视网膜静脉阻塞的光学相干断层扫描血管成像应用

Application of optical coherence tomography angiography in retinal vein occlusion

视网膜静脉阻塞(RVO)是临床上常见的引起无痛性视力下降的视网膜血管性疾病,目前荧光素眼底血管造影(FFA)是其诊断的金标准。但FFA为有创检查,可重复性差,不具备分辨和描绘深层毛细血管的能力。光学相干断层扫描血管成像(OCTA)具有无创、安全、简便、高效及较高轴向分辨率等特点,成为目前RVO诊断及疗效评价的有力工具。OCTA还可以快速分层分析RVO患者微血管图像,定性定量评估双眼黄斑及视盘区各层毛细血管的形态结构及灌注状态。本文对OCTA在RVO患者中的应用做一全面综述,包括检测患眼和对侧健眼的黄斑及视盘区视网膜结构及血流变化、评估视力预后和抗血管内皮生长因子治疗效果、探究黄斑水肿复发机制、局限性以及发展前景,有助于医生更加全面地了解RVO疾病特征,为准确有效地指导疾病治疗、预测患者预后视力奠定重要基础。

Retinal vein occlusion(RVO)is a common retinal vascular disease that causes painless visual impairment in clinical practice.Currently,fluorescein fundus angiography(FFA)is the gold standard for its diagnosis.However,FFA is an invasive examination,which has poor reproducibility and lacks the ability to distinguish and depict deep capillaries.Optical coherence tomography angiography(OCTA)has the characteristics of the non-invasive,safe,simple,efficient,and high axial resolution,making it a powerful tool for the diagnosis and efficacy evaluation of RVO.OCTA not only rapidly analyzes microvascular images of RVO patients,but also evaluates the morphologic structure and perfusion status of capillaries qualitatively and quantitatively in each layer in the macular and optic disc area of both eyes.The article comprehensively reviewed the application of OCTA in RVO patients,including the detection of changes in retinal structure and blood flow in the macula and optic disc area of the affected eye and healthy contralateral eye,the evaluation of visual prognosis and the effect of anti-vascular endothelial growth factor treatment,the investigation of the recurrence mechanism of macular edema,and the limitations and development prospects.The article aimed to help ophthalmologists have a more comprehensive understanding of the characteristics of RVO disease and lay an important foundation for accurately and effectively guiding disease treatment and predicting patients'prognosis vision.