特发性黄斑前膜患者中心凹无血管区面积与中心凹形态相关性研究

Correlation between foveal avascular zone size and foveal morphology in patients with idiopathic macular epiretinal membrane

目的观察并探讨特发性黄斑前膜(IMEM)患者中心凹无血管区(FAZ)面积与中心凹形态的相关性。方法回顾性系列病例研究。2016年11月至2017年8月于中部战区总医院眼科临床检查确诊为IMEM的54例患者54只眼(IMEM组)及正常人50名50只眼(对照组)纳入研究。采用OCT血管成像仪测量黄斑区视网膜浅层、深层毛细血管层FAZ面积;采用扫频光源OCT测量黄斑中心凹厚度(CMT)、内层视网膜厚度(IRT)、外层视网膜厚度(ORT)、中心凹下脉络膜厚度(SFCT)并观察椭圆体带(EZ)的完整性。对比观察IMEM组、对照组受检者FAZ面积、CMT、IRT、ORT、SFCT及EZ完整性;同时分析IMEM组患眼FAZ面积、CMT、IRT、ORT、CT及EZ完整性之间的相关性。结果与对照组受检眼比较,IMEM组患眼视网膜浅层、深层毛细血管层FAZ面积均明显变小,差异有统计学意义(t=-29.095、-28.743,P<0.001、<0.001);CMT、IRT、ORT、SFCT均增厚,差异有统计学意义(Z=-8.784、-8.524、-7.709、-7.535,P<0.001、<0.001、<0.001、<0.001)。相关性分析结果显示,IMEM组患眼视网膜浅层毛细血管层FAZ面积与CMT、IRT、EZ完整性呈负相关(r=-0.464、-0.536、-0.293,P<0.001、<0.001、0.039);与ORT、SFCT无明显相关(r=-0.218、-0.165,P=0.172、0.157)。深层毛细血管层FAZ面积与CMT、IRT、EZ完整性呈负相关(r=-0.306、-0.694、-0.468,P=0.037、<0.001、<0.001);与ORT、SFCT无明显相关(r=-0.242、-0.227,P=0.079、0.094)。结论IMEM患眼视网膜浅层、深层毛细血管层FAZ面积较正常眼明显缩小;均与CMT、IRT、EZ完整性呈明显负相关。

Objective To analyze the correlation between foveal avascular zone (FAZ) size and foveal morphology in patients with idiopathic macular epiretinal membrane (IMEM) using OCT angiography (OCTA). Methods A retrospective case series study contained of 54 eyes of 54 patients affected with IMEM (IEM group) and 50 eyes of 50 normal persons as the control group. The BCVA was measured using the international standard visual acuity chart, and the results were converted to the logMAR visual acuity. The FAZ areas were evaluated with OCTA in both the superficial and deep capillary plexus layers by using 3 mm×3 mm images of the macular. The central macular thickness (CMT), inner retinal layer thickness (IRT), outer retinal layer thickness (ORT), subfoveal choroidal thickness (SFCT), and the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography. The differences of FAZ areas between the two groups were analyzed. The correlative analysis was performed to investigate the relationship between areas and foveal morphology. Results Compared with control group, the FAZ area in superficial and deep capillary plexus in the IMEM group were significantly smaller (t=-29.095, -28.743;P<0.001, <0.001);the mean CMT, IRT, ORT and SFCT were significantly thickening in the IMEM group (Z=-8.784, -8.524, -7.709, -7.535;P<0.001,<0.001, <0.001, <0.001). In the IMEM group, the FAZ area in superficial capillary plexus correlated inversely with the CMT, IRT, and the integrity of EZ (r=-0.464, -0.536, -0.293;P<0.001, <0.001, 0.039), no significant correlation of superficial plexus FAZ areas with ORT and SFCT (r=-0.218, -0.165;P=0.172, 0.157). The FAZ area in deep capillary plexus correlated inversely with the CMT, IRT, and the integrity of EZ (r=-0.306, -0.694, -0.468;P=0.037, <0.001, <0.001), no significant correlation with ORT and SFCT (r=-0.242, -0.227;P=0.079, 0.094). Conclusions The FAZ areas is significantly decreased in IMEM eyes compared with normal eyes. Both superficial and deep FAZ area are correlated with the CMT, IRT, and the integrity of EZ.