【摘要】：[目的]應(yīng)用光學(xué)相干斷層掃描血管成像技術(shù)(optical coherence tomography angiography,OCTA)研究視網(wǎng)膜靜脈阻塞(Retinal vein occlusion,RVO)患者黃斑區(qū)血流灌注的變化及其與視力的關(guān)系。[方法]回顧性研究。30例單眼RVO患者納入研究范圍,患者雙眼均接受OCTA檢查,獲得視網(wǎng)膜黃斑中心3×3mm大小范圍的黃斑區(qū)血流密度、黃斑中心凹無(wú)血管區(qū)(foveal avascular zone,FAZ)面積、黃斑中心凹厚度,雙眼均接受視力檢查并獲得最佳矯正視力(best-corrected visual acuity,BCVA),比較患眼與對(duì)側(cè)眼黃斑區(qū)血流密度、FAZ面積、黃斑中心凹厚度的變化及其與視力的相關(guān)性。[結(jié)果]共30例RVO患者,其中視網(wǎng)膜中央靜脈阻塞(central retinal vein occlusion,CRVO)患者15例,視網(wǎng)膜分支靜脈阻塞(branch retinal vein occlusion,BRVO)患者15例。CRVO患者患眼淺層、深層毛細(xì)血管總血流密度較對(duì)側(cè)眼降低(淺層:43.07±4.95%vs 50.09±2.86%,P0.01;深層 45.89±4.12%vs53.29±2.62%,P0.01),且淺層、深層毛細(xì)血管血流密度與視力呈正相關(guān)(淺層:r = 0.6,P = 0.01;深層:r = 0.5,P = 0.04)。BRVO 患者患眼淺層、深層毛細(xì)血管總血流密度較對(duì)側(cè)眼降低(淺層:45.62±3.04%vs 52.10±2.98%,P0.01;深層49.21±3.80%vs 55.52±3.33%,P0.01),與視力呈正相關(guān)(淺層:r = 0.5,P=0.02;深層:r = 0.6,P = 0.01)。患眼病變區(qū)域與患眼未病變區(qū)域、對(duì)側(cè)眼相應(yīng)病變相比淺層、深層毛細(xì)血管血流密度均下降(P0.01);患眼病變區(qū)域深層毛細(xì)血管密度與視力呈負(fù)相關(guān)(深層:r=0.4,P=0.04);患眼未病變區(qū)域與對(duì)側(cè)眼相應(yīng)區(qū)域比較深層毛細(xì)血管血流密度下降(56.86±1.95 vs 58.15±2.24,P=0.02)。CRVO、BRVO患眼淺層毛細(xì)血管 FAZ面積較對(duì)側(cè)眼擴(kuò)大(CRVO:0.515±0.26mm2 vs 0.27±0.08mm2,P0.01;BRVO:0.376±0.12mm2vs0.261±0.07mm2,P0.01),且與視力呈負(fù)相關(guān)(CRVO:r=-0.6,P = 0.02;BRVO:r=-0.5,P = 0.01)。CRVO、BRVO 患眼黃斑中心凹厚度均較對(duì)側(cè)眼增加(CRVO:431.2±191.3mmvs235.5±18.2mm,P0.01;BRVO:373.2±188.7mm vs 243.8±13.7mm,P=0.01),且與視力呈負(fù)相關(guān)(CRVO:r =-0.7,P0.01;BRVO:r =-0.6,P = 0.01)。[結(jié)論]OCTA可做為測(cè)量RVO患者黃斑區(qū)血流灌注及FAZ面積的有效工具。與患者對(duì)側(cè)眼相比,RVO患者患眼淺層、深層毛細(xì)血管總血流密度降低,并且血流密度降低與視力呈正相關(guān)關(guān)系,患眼淺層毛細(xì)血管FAZ面積擴(kuò)大、黃斑中心凹厚度增加,與視力呈負(fù)相關(guān)關(guān)系。
[Abstract]:[objective] to study the changes of macular perfusion and its relationship with visual acuity in patients with retinal vein occlusion (Retinal vein occlusion) by optical coherence tomography (optical coherence tomography) angiography. [methods] Thirty patients with monocular RVO were included in the study. The patients underwent OCTA examination in both eyes. The macular area blood flow density and the area of (foveal avascular zone1 Faz in the 3 脳 3mm area of the central retinal macula were obtained. The thickness of macular fovea was examined in both eyes and the best corrected visual acuity (BCVA) was obtained. The area of blood flow in macular area and the thickness of fovea macula were compared between the affected eyes and the contralateral eyes and the correlation between the thickness of macular fovea and visual acuity was compared. [results] there were 30 patients with RVO, including 15 patients with central retinal vein occlusion (central retinal vein occlusion) and 15 patients with retinal branch vein occlusion (branch retinal vein occlusion BRVO). The total blood flow density of the deep capillary was lower than that of the contralateral eye (43.07 鹵4.95%vs 50.09 鹵2.86 P0.01 in the shallow layer; 45.89 鹵2.62 鹵2.62 P0.01 in the deep layer), and there was a positive correlation between the blood density of the capillary in the deep layer and the visual acuity (superficial: r = 0.6 P = 0.01; in the deep layer: r = 0.5, P = 0.04). The total blood flow density of the deep capillary was lower than that of the contralateral eye (45.62 鹵3.04%vs 52.10 鹵2.98 P0.01 in the superficial layer and 49.21 鹵3.80%vs 55.52 鹵3.33P0.01 in the deep layer), which was positively correlated with the visual acuity (superficial: r = 0.5P < 0.01; deep layer: r = 0.6 P = 0.01). The lesion area of the affected eye was higher than that of the non-diseased area of the affected eye, and the corresponding lesion of the contralateral eye was lower than that of the normal eye. The blood density of deep capillary decreased (P0.01), the density of deep capillary decreased negatively with visual acuity in the lesion area of the affected eye (P 0.04), and the blood density of the deep capillary decreased in the unaffected area compared with the corresponding area of the contralateral eye (56.86 鹵1.95 vs 56.86 鹵1.95). 58.15鹵2.24,P=0.02).CRVO,BRVO鎮(zhèn)ｇ溂嫻呭眰姣涚粏琛，

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