光学相干断层扫描血管成像技术在眼底疾病的研究现状

Research status of optical coherence tomography angiography in fundus diseases

目的总结光学相干断层扫描血管成像(OCTA)在眼底疾病中的临床诊疗应用中的研究现状.方法在中国知网、万方数据、谷歌学术、PubMed等数据库以"光学相干断层扫描血管成像""眼底疾病""糖尿病视网膜病变""视网膜静脉阻塞""湿性年龄相关性黄斑变性"和"optical coherence tomography angiography""fundus disease""diabetic retinopathy""retinal vein occlusion""wet type age-related macular degeneration"等为关键词进行检索,总结OCTA技术在眼底疾病临床诊疗中应用研究现状.结果检索在2014年6月—2018年12月发表的与OCTA相关的文献1103篇,最终纳入32篇,其中中文文献3篇,英文文献29篇.OCTA是近年兴起的一种无创性血管成像技术,它通过探测血管腔内血细胞的运动,快速、安全地获得高分辨的视网膜和脉络膜血管影像.OCTA技术可良好地显示视网膜血管缺失、异常吻合;对黄斑中心拱环大小和形状描绘准确;对脉络膜新生血管检出率高;有助于中心性浆液性脉络膜视网膜病变的诊断和鉴别诊断,并可以作为眼底疾病治疗后随访观察的有效检查手段.结论OCTA作为一种具有临床应用潜力的新技术,可良好地显示视网膜和脉络膜的眼底病变,为此类疾病的诊断和治疗提供重要参考,但其存在的视野小、对眼球运动追踪差等缺点仍需进一步改进.

Objective To summarize the application and progress of optical coherence tomography angiography(OCTA)in fundus diseases.Methods The key words"optical coherence tomography angiography""fundus disease""diabetic retinopathy""retinal vein occlusion"and"wet type age-related macular degeneration"were used to search the related literatures in CNKI,Wanfang Data,Google academic and PubMed.The clinical application of OCTA in fundus diseases were summarized.Results One thousand one hundred and three literatures related to OCTA published from June 2014 to December 2018 were reviewed,and 32 literatures were finally included,including 3 literatures in Chinese and 29 literatures in English.OCTA was a non-invasive angiographic technique that had been developed in recent years.It detected the movement of blood cells in the lumen of blood vessels to quickly and safely obtain high-resolution images of retinal choroid vessels.OCTA technique could well display retinal vascular absence and abnormal anastomosis.Accurately describe the size and shape of the central arch ring of the macula.The detection rate of choroidal neovascularization was high.It was helpful for the diagnosis and differential diagnosis of central serous chorioretinopathy and could be used as an effective means of follow-up observation after treatment of fundus diseases.Conclusions As a new technique with clinical application potential,OCTA can well display retinal and choroidal fundus lesions,provide important reference for the diagnosis and treatment of such diseases.However,it still needs to be further improved due to its shortcomings such as small field of vision and poor tracking of eye movements.