光学相干断层扫描血管造影在青光眼早期诊断中的应用进展

Application Progress of Optical Coherence Tomography Angiography in Early Diagnosis of Glaucoma

青光眼发病隐匿,临床上容易被忽视。虽然其病理生理学机制仍不清楚,但眼压和血流与原发性青光眼的发生、发展密切相关。光学相干断层扫描血管造影(OCTA)是基于光学相干断层扫描开发的成像技术,相较传统荧光造影,它不仅提供了视网膜脉络膜微血管的定性和定量信息,还具有无创、高分辨率、高重复性和再现性、成像速度快、三维成像、不引起过敏反应等优点,可用于监测青光眼视网膜脉络膜血流早期的变化。通过OCTA对视网膜脉络膜血流进行分析,发现青光眼患者视神经盘和黄斑区的血流密度存在不同程度的降低。未来,可对OCTA进行进一步优化,如完善高度近视及未成年人血流数据库、扩大扫描面积及提高分辨率等。

Glaucoma is featured with hidden onset and can be easily overlooked in clinic.Although its pathophysiological mechanism remains unclear,decreased vascular perfusion pressure and decreased blood flow are closely related to the occurrence and development of primary glaucoma.Optical coherence tomography angiography(OCTA)is an imaging technology developed based on optical coherence tomography.Compared with traditional fluoroscopic angiography,OCTA not only can provide qualitative and quantitative information of retinal and choroidal microvessels,but also has the advantages of non-invasiveness,high-resolution,high repeatability and reproducibility,fast imaging speed,three-dimensional imaging,and no allergic reaction.Therefore,it can be used to monitor early changes in retinal blood flow in glaucoma.The retinal choroidal blood flow analysis by OCTA discovered that the blood flow density in the optic disc and macular area of glaucoma patients is reduced to varying degrees.In the future,OCTA can be further optimized,such as improving the blood flow database of high myopia and juvenile populations,expanding the scanning area and improving the resolution,etc.