急性与慢性中心性浆液性脉络膜视网膜病变患眼黄斑区脉络膜毛细血管层血流密度及中大血管容积的量化分析

Quantitive analysis of the choriocapillaris flow density and choroidal vessel volume of acute and chronic central serous chorioretinopathy

目的对比观察急性、慢性中心性浆液性脉络膜视网膜病变(CSC)患眼脉络膜毛细血管层血流密度及脉络膜中大血管容积(CVV)变化。方法横断面观察性临床研究。2019年5月至2020年10月于四川大学华西医院眼科确诊为CSC的64例患者64只眼(CSC组)及同期年龄、性别匹配的健康志愿者64名64只眼(对照组)纳入研究。CSC组64例64只眼中,急性、慢性CSC分别为34例34只眼和30例30只眼,并据此再分为急性CSC组、慢性CSC组。CSC组、对照组受检者年龄(t=-0.041)、性别构成比(χ2=0.191)比较,差异无统计学意义(P>0.05)。急性CSC组、慢性CSC组患者年龄(t=-1.872)、性别构成比(χ2=8.778)比较,差异有统计学意义(P<0.05)。视微影像(河南)科技有限公司VG200D行黄斑区扫频源光相干断层扫描血管成像检查。扫描范围12 mm×12 mm,扫描模式512×512。应用设备自带软件(v1.28.6)记录黄斑血管3×3、6×6、12×12完整和黄斑周血管1~3、3~6、6~12的脉络膜毛细血管层血流密度以及黄斑血管3×3、6×6、12×12完整的CVV。组间年龄、脉络膜毛细血管层血流密度、CVV比较采用独立样本t检验。结果与对照组比较,CSC组患眼黄斑区脉络膜毛细血管层血流密度下降,其中黄斑血管3×3、6×6完整差异有统计学意义(t=-7.210、-4.040,P<0.001)。CSC组、对照组受检眼黄斑血管3×3、6×6、12×12完整CVV比较,差异均有统计学意义(t=1.460、12.270、11.250,P<0.05)。与急性CSC组比较,慢性CSC组患眼脉络膜毛细血管层血流密度下降,其中黄斑血管3×3、6×6完整(t=3.230、2.330),黄斑周血管1~3完整及其4个象限(t=2.780、2.060、2.140、2.620、3.770),黄斑周血管3~6上方(t=2.550),黄斑周血管6~12上方、颞侧(t=3.070、2.610)差异有统计学意义(P<0.05)。急性CSC组、慢性CSC组患眼黄斑血管3×3、6×6、12×12完整CVV比较,差异均无统计学意义(t=0.250、0.070、-0.110,P>0.05)。结论与急性CSC患眼比较,慢性CSC患眼黄斑区脉络膜毛细血管层血流密度降低,CVV无明显差异。

Objective To compare the choriocapillaris flow density and choroidal vessel volume(CVV)of acute and chronic central serous chorioretinopathy(CSC).Methods A cross-sectional observational clinical study.A total of 64 eyes of 64 patients(CSC group)diagnosed with CSC at Department of Ophthalmology of West China Hospital of Sichuan University from May 2019 to October 2020,and a total of 64 eyes of 64 age and gender matched healthy volunteers(control group)during the same period were included in this study.In the CSC group,there were 34 patients with acute CSC(acute CSC group)and 30 patients with chronic CSC(chronic CSC group).There was no significant difference in age(t=-0.041)and sex composition ratio(χ2=0.191)between CSC group and control group(P>0.05).There were statistically significant differences in age(t=-1.872)and sex composition ratio(χ2=8.778)between acute CSC group and chronic CSC group(P<0.05).Swept source optical coherence tomography angiography(SS-OCTA)was performed using VG200D.The scanning mode was 512×512 and scannig range was 12 mm×12 mm.The choriocapillaris flow density of the 3 mm,6 mm,12 mm circular area and 1-3 mm ring,3-6 mm ring,and 6-12 mm ring,and the CVV of the of the 3 mm,6 mm,12 mm circular area was automatically generated by the built-in software(v1.28.6).The age,choriocapillaris flow density and CVV were compared between two groups using independent sample t test.Results Compared with the control group,the choriocapillaris flow density decreased in the CSC group,and there were statistically significant differences in the 3 mm,6 mm circular area(t=-7.210,-4.040;P<0.001).There were statistically significant differences between CSC group and control group in the 3 mm,6 mm,12 mm circular area(t=1.460,12.270,11.250;P<0.05).Compared with the acute CSC group,the choriocapillaris flow density decreased in the chronic CSC group,and there were statistically significant differences(P<0.05)in the 3 mm,6 mm circular area(t=3.230,2.330),the total and four quadrants of 1-3 mm ring(t=2.780,2.060,2.140,2.620,3.770),the superior quadrants of the 3-6 mm ring(t=2.550),and the superior and temporal of 6-12 mm ring(t=3.070,2.610).There was no significant difference of CVV in the 3 mm,6 mm and 12 mm circular area between the acute CSC group and the chronic CSC group(t=0.250,0.070,-0.110;P>0.05).Conclusion Compared with acute CSC,chronic CSC exhibits significant decreased choriocapillaris flow density and no change in CVV.