特发性黄斑前膜患眼黄斑中心凹无血管区面积与视力及视物变形的相关性研究

Correlation of foveal avascular zone size with visual acuity and metamorphopsia in idiopathic macular epiretinal membrane eyes using optical coherence tomography angiograph3~

目的 观察特发性黄斑前膜（IMEM）患眼黄斑中心凹无血管区（FAZ）面积与视力及视物变形的相关性。 方法 横断面临床病例对照研究。临床检查确诊的IMEM患者43例43只眼（IEM组）及正常者35名35只眼（对照组）纳入研究。所有受检者均行最佳矫正视力（BCVA）、裂隙灯显微镜、间接检眼镜、视物变形评分表（M-chart表）、彩色眼底照相、频域光相干断层扫描（OCT）及OCT血管成像（OCTA）检查。BCVA统计时转换为最小分辨角对数（logMAR）视力。IEM组、对照组受检眼平均logMAR BCVA、黄斑中心视网膜厚度（CMT）比较，差异均有统计学意义（Z=？7.379、？7.560，P＜0.001）。对比观察IEM组、对照组受检眼FAZ面积；同时分析IEM组患眼FAZ面积与BCVA、视物变形度之间的相关性。 结果 与对照组受检眼比较，IEM组患眼视网膜浅层、深层FAZ面积均较小，差异有统计学意义（t=？30.316、？27.606，P＜0.001）。IEM组患眼平均视物变形度为0.41±0.32，其中平均水平变形（MH）、垂直变形（MV）分别为0.49±0.40、0.32±0.29。与MV比较，MH明显较重，差异有统计学意义（Z=？2.000，P=0.046）。相关性分析结果显示，IEM组患眼视网膜浅层FAZ面积与视物变形度呈负相关（r=？0.709，P＜0.001）；视网膜深层FAZ面积与视物变形度、BCVA呈负相关（r=？0.533、？0.838，P＜0.001）。 结论 IMEM患眼FAZ面积较正常眼明显减少。视网膜浅层FAZ面积与视物变形度明显相关；视网膜深层FAZ面积与视物变形度及BCVA明显相关。

Objective To analyze the correlation of foveal avascular zone （FAZ） size with visual acuity and metamorphopsia in idiopathic macular epiretinal membrane （IMEM） eyes. Methods This is a cross-sectional study, including 43 patients （43 eyes） with IMEM （IMEM group） and 35 health subjects （35 eyes） as control group. The best corrected visual acuity （BCVA） was measured using the international standard visual acuity chart, and the results were converted to the logarithm of the minimum angle of resolution （logMAR） visual acuity. The severity of metamorphopsia was measured using M-charts. The FAZ areas were estimated with optical coherence tomography angiography （OCTA） in both the superficial and deep capillary plexus layers. The central macular thickness （CMT） was assessed with spectral-domain optical coherence tomography. There was no difference of logMAR BCVA and CMT between two groups （Z=？7.379, ？7.560; P〈0.001）. The differences of FAZ areas between the two groups were analyzed. The correlative analysis was performed to investigate the relationship between FAZ areas and visual acuity as well as metamorphopsia. Results The FAZ area in superficial and deep capillary plexus in IMEM group were smaller than those in control group （t=？30.316, ？27.606; P〈0.001）. In IMEM group, the mean M-score was 0.41±0.32; the horizontal and vertical M-score were 0.49±0.40 and 0.32±0.29, respectively. The horizontal M-score was higher than vertical M-score with the significant difference （Z=？2.000, P=0.046）. In IMEM group, the FAZ area in superficial capillary plexus correlated inversely with metamorphopsia （r=？0.709, P〈0.001）; the FAZ area in deep capillary plexus correlated inversely with metamorphopsia and BCVA （r=？0.533, ？0.838; P〈0.001）. Conclusions The FAZ areas are significantly decreased in IMEM eyes compared with normal eyes. Both superficial and deep FAZ areas are correlated with metamorphopsia, and deep FAZ area is also correlated with BCVA.