单眼视网膜静脉阻塞患者对侧眼黄斑区血流密度和中心凹无血管区面积观察

The macular vascular density and the area of foveal avascular zone in the follow eyes of monocular retinal vein occlusion patients

目的:观察单眼视网膜静脉阻塞(RVO)患者对侧眼黄斑区血流密度和黄斑中心凹无血管区(FAZ)面积。方法:回顾性病例对照研究。2018年5~11月在长沙爱尔眼科医院临床确诊为单眼RVO的78例患者78只对侧眼纳入研究。其中,男性44例,女性34例;平均年龄(53.17±10.12)岁。视网膜中央静脉阻塞(CRVO)42例(CRVO组),视网膜分支静脉阻塞(BRVO)36例(BRVO组)。选取年龄和性别与RVO患者相匹配的33名正常健康者42只眼作为对照组。其中,男性17例22只眼,女性16例20只眼;平均年龄(53.48±10.84)岁。3组受检眼均行OCT血管成像检查,以仪器自带软件自动识别以黄斑中心凹为中心的直径6 mm区域及FAZ,自动测量黄斑区浅层和深层血流密度及FAZ面积。对比分析3组受检眼黄斑区浅层、深层血流密度和FAZ面积。结果:与对照组比较,CRVO组(t=-4.26、-4.93)、BRVO组(t=-4.79、-4.74)受检眼黄斑区浅层及深层血流密度均降低,差异均有统计学意义(P<0.05)。CRVO组、BRVO组受检眼黄斑区浅层及深层血流密度降低幅度分别为4.13%、5.51%及3.50%、4.58%,深层血流密度的降低幅度较浅层更大。CRVO组受检眼FAZ面积较对照组减小,差异有统计学意义(t=-3.43,P<0.05)。BRVO组与对照组受检眼FAZ面积比较,差异无统计学意义(t=-0.10,P>0.05)。结论:单眼RVO患者对侧眼黄斑区血流密度较正常健康眼降低,黄斑区深层血流密度的降低幅度较浅层更大。与正常健康眼比较,单眼CRVO患者对侧眼FAZ面积减小,单眼BRVO患者对侧眼FAZ面积无明显变化。

Objective To observe the macular vascular density and the area of foveal avascular zone(FAZ)in the follow eyes of monocular retinal vein occlusion(RVO)patients.Methods Retrospective case-control study.From May to November 2018,78 follow eyes of 78 monocular RVO patients who were clinically diagnosed in Changsha Aier Eye Hospital were included in the study.Among them,44 were male and 34 were female.The average age was 53.17±10.12 years.There were 42 patients with central retinal vein occlusion(CRVO group)and 36 patients with branch retinal vein occlusion(BRVO group).Forty-two eyes of 33 gender and age matched healthy volunteers were selected as the control group.Among them,17 were male(22 eyes)and 16 were female(20 eyes),with the mean age of 53.48±10.84 years.OCT angiography was performed on all eyes in CRVO group,BRVO group and control group.The scanning region in the macular area was 6 mm×6 mm.Macular vascular density and FAZ area in the superficial and deep retinal capillary plexi were measured.Results The mean overall vascular density measured in the entire scan was lower in the CRVO group(t=-4.26,-4.93)and BRVO group(t=-4.79,-4.74)compared with the control group in both the superficial and deep capillary plexus(P<0.05).The reduce degree of vascular density in the deep capillary plexus(CRVO group:5.51%,BRVO group:4.58%)was higher than that in the superficial plexus(CRVO group:4.13%,BRVO group:3.50%).In the CRVO group,the FAZ area decreased compared with the control group(t=-3.43,P<0.05).There was no statistically significant difference in the area of FAZ between the BRVO group and the control group(t=-0.10,P>0.05).Conclusions The macular vascular density in the follow eyes of monocular RVO patients is lower than that of normal healthy eyes.The reduce degree of vascular density in the deep capillary plexus is higher than that in the superficial plexus.Compared with normal healthy eyes,the FAZ area in the follow eyes of monocular CRVO patients decreased,while it did not change significantly in the follow eyes of monocular BRVO patients.