Identification of retinal thickness and blood flow in agerelated macular degeneration with reticular pseudodrusen

AIM:To investigate thickness characteristics and vascular plexuses in retinas with reticular pseudodrusen(RPD)as an early detection strategy for age-related macular degeneration(AMD).METHODS:This retrospective study included 24 subjects(33 eyes)with RPD and 25 heathy control subjects(34 eyes).The superficial capillary plexus(SCP)and the deep capillary plexus(DCP)of the retinal posterior poles were investigated with optical coherence tomography angiography(OCTA).Retinal thicknesses and vessel densities were analyzed statistically.RESULTS:The general retinal thicknesses of RPD eyes were significantly decreased(95%CI-14.080,-0.655;P=0.032).The vessel densities of DCP in RPD eyes were significantly increased in the global(95%CI 1.067,7.312;P=0.027),parafoveal(95%CI 0.417,5.241;P=0.022),and perifoveal(95%CI 0.181,6.842;P=0.039)quadrants.However,the vessel densities of the SCP were rarely increased in the eyes with RPD.CONCLUSION:The thinning of retinas in the RPD group suggests a reduction in the number of cells.Additionally,the increased vessel density of the DCP in retinas with RPD indicates a greater demand for blood supply,possibly due to the hypoxia induced RPD compensation caused by RPD in the outer retina.This study highlights the pathological risks associated with RPD and emphasizes the importance of early intervention to retard the progression of AMD.

A decrease in macular microvascular perfusion after retinal detachment repair with silicone oil

AIM:To observe whether silicone oil(SO)tamponade could decrease macular perfusion after retinal detachment repair.METHODS:A prospective observational case-control study.Patients diagnosed with primary macular off rhegmatogenous retinal detachment undergoing successful retinal repair surgery with vitrectomy were strictly selected.Optical coherence tomography angiography findings were compared between SO and air tamponade groups.Two postoperative visiting points were set(1 and 3 mo).RESULTS:Totally 29 patients(29 eyes)were enrolled.Twenty cases had SO tamponade while 9 cases were with air tamponade.At the first visiting point,superficial parafoveal vessel density(PFSVD)significantly decreased in the SO group(P=0.0403),especially in the superior quadrant or superior-hemi area(P=0.0089,0.0426,respectively).Parafoveal deep vessel density(PFDVD)had no difference between the two groups.At the second visiting point,all quadrants of PFSVD reduced significantly in the SO group(P=0.0256,0.0001,0.0031,<0.0001 in temporal,superior,nasal,and inferior area,respectively),but PFDVD remained no different.In the air group,all areas of PFSVD showed significantly improving from the first visit to the second one(P=0.0324,0.0001,0.0371,0.0026,in temporal,superior,nasal,and inferior area,respectively);however,almost all quadrants of PFDVD showed no changes during this period.In the SO group,both PFSVD and PFDVD showed no obvious changes between the two visiting points.Besides,parafoveal full retinal thickness in the SO group reduced significantly at both visiting points over the air tamponade,while the foveal avascular zone area showed no difference in the two groups.CONCLUSION:After retinal detachment surgery with vitrectomy and SO tamponade,superficial macular perfusion and full retinal thickness could decrease obviously when compared to air tamponade.This reduction process could persist throughout the tamponade period.

Retinal thickness and vascular parameters using optical coherence tomography in Alzheimer's disease:a meta-analysis

Examining the retinal tissue has the potential to provide a unique method and technique to quantify Alzheimer’s disease-related changes in participants at various stages of the disease.In this metaanalysis,we aimed to investigate the association of various optical coherence tomography parameters with Alzheimer’s disease and whether retinal measurements can be used to diffe rentiate between Alzheimer’s disease and control subjects.Scientific databases including Google Schola r,Web of Science,and PubMed were systematically searched for published articles that evaluated retinal nerve fiber layer thickness and retinal microvascular network in Alzheimer’s disease and control subjects.Seventy-three studies(5850 participants,including 2249 Alzheimer’s disease patients and 3601controls) were included in this meta-analysis.Relative to controls,Alzheimer’s disease patients had a significantly lower global retinal nerve fiber layer thickness(standardized mean difference [SMD]=-0.79,95% confidence intervals [CI]:-1.03 to-0.54,P <0.00001) as well as each quadrant being thinner in Alzheimer’s disease versus controls.Regarding macular paramete rs,values measured by optical coherence tomography were significantly lower in Alzheimer’s disease than controls for macular thickness(pooled SMD:-0.44,95% CI:-0.67 to-0.20,P=0.0003),foveal thickness(pooled SMD=-0.39,95% CI:-0.58 to-0.19,P <0.0001),ganglion cell inner plexiform layer(SMD=-1.26,95% CI:-2.24 to-0.27,P=0.01) and macular volume(pooled SMD=-0.41,95% CI-0.76 to-0.07,P=0.02).Analysis using optical coherence tomography angiography parameters revealed mixed results between Alzheimer’s disease and controls.Superficial vessel density(pooled SMD=-0.42,95% CI:-0.68 to-0.17,P=0.0001) and deep vessel density(pooled SMD=-0.46,95% CI:-0.75 to-0.18,P=0.001) were found to be thinner in Alzheimer’s disease patients whereas the foveal avascular zone(SMD=0.84,95% CI:0.17-1.51,P=0.01) was larger in controls.Vascular density and thickness of various retinal laye rs were decreased in Alzheimer’s disease patients compared to controls.Our results provide evidence for optical coherence tomography technology having the potential to detect retinal and microvascular changes in patients diagnosed with Alzheimer’s disease and aid in monito ring and early diagnosis methods.

Effects of obstructive sleep apnea on retinal microvasculature

AIM:To detect retinal microvascular variations in obstructive sleep apnea syndrome patients.METHODS:This prospective,observational case-control study included healthy controls and patients with mild,moderate,and severe obstructive sleep apnea syndrome.Vascular parameters,foveal avascular area,and flow areas in macula-centered,6.00×6.00 mm2 scan size optical coherence tomography angiography images were compared.RESULTS:The control group had the highest whole image,parafoveal,and perifoveal vessel density among the groups in both superficial and the deep capillary plexus(all P<0.05).Rapid eye movement sleep apnoea-hypopnoea index was reversely correlated with whole(Rho=-0.195,P=0.034),parafoveal(Rho=-0.242,P=0.008),perifoveal(Rho=-0.187,P=0.045)vessel density in the superficial capillary plexus,and whole(Rho=-0.186,P=0.046),parafoveal(Rho=-0.260,P=0.004),perifoveal(Rho=-0.189,P=0.043)vessel density in the deep capillary plexus,though the mean and non-rapid eye movement sleep apnoeahypopnoea index related with only parafoveal vessel density in the superficial capillary plexus(Rho=-0.213,P=0.020;Rho=-0.191,P=0.038)and the deep capillary plexus(Rho=-0.254,P=0.005;Rho=-0.194,P=0.035).CONCLUSION:This study shows decreased vessel density and its reverse correlation with the apnoea-hypopnoea index in patients with obstructive sleep apnea syndrome.

Retinal microvascular and microstructural alterations in the diagnosis of meibomian gland dysfunction in severely obese population:a new approach

AIM:To study retinal microvascular and microstructural alterations in meibomian gland dysfunction(MGD)in severely obese population using optical coherence tomography angiography(OCTA).METHODS:Twelve MGD patients with severely obese population(PAT group;24 eyes)and 12 healthy controls(HC group;24 eyes)were recruited.OCTA images were segmented into five[superior(S),nasal(N),inferior(I),temporal(T),and central foveal(C)]or nine[inner superior(IS),outer superior(OS),inner nasal(IN),outer nasal(ON),inner inferior(II),outer inferior(OI),inner temporal(IT),outer temporal(OT),and C]subregions.The superficial vessel density(SVD),retinal thickness(RT),foveal avascular zone(FAZ)parameters,and retinal volume were measured.RESULTS:Visual acuity was significantly different between two groups(0.8±0.17 in PAT group vs 0.2±0.06 in HC group).SVD was significantly lower in PATs in N,T,OS,IN,OT,and ON.The area under the receiver operating characteristic curve(AUC)for T was 0.961[95% confidence interval(CI):0.908 to 1.000],for OS was 0.962(95%CI:0.915 to 1.000).RT was significantly lower in PATs in IS,OS,OI,OT,ON,IT,IN,and II.AUC for OT was 0.935(95%CI:0.870 to 0.999),for IS was 0.915(95%CI:0.838 to 0.992).Angiography results showed significantly lower area and perimeter of FAZ,SVD of the inner retina and both retinal volume and the average volume thickness in the PAT group.CONCLUSION:Vision may be affected in patients with MGD due to changes in retinal microvessels and microstructures.These changes detected by OCTA may be a potential marker for diagnosing MGD in severe obesity.

Microvascular changes after conbercept therapy in central retinal vein occlusion analyzed by optical coherence tomography angiography

AIM: To investigate microvascular changes in eyes with central retinal vein occlusion(CRVO) complicated by macular edema before and after intravitreal conbercept injection and evaluate correlations between these changes and best-corrected visual acuity(BCVA) and retinal thickness. METHODS: Twenty-eight eyes of 28 patients with macular edema caused by CRVO were included in this retrospective study. All patients received a single intravitreal conbercept injection to treat macular edema. BCVA and the results of optical coherence tomography angiography(OCTA) automatic measurements of the vessel density in the superficial(SCP) and deep retinal capillary plexus(DCP), the foveal avascular zone(FAZ) area, the FAZ perimeter(PERIM), the vessel density within a 300-μm wide ring surrounding the FAZ(FD-300), the acircularity index(AI), the choriocapillaris flow area, and retinal thickness were recorded before and at one month after treatment and compared with the results observed in age-and sexmatched healthy subjects. RESULTS: The vessel density in the SCP and DCP, the FD-300, and the flow area of the choriocapillaris were allsignificantly lower in CRVO eyes than in healthy eyes, while the AI and retinal thickness were significantly higher(all P<0.05). After treatment, retinal thickness was significantly decreased, and the mean BCVA had markedly improved from 20/167 to 20/65(P=0.0092). The flow area of the choriocapillaris was also significantly improved, which may result from the reduction of shadowing effect caused by the attenuation of macular edema. However, there were no significant changes in SCP and DCP vessel density after treatment. The flow area of the choriocapillaris at baseline was negatively correlated with retinal thickness.CONCLUSION: OCTA enables the non-invasive, layerspecific and quantitative assessment of microvascular changes both before and after treatment, and can therefore be used as a valuable imaging tool for the evaluation of the follow-up in CRVO patients.

Analysis of retinal vasculature changes in indirect traumatic optic neuropathy using optic coherence tomography angiography

AIM:To assess the retinal vasculature alterations in indirect traumatic optic neuropathy(ITON)patients following craniofacial trauma by optic coherence tomography angiography(OCTA).METHODS:Patients diagnosed of monocular ITON were recruited from August 2016 to May 2020.OCTA was performed using the Angio Vue OCT-A system for two cube scans centered at the optic nerve head and fovea.OCTA data included thicknesses of peripapillary retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC),as well as proportion of capillary perfusion and data were analyzed for correlation with post-injury timepoints:within 7,8-30,31-90,and 91-365d.RESULTS:A total of 73 ITON patients were studied.Significant thinning of RNFL and GCC layers and attenuation of microvascular perfusion were observed in ITON eyes as compared to contralateral unaffected eyes(for most of the analyzed sectors and quadrants,P<0.05).Without respect to surgical intervention and vision recovery,the decrease in retinal layer thicknesses and microvascular perfusion was time-dependent,and most significant within three months(P<0.001).CONCLUSION:ITON presents with time-dependent thinning of retinal layers and attenuation of microvasculature,indicating possible degeneration of retinal ganglion cells due to reduced retinal blood supply.

正常眼压性青光眼患者黄斑区血流灌注状态与视野缺损的相关性研究

目的观察正常眼压性青光眼(NTG)患者黄斑区血流灌注状态,分析其与视野缺损之间的相关性。方法纳入2020年1月—2021年2月就诊于上海中医药大学附属曙光医院的符合纳入标准的NTG患者70例(70只眼)作为观察组,选取同期同医院就诊的同年龄段的健康志愿者49例(49只眼)作为对照组。采集受试者黄斑区视网膜浅层血管线性密度(MSRVLD)、黄斑区视网膜浅层血管灌注密度(MSRPD)、黄斑中心凹无血管区面积(FAZ)及观察组患者的视野平均缺损(MD),并对以上数据进行统计学分析。结果(1)MSRVLD:观察组黄斑区下方及鼻侧较对照组下降,差异均有统计学意义(t_(下方)=4.041,P=0.000;t_(鼻侧)=2.945,P=0.004)。(2)MSRPD:观察组黄斑区下方及鼻侧较对照组下降,差异均有统计学意义(t_(下方)=3.291,P=0.001;t_(鼻侧)=2.924,P=0.004)。(3)黄斑中心凹FAZ:观察组黄斑中心凹FAZ面积为(0.21±0.13)mm^(2),对照组为(0.23±0.17)mm^(2)。2组比较,差异无统计学意义(P>0.05)。(4)相关性分析:观察组MD与MSRVLD、MSRPD呈正相关(r_(MSRVLD)=0.387,r_(MSRPD)=0.402,均P=0.001)。结论NTG患者黄斑区存在血流灌注不足,且与MD相关。

光学相干断层扫描血管成像技术评估青少年近视眼黄斑区视网膜血管密度及厚度变化

目的 采用光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)技术检测不同近视程度青少年黄斑区视网膜血管密度、厚度变化,并分析其相关性。方法 选取2019年6月至2022年6月温州医科大学附属眼视光医院诊治的青少年近视眼患者196例(392眼)。根据等效球镜度(spherical degree,SE)分为轻度近视组43例、中度近视组55例、高度近视组51例、超高度近视组47例。采用OCTA技术测量四组患者的黄斑区视网膜浅层血管密度、厚度水平;采用Pearson相关分析黄斑区视网膜血管密度与厚度的相关性;采用线性回归分析黄斑区视网膜血管密度的相关影响因素。结果 四组SE、眼轴长度比较,差异有统计学意义(P <0.05),随近视程度增加,SE逐渐降低,眼轴长度逐渐增加(P <0.05)。四组黄斑区不同部位(中心凹、中心凹旁、上侧、鼻侧、下侧、颞侧)视网膜血管密度比较,差异有统计学意义(P <0.05),随近视程度增加,黄斑区不同部位视网膜血管密度均降低(P <0.05)。四组黄斑区不同部位(中心凹、中心凹旁、上侧、鼻侧、下侧、颞侧)视网膜厚度比较,差异有统计学意义(P <0.05),随近视程度增加,黄斑区不同部位视网膜厚度均降低(P<0.05)。Pearson相关性分析显示,黄斑区中心凹、中心凹旁视网膜血管密度与中心凹(r=0.464、0.515)、中心凹旁(r=0.312、0.330)、上侧(r=0.398、0.422)、鼻侧(r=0.391、0.326)、下侧(r=0.324、0.273)、颞侧(r=0.353、0.428)厚度均呈正相关(P <0.05)。线性回归分析显示,眼轴长度、SE均负向影响黄斑区中心凹、中心凹旁视网膜血管密度(P <0.05)。结论 随着青少年近视程度增加,其黄斑区视网膜血管密度、厚度均降低,且黄斑区视网膜血管密度与厚度呈正相关,与眼轴长度呈负相关。

康柏西普对RVO继发黄斑水肿患者黄斑区视网膜血管密度的影响

目的:评价视网膜静脉阻塞(RVO)继发黄斑水肿抗血管内皮生长因子(VEGF)治疗前后黄斑区视网膜血管密度的变化。方法:回顾性病例对照研究。选取2018-04/06临床确诊为RVO继发黄斑水肿患者23例,给予玻璃体腔注射0.5mg/0.05mL康柏西普。对比治疗前后BCVA以及行OCTA检查,软件自动识别及测量治疗前后CMT和浅层视网膜毛细血管网血管长度密度和灌注密度的变化。结果:随访时间为1mo,治疗后BCVA较治疗前提高(P<0.05),CMT较治疗前降低(P<0.05),治疗后浅层视网膜毛细血管网中位于中心凹、旁中心凹及总区域的血管长度密度和灌注密度与治疗前均无差异(P>0.05)。结论:单次抗VEGF治疗RVO继发黄斑水肿在短期内BCVA和CMT明显好转,并且未加重黄斑缺血。

雷珠单抗对视网膜中央静脉阻塞继发黄斑水肿患者黄斑区视网膜血流参数的影响

目的观察视网膜中央静脉阻塞(CRVO)继发黄斑水肿患者黄斑区视网膜血流参数以及观察雷珠单抗治疗前后黄斑区视网膜血流参数的变化。方法前瞻性对照研究。纳入2015年11月至2017年1月在襄阳市中心医院眼科就诊的CRVO继发黄斑水肿的患者33例为CRVO组,同时纳入健康人30例为对照组。所有CRVO继发黄斑水肿患者接受玻璃体腔内雷珠单抗注射治疗。用RTVue-100光学相干断层扫描血流成像技术3 mm×3 mm扫描模式测量研究对象黄斑区视网膜血管密度以及中央凹无血管区域(FAZ)面积。结果 CRVO组的黄斑区视网膜浅层血管密度与深层血管密度分别为43. 03%±5. 11%以及47. 00%±7. 54%,对照组浅层以及深层视网膜血管密度分别为63. 23%±5. 50%以及61. 43%±7. 90%,两组之间均差异有统计学意义(P <0. 001)。CRVO组FAZ面积为(0. 49±0. 08) mm2,对照组为(0. 28±0. 07) mm2,CRVO组FAZ面积明显小于对照组,均差异有统计学意义(P <0. 001)。球内注射雷珠单抗后,CRVO组视网膜浅层与深层血管密度以及FAZ面积均未发生明显变化。结论相对于健康人,CRVO继发黄斑水肿的视网膜血管密度较低,FAZ面积偏大。CRVO继发黄斑水肿患者接受球内雷珠单抗治疗后,视网膜血管密度以及FAZ面积未见明显变化。

缺血型与非缺血型视网膜分支静脉阻塞患者黄斑区血流对比

目的应用光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)观察缺血型和非缺血型视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)黄斑区深浅层视网膜血流密度、深浅层血流比(deep-superficial flow ratio,DSFR)及浅层黄斑中心凹无灌注区(foveal avascular zone,FAZ)面积的差异。方法将临床确诊为颞侧BRVO患者45例45眼纳入研究,依据荧光素眼底血管造影(fundus fluorescein angiography,FFA)结果将患眼分为两组,其中缺血型BRVO 23例23眼(缺血组)、非缺血型BRVO 22例22眼(非缺血组)。另选取与其年龄、性别相匹配的健康22人(22眼)为对照组。对所有入选者均行OCTA检查,扫描以黄斑中心凹为中心3 mm×3 mm的范围,以设备自带软件自动识别并测量此区域内深浅层血流密度及浅层FAZ面积,再计算出DSFR。比较缺血组、非缺血组及对照组各区域内深浅层黄斑区血流密度、DSFR、FAZ面积的差异。结果三组黄斑区浅层和深层总血流密度、最严重无灌注区DSFR及浅层FAZ面积缺血组分别为(39.82±5.01)%、(41.61±6.28)%、0.95±0.20、(0.30±0.10)mm 2,非缺血组分别为(39.26±5.07)%、(42.48±5.77)%、1.11±0.23、(0.32±0.19)mm 2,对照组分别为(49.00±2.72)%、(53.05±3.26)%、1.08±0.10、(0.32±0.13)mm 2。与对照组相比,缺血组和非缺血组深浅层血流密度均明显降低,差异均有统计学意义(均为P<0.05),而浅层FAZ面积均无明显差异(均为P>0.05)。非缺血组DSFR与对照组无明显差异;而缺血组最严重无灌注区DSFR较非缺血组和对照组明显下降,差异均有统计学意义(均为P<0.05)。缺血组与非缺血组相比,深浅层血流密度及浅层FAZ均无明显差异(均为P>0.05)。结论缺血型BRVO较非缺血型BRVO的黄斑区血流缺失更重,且深层较浅层更重;DSFR可作为BRVO血流改变异常新的生物标志物,可反映深浅层血管的相对损伤。

62例近视儿童青少年黄斑区浅层视网膜微循环变化观察

目的观察62例近视儿童青少年黄斑区浅层视网膜微循环变化。方法近视儿童青少年62例(123眼),正常视力(裸眼视力≥1.0)儿童青少年50例(69眼),比较两者等效球镜度数(SE度数)、眼轴长度(AL);62例近视儿童青少年又按照SE度数不同分为SE度数≥-0.50 D(12眼)、-0.50 D>SE度数≥-1.00 D(10眼)、-1.00 D>SE度数≥-3.00 D(70眼)、-3.00 D>SE度数(31眼),按照AL不同分为AL>25.0 mm(36眼)、25.0 mm≥AL>24.0 mm(53眼)、AL≤24.0 mm(34眼),比较其视网膜血管长度密度(VLD)、血管灌注密度(VPD)及黄斑中心凹无灌注区面积(FAZ-A)、黄斑中心凹无灌注区周长(FAZ-P)、黄斑中心凹无灌注区形态指数(FAZ-CI);分析62例(123眼)儿童青少年的SE度数、AL、VLD、VPD、FAZ-A、FAZ-P、FAZ-CI间的相关性。结果与正常儿童青少年比较,近视儿童青少年SE度数小,AL长(P均<0.05);不同SE度数者黄斑区浅层视网膜微循环不存在差异性,但随着近视的增加,黄斑区浅层视网膜微循环存在下降趋势(P均>0.05)。不同AL的FAZ-A和FAZ-P比较有统计学意义(P均<0.05),其余参数比较均无统计学意义(P均>0.05),但从数值上来看,随着AL的延长,除了中心VLD及VPD有增加趋势外,其余的参数均存在下降的趋势;AL>25.0 mm、AL≤24.0 mm者FAZ-A和FAZ-P比较,25.0 mm≥AL>24.0 mm、AL≤24.0 mm者FAZ-A比较,P均<0.05。SE度数与内层VPD、外层VPD、整体VPD呈正相关(r分别为0.183、0.206、0.194,P均<0.05);SE度数与中心VLD、内层VLD、外层VLD、整体VLD、中心VPD、FAZ-A、FAZ-P、FAZ-CI均不存在相关关系(r分别为-0.037、0.144、0.154、0.150、-0.006、0.044、0.016、0.049,P均>0.05)。AL与中心VLD、中心VPD存在正相关关系(r分别为0.222、0.187,P均<0.05),与FAZ-A、FAZ-P、FAZ-CI存在负相关关系(r分别为-0.305、-0.224、-0.188,P均<0.05),即随着眼轴的增长,中心的VLD及VPD逐渐增加,且黄斑中心凹无灌注区缩小;AL与内层VLD、外层VLD、整体VLD、内层VPD、外层VPD、整体VPD均不存在相关关系(r分别为-0.120、-0.090、-0.068、-0.174、-0.166、-0.161,P均>0.05)。AL与SE度数存在负相关关系(r=-0.503,P<0.05)。结论随着近视程度的增加、眼轴的延长,近视儿童青少年黄斑区浅层视网膜微循环出现不同程度的降低,存在黄斑区浅层视网膜微循环障碍,而改善微循环障碍可能会控制或延缓近视的发生与发展。

基于OCTA的单眼近视患儿黄斑区视网膜毛细血管血流密度及厚度分析

目的:应用光学相干断层扫描血管成像技术(OCTA)观察单眼近视患儿黄斑区视网膜毛细血管血流密度及各层视网膜厚度,并探讨上述视网膜参数与眼轴长度(AL)之间的关系。方法:横断面研究。选取2020-11/2021-04于南京医科大学眼科医院就诊的单眼近视患儿32例64眼,平均年龄10.88±2.34岁。根据患儿的等效球镜度(SER)分组,SER≤-0.75D纳入近视组,平均SER-2.15±1.10D;对侧健眼纳入非近视组,平均SER 0.01±0.48D。所有患儿均行眼科一般检查并采用OCTA检查黄斑区浅层视网膜毛细血管(SCP)血流密度、深层视网膜毛细血管(DCP)血流密度及各层视网膜厚度。结果:近视组UCVA低于非近视组,SER、AL高于非近视组(均P<0.01),眼压、角膜平坦K值无差异(均P>0.05)。近视组黄斑区上方SCP血流密度及黄斑中心凹DCP血流密度明显大于非近视组(P=0.029、0.010),余区域视网膜毛细血管血流密度无差异(均P>0.05)。除中心凹以外,近视组黄斑区颞侧、上方、鼻侧及下方的全层视网膜厚度均明显低于非近视组(均P<0.01)。近视组黄斑区颞侧内层视网膜厚度略低于非近视组(P=0.043)。近视组黄斑中心凹、黄斑区颞侧、上方、鼻侧及下方的外层视网膜厚度均明显小于非近视组(均P<0.05)。Pearson相关分析显示,黄斑中心凹SCP、DCP血流密度与AL呈正相关(r=0.432、0.541,均P<0.01)。黄斑中心凹、黄斑区颞侧、上方、鼻侧及下方内层视网膜厚度与AL呈正相关(r=0.452、0.389、0.313、0.401、0.445,均P<0.05)。黄斑区上方、鼻侧及下方外层视网膜厚度与AL呈负相关(r=-0.308、-0.309、-0.330,均P<0.05)。结论:单眼近视患儿近视眼黄斑区上方SCP及中心凹DCP呈代偿性血流密度升高状态;除中心凹以外,黄斑区全层视网膜厚度显著降低。AL延长与黄斑区内层视网膜厚度增加,上方、鼻侧及下方外层视网膜厚度变薄相关。

高度近视眼黄斑区神经纤维层厚度分布特点及其与血流密度的关系

目的:研究高度近视眼黄斑区神经纤维层厚度和血流密度的分布特点并分析其相关因素。方法:收集高度近视患者20例40眼,年龄为29.90±7.92岁,等效球镜屈光度为-8.95±2.01 D。采用光学相干断层扫描血管成像技术(OCTA)测量黄斑区神经纤维层厚度,获取视网膜浅层毛细血管层、视网膜深层毛细血管层及脉络膜毛细血管层的血流分布图像并计算各层血流密度。直径6 mm的黄斑区分为9个亚区域:黄斑中心凹区,旁中心凹区和中心凹外区各自分为上方、下方、鼻侧和颞侧4个象限。比较黄斑不同亚区域的神经纤维层厚度的差别,分析其与屈光度、眼轴、各层血流密度的关系。结果:旁中心凹区的4个象限中,上方神经纤维厚度最低,下方神经纤维厚度最高(均P<0.05)。中心凹外区4个象限中颞侧神经纤维厚度最低(均P<0.05)。中心凹外区上方神经纤维层厚度与屈光度存在负相关(r=-0.356,P=0.024)。视网膜浅层毛细血管层的血流密度与旁中心凹区鼻侧和下方象限,以及中心凹外区上方、鼻侧和下方象限的神经纤维层厚度呈正相关(r=0.314、0.408、0.467、0.655、0.737,均P<0.05);脉络膜毛细血管层血流密度与中心凹外区的上方象限呈负相关(r=-0.356,P=0.024)。结论:高度近视眼黄斑区神经纤维层具有各象限不均匀分布特点。随着屈光度的增加,局部神经纤维层变薄,并且存在区域特异性,部分区域神经纤维层厚度的变化与视网膜浅层毛细血管丛及脉络膜毛细血管层的血流密度相关。

屈光参差患者双眼血管密度与视网膜厚度的相关性研究

目的:研究屈光参差患者双眼在屈光度数、眼轴及OCTA黄斑区和视乳头区血流密度、黄斑区神经纤维厚度方面的差异,并研究眼轴与眼底血流密度及视网膜厚度的关系,分析其在屈光参差发生、发展中的临床意义。方法:回顾性分析我院2018-05/11的符合纳入标准的屈光参差患者27例,所有患者均接受双眼的屈光度数、眼压、眼轴及OCTA黄斑区和视乳头区血流密度、黄斑区视网膜厚度的检查。应用SPSS 23.0软件,采用配对t检验分析对比患者双眼在各指标之间的差异。并分析眼轴和黄斑中心无血管区(FAZ)、脉络膜3.14mm2血流密度、黄斑区血流密度及视网膜厚度、视乳头血流密度的关系。结果:患者27例中,高度眼的屈光度数及眼轴均大于低度眼(t=-3.559、3.083,P<0.05)。高度眼和低度眼间在OCTA黄斑1mm及3mm浅层血流密度、深层血流密度、视网膜厚度上均无差异(P>0.05)。选取患者中高度眼较低度眼相比,视盘内血流密度大(t=2.36,P=0.022)和上鼻方(SN)血流密度小(t=-2.154,P=0.036)。屈光状态、黄斑中心凹浅层和深层血流密度、旁中心凹深层血流密度、黄斑中心凹及旁中心凹视网膜厚度与眼轴相关(r=-0.897、0.458、0.446、-0.328、0.301、-0.397,均P<0.05)。结论:屈光参差患者高度眼较低度眼黄斑区3mm×3mm浅层和深层血流密度及视网膜厚度无差异,视盘内及上鼻方血流密度存在差异,余视乳头分区无差异。眼轴与屈光状态、黄斑中心凹浅层和深层血流密度、旁中心凹深层血流密度、黄斑中心凹及旁中心凹视网膜厚度相关。

基于OCTA分析妊娠期高血压患者产后视网膜微循环的变化

目的:利用光学相干断层扫描血管成像技术(OCTA)定量分析产后6mo以上妊娠期高血压综合征(PIH)患者的视网膜微循环变化。方法:分别测量19例PIH患者、23例正常妊娠女性(HPW)及19例未妊娠女性(CNPW)的屈光度、最佳矫正视力及眼轴长度,并使用OCTA测量三组视乳头及黄斑区血流参数、神经纤维层厚度和脉络膜厚度。所有妊娠患者数据均采集自分娩6mo以后。运用统计软件SPSS20.0,单因素方差分析比较三组间视网膜微循环相关参数的组间差异。结果:PIH组的黄斑区无灌注区面积(FAZ)明显大于HPW组和CNPW组(均P<0.05);三组间的黄斑区各区域视网膜浅层血管密度无差异;PIH组的视乳头各区域浅层血管密度,其中视乳头整层6mm区域、外层、下外侧、鼻外侧高于HPW组和CNPW组;视神经纤维层平均厚度三组间无差异,但PIH组的视神经颞侧纤维层厚度明显低于HPW组和CNPW组(均P<0.05);PIH组的黄斑中心区视网膜厚度明显低于HPW和CNPW(均P<0.05);中心凹下脉络膜厚度三组间无差异。结论:PIH患者产后视网膜部分区域血管密度、黄斑中心区厚度及颞侧视神经纤维层厚度与HPW及CNPW组间均存在差异,提示PIH对视网膜微循环的影响可能在产后仍持续存在。

非黄斑裂孔性视网膜脱离术后黄斑区血流及结构的改变分析

目的探讨非黄斑裂孔性视网膜脱离患者行玻璃体切除术(PPV)后黄斑区血流及结构改变。方法收集2019年1月至2020年1月于本院确诊视网膜脱离的患者36例(36只眼)纳入研究(PPV组),患者的对侧眼作为对照组。PPV组术后1周、1个月、3个月、6个月及对照组均进行最佳矫正视力(BCVA)和相干光层析血管成像术(OCTA)检查。观察PPV组术后各个时期视网膜全层厚度(FT)、椭圆体带断裂、浅层视网膜血流密度(SVD)、深层视网膜血流密度(DVD)等变化情况并与对照组比较差异。结果PPV组患者术后BCVA随着时间延长逐渐改善,在术后各时期,椭圆体带断裂者BCVA均较椭圆体完整者差(均P<0.05)。与对照组相比,PPV组患者术后1周时均发生不同程度的黄斑水肿,FT显著增加,而SVD、DVD显著降低(均P<0.05);术后1个月到术后6个月,FT、SVD及DVD随时间延长逐渐增加,术后6个月时FT恢复正常(P>0.05),SVD、DVD仍低于对照组(均P<0.05)。结论非黄斑裂孔性视网膜脱离的患者即使手术成功修复,术后也有可能发生椭圆体带断裂、视网膜血流灌注减少,观察术后黄斑区血流及结构的动态改变,可为将来实施改善视功能的干预治疗提供临床参考。

视网膜分支静脉阻塞的黄斑血流及结构特征分析

目的:采用光学相干断层扫描血管成像(OCTA)技术观察视网膜分支静脉阻塞(BRVO)患者黄斑区血流及结构特征,并分析视力的危险因素。方法:收集2018-01/2019-06在抚顺市眼病医院经眼底及眼底荧光造影检查确诊的BRVO患者92例92眼为BRVO组,另选取同期基线资料与BRVO组患者相匹配的健康志愿者38例38眼作为对照组。记录两组受检者的基线资料,并采用OCTA技术观察3mm×3mm范围内黄斑区深层和浅层血流密度、深层和浅层中心凹血流密度、黄斑中心凹厚度、神经上皮层厚度、神经上皮层下积液高度。分析BRVO患者上述参数的相关性,并采用多因素Logistic回归法分析影响视力的危险因素。结果:与对照组相比,BRVO患者视力、黄斑中心凹厚度、深层血流密度、浅层血流密度、深层中心凹血流密度、浅层中心凹血流密度均有差异(P<0.01)。多因素Logistic回归分析显示,年龄(P=0.033,OR=1.152,95%CI 1.011~1.312)、浅层中心凹血流密度(P=0.010,OR=1.260,95%CI 1.056~1.504)、黄斑中心凹厚度(P<0.01,OR=1.033,95%CI 1.021~1.045)均是视力的危险因素。BRVO患者深层及浅层血流密度与黄斑中心凹厚度、神经上皮层厚度均呈负相关(P<0.01),黄斑中心凹厚度与神经上皮层厚度、神经上皮层下积液高度均呈正相关(P<0.01)。结论:利用OCTA可以观察BRVO患者视网膜血流状态及视网膜切面结构的变化,将两者结合起来可以更全面地观察BRVO患者黄斑区视网膜的病变特点。年龄、黄斑中心凹厚度、浅层中心凹血流密度为影响视力的危险因素。

不同强度有氧运动对原发性开角型青光眼患者黄斑区视网膜血管密度的影响

目的:探讨不同强度有氧运动对原发性开角型青光眼(POAG)患者黄斑区视网膜血管密度的影响。方法:前瞻性病例对照研究。纳入2019-01/2021-04于我院诊断为POAG患者48例88眼。招募本院学生、职工及其他科室患者家属43例86眼为正常对照组。使用免散瞳眼底照相机行免散瞳眼底照相检查。采用黄斑血管分割法进行黄斑区血管密度测定。根据黄斑区血管密度将POAG患者分为低血管密度组和高血管密度组,各24例。指导48例POAG的患者进行跑台负荷运动,比较高强度(76%~87%HRmax)、中等强度(64%~75%HRmax)和低强度(52%~63%HRmax)运动下患者的黄斑区血管密度水平。结果:正常对照组患者的黄斑区血管密度明显高于POAG组患者;与高血管密度组患者相比,低血管密度组患者的年龄、收缩压均明显较高,体质量明显较低;低血管密度组和高血管密度组患者,在中等强度有氧运动下的黄斑区视网膜血管密度均明显高于低强度和高强度有氧运动;收缩压和有氧运动是黄斑区血管密度的影响因素;以上比较结果均有差异(P<0.05)。结论:收缩压和有氧运动是黄斑区血管密度的影响因素,中等强度有氧运动可使低血管密度组和高血管密度组患者的黄斑区血管密度明显增加。