视网膜分支动脉阻塞视力预后相关因素分析

Analysis of visual prognosis and correlative factors in branch retinal artery occlusion

目的:研究视网膜分支动脉阻塞(branch retinal artery occlusion,BRAO)患眼视力预后的相关因素分析。方法:选取2015-06/2017-06来我院就诊并诊断为视网膜分支动脉阻塞的患者68例。收集患者的年龄、性别、发病时间等基本信息及初诊时最佳矫正视力、眼底彩色照相、频域OCT及OCTA等眼科检查结果。OCTA检查采用RTVue XRAVANTI仪进行。选择视网膜血流成像扫描模式,扫描区域分别为黄斑区3mm×3mm。随访时间为6mo,随访时检查最佳矫正视力。结果:患者就诊时基线视力:轻度视力损害(≥0. 5)为69%,中度视力损害(0. 1～0. 4)为24%,重度视力损害(<0. 1)为7%;随访预后视力的轻、中、重度损害分别为75%、19%、6%。影响预后视力的相关因素分析:就诊时基线视力(r=0. 776,P<0. 001)、浅层视网膜毛细血管黄斑区拱环存留度(r=-0. 003,P<0. 001)、深层视网膜毛细血管黄斑区拱环存留度(r=-0. 003,P<0. 001)、黄斑区浅层毛细血管密度(r=-0. 034,P=0. 029)及黄斑区深层毛细血管密度(r=-0. 014,P=0. 012)与预后视力密切相关。性别、年龄、就诊时间、黄斑中心凹厚度、视网膜动脉受阻位置(颞上或颞下)以及是否发现明确视网膜血管动脉栓子与预后视力无相关性(r=-0. 273、0. 01、0、0. 82、0. 41、0. 109,均P>0. 05)。结论:BRAO患眼黄斑拱环存留度、黄斑区毛细血管密度和发病早期视力与预后视力密切相关。

AIM：Analysis of visual prognosis and correlative factorsin patients with branch retinal artery occlusion （BRAO）.METHODS： Retrospective medical record review of 68eyes of 68 patients with BRAO seen at FushunOphthalmology Hospital from June 2015 and June 2017.Demographic and clinical characteristics were recorded,including gender, age, race, eye involved, and best -corrected visual acuity （BCVA）, spectral domain opticalcoherence tomography （SD-OCT） and optical coherencetomography angiography （OCTA, OptoVue）. The OCTAretinal blood flow imaging scan mode was performed, thescanning region in the macular area were 3mm×3mm. thepatients were followed up for 6mo.RESULTS： On presentation, 69% of eyes with BRAOhad BCVA of 0. 5 or better, 24% of moderate visualimpairment （ 0. 1 - 0. 4 ） and 7% of severe visualimpairment （ 〈0. 1）. At the 6-month visit, the percentageof eyes with slight, moderate and severe visualimpairment was 75%, 19% and 6% respectively. Thepresenting BCVA （ r = 0. 776, P 〈 0. 001）, the integrity ofsuperficial foveal capillary arcade （ r = - 0. 003, P〈 0. 001）,the integrity of deep foveal capillary arcade （r = -0. 003, P〈0. 001）, the density of superficial retinal capillary plexuses（r = - 0. 034, P = 0. 029 ） and the density of deep retinalcapillary plexuses （r = -0. 014, P = 0. 012） were found to bestatistically significant with regard to visual outcome.Male, age, duration of symptoms, macular retinalthickness, area of macular involvement （ superior orinferior） and presence or absence of emboli were notfound to be statistically significant with regard to follow-upBCVA （r = 0. 273, 0. 01, 0, 0. 082, 0. 41, 0. 109, all P〉0. 05）.CONCLUSION： The integrity of foveal capillary arcade,the density of retinal capillary plexuses and the presentingBCVA are dosely associated with visual outcome ofpatients with branch retinal artery occlusion.