光学相干断层扫描血管成像技术在慢性阻塞性肺疾病中应用的系统评价与荟萃分析

Optical coherence tomography angiography measurements in chronic obstructive pulmonary disease:a systematic review and meta-analysis

目的评价光学相干断层扫描血管成像(OCTA)技术在慢性阻塞性肺疾病(慢阻肺)中的应用价值。方法计算机检索PubMed、Embase、Cochrane、Web of science等数据库,检索日期为建库至2024年2月,利用Revman 5.4软件进行meta分析。由2名研究人员背对背筛选文献、资料提取、并进行核对,如有分歧则通过讨论或第三人仲裁解决,从而确定最终纳入文献。采用AHRQ量表进行偏倚风险评价。结果初检33篇文献,经过筛选最终纳入6篇符合标准的文献,meta分析结果显示,慢阻肺患者视网膜浅层毛细血管丛密度低于健康组,差异有统计学意义(MD=-1.40,95%CI:-2.33~-0.47,Z=2.96,P=0.003),以凹旁区最为显著(MD=-0.95,95%CI:-1.88~-0.02,Z=2.01,P=0.040)。慢阻肺患者视网膜深层毛细血管丛密度低于健康组,差异有统计学意义(MD=-2.65,95%CI:-4.44~-0.86,Z=2.91,P=0.004),以凹旁区、凹周区为显著[(MD=-2.17,95%CI:-3.44~-0.91,Z=3.37,P<0.001);(MD=-3.33,95%CI:-5.89~-0.77,Z=2.55,P=0.010)]。慢阻肺患者放射状视乳头周围毛细血管丛全区、上半区、下半区、视盘区、盘周区密度均低于健康组,差异均有统计学意义[(MD=-1.51,95%CI:-2.21~-0.81,Z=4.23,P<0.0001);(MD=-1.79,95%CI:-2.95~-0.63,Z=3.01,P=0.003);(MD=-1.92,95%CI:-2.69~-1.16,Z=4.91,P<0.001);(MD=-2.10,95%CI:-3.67~-0.53,Z=2.61,P=0.009);(MD=-1.83,95%CI:-2.91~-0.76,Z=3.34,P<0.001)]。结论OCTA相关眼部生物学指标与慢阻肺的发生可能存在相关性,其在慢阻肺的诊疗中可能具有潜在应用价值。

ObjectiveTo evaluate the application value of Optical Coherence Tomography Angiography(OCTA)in Chronic Obstructive Pulmonary Disease(COPD).MethodsA systematic search was conducted using databases including PubMed,Embase,Cochrane Library,and Web of Science up to February 2024.Meta-analysis was performed using Revman 5.4 software.Two researchers independently screened the literature,extracted data,and cross-checked the results.Any disagreements were resolved through discussion or third-party arbitration,leading to the final selection of studies.The risk of bias was assessed using the AHRQ scale.ResultsInitially,33 articles were screened,and 6 studies meeting the inclusion criteria were analyzed.The meta-analysis indicated that the density of the superficial retinal capillary plexus in COPD patients was significantly lower than that in healthy individuals(MD=-1.40,95%CI:-2.33 to-0.47,Z=2.96,P=0.003),with the most notable differences observed in the perifoveal region(MD=-0.95,95%CI:-1.88 to-0.02,Z=2.01,P=0.040).Similarly,the density of the deep retinal capillary plexus was lower in COPD patients than that in healthy individuals(MD=-2.65,95%CI:-4.44 to-0.86,Z=2.91,P=0.004),especially in the perifoveal and peripapillary regions(MD=-2.17,95%CI:-3.44 to-0.91,Z=3.37,P<0.001;MD=-3.33,95%CI:-5.89 to-0.77,Z=2.55,P=0.010).The radial peripapillary capillary plexus density in the whole region,superior hemisphere,inferior hemisphere,inside disc,and peripapillary region of COPD patients was lower than that of healthy individuals,with statistically significant differences(MD=-1.51,95%CI:-2.21 to-0.81,Z=4.23,P<0.001;MD=-1.79,95%CI:-2.95 to-0.63,Z=3.01,P=0.003;MD=-1.92,95%CI:-2.69 to-1.16,Z=4.91,P<0.001;MD=-2.10,95%CI:-3.67 to-0.53,Z=2.61,P=0.009;MD=-1.83,95%CI:-2.91 to-0.76,Z=3.34,P<0.001).ConclusionsThe ocular biological markers related to OCTA may be correlated with the pathogenesis of COPD and hold potential diagnostic and therapeutic value in its management.