光学相干断层扫描血管成像在屈光参差性弱视儿童中的应用

Application of optical coherence tomography angiography in children with anisometropic amblyopia

目的·探讨光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)在屈光参差性弱视儿童视网膜微血管血流方面的应用价值。方法·纳入2018年6月—8月于上海交通大学附属第一人民医院眼科就诊的单眼屈光参差性弱视儿童31例。使用OCTA技术对患儿双眼黄斑区行3 mm×3 mm黄斑扫描、6 mm×6 mm黄斑扫描及4.5 mm×4.5 mm视盘扫描,分别由软件计算双眼浅层视网膜毛细血管丛(superficial capillary plexus,SCP)和深层视网膜毛细血管丛(deep capillary plexus,DCP)的血流平均密度、黄斑中心凹无灌注区(foveal avascular zone,FAZ)的平均面积、视盘及视盘旁的血流平均密度、黄斑中心凹平均厚度。患儿弱视眼归为弱视眼组,对侧非弱视眼归为对侧眼组,观察比较2组眼部血流参数的差异。结果·在3 mm×3 mm黄斑扫描中,弱视眼组SCP及DCP的血流平均密度分别为(46.40±4.72)%、(52.17±2.82)%,对侧眼组分别为(48.48±3.46)%、(54.31±2.18)%,2组间差异均具有统计学意义(P=0.012,P=0.012)。在6 mm×6 mm黄斑扫描中,弱视眼组SCP及DCP的血流平均密度分别为(47.41±3.04)%、(48.92±5.34)%,对侧眼组分别为(50.36±2.70)%、(51.54±4.69)%,2组间差异均具有统计学意义(P=0.016,P=0.046)。在4.5 mm×4.5 mm视盘扫描中,弱视眼组视盘的血流平均密度为(48.98±4.03)%,对侧眼组为(52.06±3.90)%,差异亦具有统计学意义(P=0.040);而弱视眼组视盘旁的血流平均密度为(52.16±2.22)%,对侧眼组为(52.44±1.50)%,2组差异则无统计学意义。结论·患儿屈光参差性弱视眼的SCP、DCP和视盘的血流平均密度均较对侧眼显著下降。OCTA技术在评估患儿屈光参差性弱视眼的视网膜微血流状态上具有一定的临床价值。

Objective·To explore the application value of optical coherence tomography angiography(OCTA)in retinal microvascular blood flow in children with anisometropic amblyopia.Methods·31 children with monocular anisometropic amblyopia in the Department of Ophthalmology in Shanghai General Hospital,Shanghai Jiao Tong University from June to August in 2018 were included.The 3 mm×3 mm and 6 mm×6 mm area centered on the macular area and 4.5 mm×4.5 mm area centered on the optic disc area were detected by OCTA.The software automatically calculated the average blood flow densities of superficial capillary plexus(SCP)and deep capillary plexus(DCP),and the average blood flow densities of optic disc and the peripapillary area,the average area of foveal avascular zone(FAZ),as well as the average foveal thickness in the anisometropic amblyopia and the contralateral eyes.The anisometropic amblyopia eyes of the children were classified as the amblyopia group,and the contralateral non-ambly eyes were classified as the contralateral eye group.The differences in blood flow parameters between two groups were compared.Results·In the 3 mm×3 mm macular scan,the average blood flow densities of SCP and DCP in the amblyopia group were(46.40±4.72)%and(52.17±2.82)%,respectively,and the average blood flow densities in the contralateral eye group were(48.48±3.46)%and(54.31±2.18)%,respectively.The differences in the average blood flow densities of SCP and DCP between two groups were statistically significant(P=0.012,P=0.012).In the 6 mm×6 mm macular scan,the average blood flow densities of SCP and DCP in the amblyopia group were(47.41±3.04)%and(48.92±5.34)%,respectively,and the average blood flow densities in the contralateral eye group were(50.36±2.70)%and(51.54±4.69)%,respectively.The differences between two groups were statistically significant(P=0.016,P=0.046).In the 4.5 mm×4.5 mm optic disc scan,the average blood flow densities of the optic disc in the amblyopia group and the contralateral eye group were(48.98±4.03)%and(52.06±3.90)%,respectively.The difference was also statistically significant(P=0.040).The average blood flow densities of the peripapillary area in the amblyopia group and the contralateral eye group were(52.16±2.22)%and(52.44±1.50)%,respectively.The difference was not statistically significant.Conclusion·The average blood flow densities of SCP,DCP and optic disc in the anisometropic amblyopia eyes are significantly lower than that in the contralateral eyes.OCTA has certain application value in evaluating retinal blood flow in children with anisometropic amblyopia.