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[摘要]
目的:采用光学相干断层扫描血管成像(OCTA)技术观察视网膜分支静脉阻塞(BRVO)患者黄斑区血流及结构特征,并分析视力的危险因素。方法:收集2018-01/2019-06在抚顺市眼病医院经眼底及眼底荧光造影检查确诊的BRVO患者92例92眼为BRVO组,另选取同期基线资料与BRVO组患者相匹配的健康志愿者38例38眼作为对照组。记录两组受检者的基线资料,并采用OCTA技术观察3mm×3mm范围内黄斑区深层和浅层血流密度、深层和浅层中心凹血流密度、黄斑中心凹厚度、神经上皮层厚度、神经上皮层下积液高度。分析BRVO患者上述参数的相关性,并采用多因素Logistic回归法分析影响视力的危险因素。结果:与对照组相比,BRVO患者视力、黄斑中心凹厚度、深层血流密度、浅层血流密度、深层中心凹血流密度、浅层中心凹血流密度均有差异(P<0.01)。多因素Logistic回归分析显示,年龄(P=0.033,OR=1.152,95%CI 1.011~1.312)、浅层中心凹血流密度(P=0.010,OR=1.260,95% CI 1.056~1.504)、黄斑中心凹厚度(P<0.01,OR=1.033,95% CI 1.021~1.045)均是视力的危险因素。BRVO患者深层及浅层血流密度与黄斑中心凹厚度、神经上皮层厚度均呈负相关(P<0.01),黄斑中心凹厚度与神经上皮层厚度、神经上皮层下积液高度均呈正相关(P<0.01)。结论:利用OCTA可以观察BRVO患者视网膜血流状态及视网膜切面结构的变化,将两者结合起来可以更全面地观察BRVO患者黄斑区视网膜的病变特点。年龄、黄斑中心凹厚度、浅层中心凹血流密度为影响视力的危险因素。
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[Abstract]
AIM: To analyse the characteristic of macular microcirculation and structural features detected by optical coherence tomography angiography(OCTA)in retinal branch vein occlusion(BRVO), and analyse the risk factors of visual acuity(VA).METHODS: Eligible eyes from subjects(92 with BRVO and 38 healthy people)were included. The relationship between factors and VA was analyzed by retrospective. Vessel density affected by vein occlusion of 3×3mm2 centered on the fovea(3×3mm VD)and foveal vessel density(foveal VD)in the superficial capillary plexus(SCP)and deep capillary plexus(DCP), were measured by OCTA. Central macular thickness(CMT), neuroepithelial layer thickness and height of subcortical fluid in patients with BRVO were measured.RESULTS: The DCP, SCP, FD300, density of superficial fovea, density of superficial fovea and AI of the BRVO group were significantly different with control group(P<0.01). Multivariate regression: Age(P=0.033, OR=1.152, 95%CI=1.011-1.312). Density of superficial fovea(P=0.010, OR=1.260, 95%CI=1.056-1.504)and Macular fovea thickness(P<0.01, OR=1.033, 95%CI=1.021-1.045)were risk factors of VA. DCP and SCP were negatively related with CMT and neuroepithelial layer(P<0.01). CMT was positively correlated with the thickness of neuroepithelial layer and the height of subcortical fluid(P<0.01).CONCLUSION: Using OCTA, we can observe the BRVO retinal blood flow and the changes of the structure of the retinal section, and the pathological features of macular retina in BRVO patients can be observed more comprehensively. Age, density of superficial fovea and macular fovea thickness were risk factors of VA.
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