特发性视神经炎患者视盘及黄斑区血流密度的定量研究

Quantitative analysis of vessel density in the optic disc and macular of patients with idiopathic optic neuritis

摘要:

目的：评估特发性视神经炎(ON)患者的患眼和未受累对侧眼的视盘及黄斑的血流密度改变情况，为特发性ON的治疗和随访提供一定的临床指导。

方法：横断面研究。收集2019-12/2021-12于扬州大学附属苏北人民医院眼科确诊的初次发病且病程≤3 mo的单眼特发性ON患者16例，分为患眼组16眼与未受累对侧眼组16眼，另收集性别、年龄相匹配的健康者20例20眼作为对照组。所有眼均行视盘区4.5 mm×4.5 mm及黄斑区6 mm×6 mm光相干断层扫描血管成像(OCTA)检查，收集视盘区及黄斑区各血流指标，并对三组间各指标进行对比及分析。

结果：与对照组及未受累对侧眼组相比，ON患眼组视盘全区域及视盘周围各分区毛细血管、全部血管血流密度均降低(P<0.05)。与未受累对侧眼组相比，ON患眼黄斑区整体及中心凹周围全部分区SCP血流密度均显著降低(P<0.05)，旁中心凹SCP血流密度仅在上半侧及上侧分区显著降低(P<0.05)。与对照组相比，ON患眼组黄斑中心凹周围下半侧、鼻侧、下侧SCP密度降低(均P<0.05)。与对照组相比，未受累对侧眼组黄斑区整体及各分区SCP血流密度均增加(P<0.05)，旁中心凹SCP血流密度增加(P<0.05)，但下半侧、鼻侧分区改变无统计学差异(P>0.05)，中心凹周围SCP血流密度增加仅在上半侧及上侧分区有统计学意义(P<0.05)。

结论：病程3 mo以内的ON患者会出现视盘周围各分区血管密度的降低和黄斑中心凹周围部分分区SCP血流密度的降低，同时伴随着对侧眼黄斑区部分分区的SCP血流密度的增加。

Abstract:

AIM: To assess the changes of vessel density in the optic disc and macular of the affected eye and the uninvolved contralateral eye in patients with idiopathic optic neuritis(ON)and to provide clinical guidance for the treatment and follow-up of idiopathic ON.

METHODS: A total of 16 patients with first-episode monocular idiopathic ON ≤3 mo diagnosed between December 2019 and December 2021 were included in this cross-sectional study. The eye of patients was divided into 16 eyes in the affected eye group and 16 eyes in the uninvolved contralateral eye group, and 20 healthy age-matched eyes(n=20)served as controls. Optical coherence tomography angiography(OCTA)was performed in all eyes at 4.5 mm×4.5 mm region of the optical disc and 6 mm×6 mm region of the macular, and blood flow indicators were collected and compared.

RESULTS: Compared with the control group and the uninvolved contralateral eye group, the density of all vessels and capillary were reduced in the whole area of optic disc, and all subdivisions of the peripapillary region in the ON group(all P<0.05). Compared with the uninvolved contralateral eye group, the density of superficial capillary plexus(SCP)was significantly lower in the whole area of macular and perifovea region, and its all subdivisions of the ON eye, as well as in the superior-hemi and superior subdivision of the parafovea region(all P<0.05). Compared with the control group, the density of SCP in the inferior-hemi, nasal, and inferior perifovea region was significantly reduced in the ON affected eye group(all P<0.05). Compared with the control group, the whole area of macular and its subdivisions in the uninvolved contralateral eye group showed an increase in the density of SCP(P<0.05)and an increase in the density of SCP in the parafovea region(P<0.05), but no significant change in the inferior-hemi and nasal subdivisions; the increase in the density of SCP in the perifovea region was only significant in the superior-hemi and superior subdivisions(P<0.05).

CONCLUSION: Patients with ON in the duration of ≤3 mo may showed a decreased vessel density in all peripapillary subdivisions, and a decreased density of SCP in some subdivisions of the perifovea region, accompanied by an increased density of SCP in some subdivisions of the macular region of the contralateral eyes.