黄斑部脉络膜新生血管的OCT图像特征及与视力的相关性

Correlation between optical coherence tomography image characteristics of macular choroidal neovascularization and visual acuity

目的观察黄斑部脉络膜新生血管(choroidal neovascularization,CNV)的光学相干断层扫描(optical coherence tomo-graphy,OCT)图像特征,评估其与最佳矫正视力的相关性。方法 收集在我院经眼底荧光血管造影(fundus fluorescein angiogra-phy,FFA)及吲哚氰绿血管造影(indocyanine green angiography,ICGA)检查确诊为黄斑部典型性CNV高度近视(high myopia,HM)、年龄相关性黄斑变性(age-related macular degeneration,AMD)及中心性渗出性脉络膜视网膜病变(central exudative chori-oretinopathy,CEC)患者共34例36眼,经验光检查得到最佳矫正视力(best corrected visual acuity,BCVA);采用OCT仪检查并分析CNV的图像特征,并测量CNV突破RPE/脉络膜毛细血管复合层的基底部宽度、高度、离中心凹的距离及中心处视网膜神经上皮层组织厚度,分别评估其与视力改变的相关性。结果 CNV的OCT图像特征:RPE/脉络膜毛细血管层下见大小不等局限性增强隆起反射带;合并病灶周围视网膜神经上皮层组织下局限性无反射暗区或组织内反射增厚。AMD所引起的CNV基底部宽度、高度及中心处神经上皮层组织厚度值均最大。经直线相关分析统计显示:AMD和CEC所引起CNV的基底部宽度及中心处视网膜神经上皮层组织厚度均与BCVA具有负相关性(均为P<0.05),而HM所引起的CNV仅中心处视网膜神经上皮层组织厚度与BCVA具有负相关性(P<0.05)。结论 OCT能有效测量CNV的长度及黄斑水肿程度,在有效评估其与BCVA的相关性中具有重要作用。

Objective To investigate the optical coherence tomography（OCT） image characteristics of macular choroidal neovascularization（CNV） and evaluate their correlation with visual acuity.Methods Thirty-six eyes of 34 cases with high myopia,age-related macular degeneration（AMD） and center exudation chorioretinopathy,which were diagnosed as typical macular CNV using fundus fluorescein angiography and indocyanine green angiography,were examined by OCT.The best corrected visual acuity was checked by optometry.The image characteristics of CNV were analyzed and its width,height,the distance to macular foveola and the thickness of retinal neurosensory layer in foveola were measured.The correlation between each of them and BCVA was evaluated as well.Results OCT image showed some limited and enhanced refractive band with inequality of size appeared under RPE/choriocapillary layer,no refractive area was observed in retinal ganglion layer around the focus,or limited refractive area was observed under that.All index values of CNV caused by AMD including the average width,height and the thickness of retinal neurosensory layer in foveola were the largest.Linear correlation analysis results showed the width and the thickness of retinal neurosensory layer in foveola of CNV were negatively correlated with BCVA respectively in AMD and center exudation chorioretinopathy（All P0.05）.However,the results only showed the thickness of retinal neurosensory layer in foveola of CNV was negatively correlated with BCVA in high myopia（P0.05）.Conclusion OCT is useful to measure the size of CNV and macular edema,which play an important role in evaluating its correlation with BCVA.