compared with the corresponding sector in the fellow eye [(56.86±1.95)% vs(58.15±2.24)%; P=0.02]. The mean FAZ area in CRVO and BRVO eyes was significantly lower at the superficial network when compared to the fellow eyes \ and correlated positively with visual acuity(CRVO: rs=0.6, P=0.01; BRVO: rs=0.5, P=0.01). The mean foveal thickness in CRVO and BRVO eyes was significantly thicker when compared to the fellow eyes \ and correlated positively with visual acuity(CRVO: rs=0.9, P=0.01; BRVO: rs=0.6, P=0.01).CONCLUSION: Quantitative OCTA can be used as an effective tool for measuring blood flow in macular areas and FAZ area of RVO patients.

遵义市科技计划项目[No.遵市科合社字(2018)168号]