[关键词]
[摘要]
目的:利用光学相干断层扫描血管成像(OCTA)观察视网膜中央动脉阻塞(CRAO)急性期患者黄斑区视网膜血管密度,并分析其与眼底荧光素血管造影(FFA)视网膜循环时间的关系。
方法:回顾性病例分析。纳入2019-01/2021-03就诊于陕西省眼科医院且临床诊断为CRAO急性期(病程≤7d)的患者43例43眼,均行FFA、OCTA、最佳矫正视力(BCVA)等检查及溶栓治疗。将治疗前OCTA显示患眼视网膜血管血流信号较对侧健眼增强或不变的患者纳入A组,OCTA显示患眼视网膜血管血流信号较对侧健眼降低的患者纳入B组。应用Image J软件处理OCTA图像评估治疗前黄斑区视网膜血管密度,FFA检查记录治疗前患眼视网膜循环时间。
结果:A组患者患眼和对侧健眼视网膜血管密度均高于B组(25.08%±4.40% vs 12.24%±3.41%,25.72%±2.70% vs 17.89%±4.55%,均P<0.001),B组患者视网膜动脉主干-末梢充盈时间(FT)\〖96(20.50,193.50)s\〗较A组\〖11(5.00,19.50)s\〗延长(P<0.001)。病程、对侧健眼视网膜血管密度、FT是患眼视网膜血管密度的相关因素(均P<0.05),且影响强度由大到小依次是FT、病程、对侧健眼视网膜血管密度,其中病程、FT与患眼视网膜血管密度具有负相关性。
结论:CRAO患者OCTA视网膜血管密度与FFA视网膜循环时间具有相关性。
[Key word]
[Abstract]
AIM: To observe the macular retina vascular density of patients with acute central retinal artery occlusion(CRAO)by optical coherence tomography angiography(OCTA)and to analyze the relationship with retinal circulation time of these patients on fundus fluorescein angiography(FFA).
METHODS: Retrospective case analysis. A total of 43 patients(43 eyes)from January 2019 to March 2021 admitted to Shaanxi Eye Hospital with clinical diagnosis of acute CRAO(course of disease ≤7d)were included. All patients underwent FFA, OCTA, best corrected visual acuity(BCVA)examination and thrombolytic therapy. The patients with enhanced or unchanged retinal blood flow signal in the affected eye showed on OCTA before treatment compared with the contralateral healthy eye were assigned to group A, and the patients with retinal blood flow signal of the affected eye was lower than that in the contralateral healthy eye by OCTA were assigned to group B. Image J software was used for OCTA image processing to evaluate the macular retina vascular density before treatment, and FFA examination was performed to record the affected retinal circulation time before treatment.
RESULTS: The retinal vascular density of patients in the affected eye and the contralateral healthy eye in group A was higher than that in group B(25.08%±4.40% vs 12.24%±3.41%, 25.72%±2.70% vs 17.89%±4.55%, all P<0.001), the filling time(FT)of retinal artery trunk to terminal in group B \〖96(20.50, 193.50)s\〗 was longer than that in group A \〖11(5.00, 19.50)s\〗(P<0.001). The course of disease, the retinal vascular density of contralateral healthy eye and FT were related factors of retinal vascular density of the affected eye(all P<0.05), and the influence strength order was FT, course of disease and the retinal vascular density of contralateral healthy eye, in which the course of disease and FT was negatively correlated with the retinal vascular density.
CONCLUSION: OCTA retinal vascular density was correlated with FFA retinal circulation time in CRAO patients.
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[基金项目]
陕西省重点研发计划项目(No.2020SF-267); 陕西省自然科学基础研究计划项目(No.2022JM-514); 白求恩·朗沐中青年眼科科研基金项目(No.BJ-LM2021011J); 西安市科技计划项目\〖No.20YXYJ0008(3)\〗; 西安市人民医院(西安市第四医院)孵化基金项目(No.ZD-5,ZD-7,ZD-8)