眼球钝挫伤患者黄斑区光相干断层扫描血管成像的特征

Optical coherence tomography angiography characteristics in patients with ocular blunt trauma

目的探讨眼球钝挫伤后光相干断层扫描血管成像(OCTA)检查黄斑区毛细血管丛血流密度(MVD)、视网膜厚度、及黄斑中心凹无血管区(FAZ)面积的改变。方法采取横断面研究。收集确诊为眼球钝挫伤且视力下降的患者的病例资料18例(18只眼),患眼作为实验组,自身健眼作为对照组。所有患者均行最佳矫正视力(BCVA)、前置镜检查眼底、OCTA等检查。采用OCTA对所有患者黄斑3 mm×3 mm区域进行扫描,设备自带软件自动获得浅层毛细血管丛(SCP)、深层毛细血管丛(DCP)的血流密度、视网膜厚度及FAZ面积,并分析比较钝挫伤眼与健眼的OCTA参数改变。结果实验组LogMAR BCVA为(0.15±0.08),对照组LogMAR BCVA为(0.02±0.03),实验组视力较差(P<0.05)。实验组与对照组相比较,黄斑区浅层总体血流密度减少(t=-3.983,P<0.05);且中心凹旁,浅层上、下、鼻、颞浅层MVD均较对照组减小(t值分别为-3.942、-3.627、-4.352、-3.630、-3.214,P<0.05);而FAZ、视网膜厚度及深层总体、中心凹旁、上、下、鼻、颞侧MVD均较对照组无明显差异(t值分别为-0.192、0.523、0.806、0.941、0.761、0.940、0.473、1.107,P>0.05)。结论在视力下降但眼底检查黄斑区没有明显结构性异常钝挫伤眼中,OCTA可见视网膜浅层的MVD显著降低,而深层的MVD、黄斑区视网膜厚度及FAZ并无明显改变。

Objective To observe changes in clinically macular vascular density(MVD),retinal thicknes and foveal avascular zone(FAZ)in ocular blunt trauma with optical coherence tomography angiography(OCTA).Methods The data of 18 patients with ocular blunt trauma and decreased vision were involved in this cross-sectional study.The sick eyes were divided in the experimental group while their healthy eyes as the control group.All patients underwent the ecxaminations involved best corrected visual acuity(BCVA),the fundus examination with fundus pre-set lens,OCT angiography(OCTA).OCTA was performed among the patients on 3 mm×3 mm fovea sections.The software automatically obtained the superficial capillary plexus(SCP)and deep capillary plexus(DCP)vascular density,retinal thickness and FAZ area.The changes of OCTA parameters in experimental group and control group were compared and analyzed.Results LogMAR BCVA in the experimental group was(0.15±0.08),which was worse than that in the control group(0.02±0.03).Compared with the control group,the overall macular area superficial MVD was decreased(t=-3.983,P0.05).Conclusions In the eyes with decreased visual acuity but no obvious structural abnormalities in the macular area of fundus examination,the superficial MVD was decreased significantly,while the deep MVD,macular retinal thickness and FAZ did not change significantly.