視網膜色素變性患者脈絡膜厚度和血管密度與視功能的相關性分析
發(fā)布時間：2018-09-17 20:24
【摘要】：第一部分視網膜色素變性患者脈絡膜厚度和血管密度與視功能的相關性分析目的:應用Cirrus HD-OCT對視網膜色素變性(RP)患者脈絡膜厚度和血管密度進行分析,并探討其與視功能的相關性。方法:從2014年9月至2017年3月,分別收集60例散發(fā)型RP患者(120眼)和與其年齡、屈光度相匹配的健康對照者60(120眼)入選本研究。采用Cirrus HD-OCT的增強深部成像技術(enhanced depth imaging,EDI)測量所有受檢眼的黃斑中心凹脈絡膜厚度及血管密度。RP組患眼同時行視網膜電圖(ERG)檢查,并采用OCTOPUS自動視野計T32或LVC程序行30°視野檢查,對兩組檢查結果進行比較分析,并探討RP患者的脈絡膜厚度、血管密度與視功能的相關性。結果:RP組黃斑中心凹脈絡膜厚度和黃斑脈絡膜血管密度之間存在明顯的正相關性(r=0.398,P0.001);在31-40歲年齡組,RP組的黃斑中心凹脈絡膜厚度和黃斑血管密度存在明顯的正相關性(r=0.647,P0.001)。在31～40歲年齡組,RP組的黃斑中心凹脈絡膜厚度和黃斑脈絡膜血管密度明顯低于正常組(P0.001)。RP組的黃斑中心凹脈絡膜厚度和黃斑脈絡膜血管密度與其發(fā)現(xiàn)年齡有一定的相關性(P0.05)。RP患者黃斑中心凹脈絡膜厚度、黃斑脈絡膜血管密度分別與視功能分析均無明顯相關性(P0.05)。結論:RP的脈絡膜厚度及血管密度僅能在一定程度上反映患眼的病變程度,并與其發(fā)現(xiàn)年齡關系密切。RP患者黃斑中心凹脈絡膜厚度、黃斑脈絡膜血管密度與視功能無明顯相關性。第二部分Angio-OCT與HD-OCT對RP患者檢測分析目的:比較兩種OCT(光學相干斷層掃描血流成像術(Angio-optical coherence tomography,Angio-OCT)和Cirrus HD-OCT)對RP患者檢測的差異性和相關性。方法:從已入組觀察例中共選取RP患者30例(60眼)與年齡、屈光度相匹配的健康對照者30人(60眼),分別應用Angio-OCT和HD-OCT測量所有眼黃斑中心凹視網膜、脈絡膜厚度,黃斑視網膜血流密度、脈絡膜血流面積和血流密度,對兩組人群的測量指標進行差異性和相關性分析,并對Angio-OCT與HD-OCT的視網膜、脈絡膜厚度測量值進行差異性和相關性分析。結果:1.視網膜厚度:兩種OCT所測黃斑中心凹視網膜厚度差異無統(tǒng)計學意義(P0.05)。RP組黃斑中心凹視網膜厚度、黃斑視網膜血流密度均較正常組明顯降低(P0.001)。RP組黃斑中心凹視網膜厚度與黃斑視網膜血流密度無明顯相關性(r=0.051,P=0.697)。2.脈絡膜厚度:Angio-OCT所測兩組人群的黃斑中心凹脈絡膜厚度均較HD-OCT所測升高,差異有統(tǒng)計學意義(P0.05);RP組黃斑中心凹脈絡膜厚度較正常組降低(P0.05),而兩組人群的黃斑脈絡膜血流面積和血流密度差異均無統(tǒng)計學意義(P0.05)。兩組人群的黃斑中心凹脈絡膜厚度與黃斑脈絡膜血流面積、血流密度均無明顯相關性(P0.05)。3.兩種OCT所測黃斑中心凹視網膜、脈絡膜厚度測量值均有明顯的正相關性(P0.001)。結論:兩種設備成像原理和技術不同,在黃斑中心凹視網膜脈絡膜厚度測量中有一定的相關性,臨床中均可以應用。第三部分RP患者中西醫(yī)結合治療前后Angio-OCT分析目的:探索性應用Angio-OCT觀察RP患者中西醫(yī)結合治療前后眼底變化及視功能的改變。方法:從2016年1月至2017年3月,共納入13例符合納入標準和排除標準的散發(fā)型RP患者(26眼)入選本研究。應用Angio-OCT檢測RP患者中西醫(yī)結合治療前后眼底視網膜和脈絡膜的血流變化,并與最佳矯正視力和視野改變進行分析。結果:RP患者13例(26眼)中西醫(yī)結合治療后的視網膜血流密度、脈絡膜的血流面積、血流密度較治療前均升高,但差異均無統(tǒng)計學意義(P0.05),治療后最佳矯正視力和視敏度均較治療前提高(P0.05)。結論:中西醫(yī)結合治療在改善RP患者視功能有明顯的療效,而眼底視網膜、脈絡膜血流方面改變不明顯,還有待進一步研究。
[Abstract]:Part I Correlation between Choroidal Thickness, Vascular Density and Visual Function in Patients with Retinopathy Objective: To analyze the choroidal thickness and vascular density in patients with retinitis pigmentosa (RP) by Cirrus HD-OCT, and to explore the correlation between choroidal thickness and vascular density and visual function. Type I RP patients (120 eyes) and 60 healthy controls (120 eyes) matched with their age and diopter were enrolled in the study. The thickness of choroidal fovea and vascular density were measured by enhanced depth imaging (EDI) with Cirrus HD-OCT. The eyes in RP group underwent electroretinogram (ERG) and OC simultaneously. TOPUS automatic perimeter T32 or LVC program for 30 degree visual field examination, the results of the two groups were compared and analyzed, and to explore the RP patients with choroidal thickness, vascular density and visual function correlation. Results: RP group macular fovea choroidal thickness and macular choroidal vascular density between the obvious positive correlation (r = 0.398, P 0.001); There was a significant positive correlation between macular foveal choroidal thickness and macular vascular density in RP group (r = 0.647, P 0.001). In 31-40 years old group, macular foveal choroidal thickness and macular choroidal vascular density in RP group were significantly lower than those in normal group (P 0.001). There was no significant correlation between macular foveal choroidal thickness, macular choroidal vascular density and visual function analysis in RP patients (P There was no significant correlation between macular foveal choroidal thickness, macular choroidal vascular density and visual function in RP patients. Part 2 Angio-OCT and HD-OCT were used to detect RP patients. Objective: To compare the difference between two kinds of OCT (Angio-optical coherence tomography, Angio-OCT) and CIRRUS HD-OCT) in detecting RP patients. Methods: Angio-OCT and HD-OCT were used to measure the foveal retina, choroidal thickness, macular retinal blood flow density, choroidal blood flow area and blood flow density in 30 RP patients (60 eyes) and 30 healthy controls (60 eyes) matched with age and diopter. Results: 1. Retinal thickness: There was no significant difference in macular fovea retinal thickness between the two OCTs (P 0.05). There was no significant difference in macular fovea retinal thickness between RP group and HD-OCT group (P 0.05). There was no significant correlation between foveal retinal thickness and macular retinal blood flow density in RP group (r = 0.051, P = 0.697). 2. Choroidal thickness: Choroidal thickness in both groups measured by Angio-OCT was higher than that measured by HD-OCT, the difference was statistically significant (P 0.05). Fovea choroidal thickness was lower than normal group (P 0.05), but there was no significant difference in macular choroidal blood flow area and density between the two groups (P 0.05). There was no significant correlation between fovea choroidal thickness and macular choroidal blood flow area, blood flow density (P 0.05). 3. Retinal and choroidal thickness measurements have significant positive correlation (P 0.001). Conclusion: The imaging principles and techniques of the two devices are different, and they have a certain correlation in the measurement of retinal and choroidal thickness in macular fovea, and can be used in clinical practice. Methods: From January 2016 to March 2017, 13 patients (26 eyes) with sporadic RP who met the inclusion criteria and exclusion criteria were enrolled in this study. Angio-OCT was used to detect the retinal and choroidal blood of RP patients before and after treatment. Result: The retinal blood flow density, choroidal blood flow area and blood flow density of 13 patients (26 eyes) with RP were higher than those before treatment, but the difference was not statistically significant (P 0.05). After treatment, the best corrected visual acuity and visual acuity were improved (P 0.05). 05). Conclusion: The treatment of integrated traditional Chinese and Western medicine has obvious effect on improving the visual function of RP patients, but the changes of fundus retina and choroidal blood flow are not obvious.
【學位授予單位】：中國中醫(yī)科學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R774.1
本文編號：2246991
[Abstract]:Part I Correlation between Choroidal Thickness, Vascular Density and Visual Function in Patients with Retinopathy Objective: To analyze the choroidal thickness and vascular density in patients with retinitis pigmentosa (RP) by Cirrus HD-OCT, and to explore the correlation between choroidal thickness and vascular density and visual function. Type I RP patients (120 eyes) and 60 healthy controls (120 eyes) matched with their age and diopter were enrolled in the study. The thickness of choroidal fovea and vascular density were measured by enhanced depth imaging (EDI) with Cirrus HD-OCT. The eyes in RP group underwent electroretinogram (ERG) and OC simultaneously. TOPUS automatic perimeter T32 or LVC program for 30 degree visual field examination, the results of the two groups were compared and analyzed, and to explore the RP patients with choroidal thickness, vascular density and visual function correlation. Results: RP group macular fovea choroidal thickness and macular choroidal vascular density between the obvious positive correlation (r = 0.398, P 0.001); There was a significant positive correlation between macular foveal choroidal thickness and macular vascular density in RP group (r = 0.647, P 0.001). In 31-40 years old group, macular foveal choroidal thickness and macular choroidal vascular density in RP group were significantly lower than those in normal group (P 0.001). There was no significant correlation between macular foveal choroidal thickness, macular choroidal vascular density and visual function analysis in RP patients (P There was no significant correlation between macular foveal choroidal thickness, macular choroidal vascular density and visual function in RP patients. Part 2 Angio-OCT and HD-OCT were used to detect RP patients. Objective: To compare the difference between two kinds of OCT (Angio-optical coherence tomography, Angio-OCT) and CIRRUS HD-OCT) in detecting RP patients. Methods: Angio-OCT and HD-OCT were used to measure the foveal retina, choroidal thickness, macular retinal blood flow density, choroidal blood flow area and blood flow density in 30 RP patients (60 eyes) and 30 healthy controls (60 eyes) matched with age and diopter. Results: 1. Retinal thickness: There was no significant difference in macular fovea retinal thickness between the two OCTs (P 0.05). There was no significant difference in macular fovea retinal thickness between RP group and HD-OCT group (P 0.05). There was no significant correlation between foveal retinal thickness and macular retinal blood flow density in RP group (r = 0.051, P = 0.697). 2. Choroidal thickness: Choroidal thickness in both groups measured by Angio-OCT was higher than that measured by HD-OCT, the difference was statistically significant (P 0.05). Fovea choroidal thickness was lower than normal group (P 0.05), but there was no significant difference in macular choroidal blood flow area and density between the two groups (P 0.05). There was no significant correlation between fovea choroidal thickness and macular choroidal blood flow area, blood flow density (P 0.05). 3. Retinal and choroidal thickness measurements have significant positive correlation (P 0.001). Conclusion: The imaging principles and techniques of the two devices are different, and they have a certain correlation in the measurement of retinal and choroidal thickness in macular fovea, and can be used in clinical practice. Methods: From January 2016 to March 2017, 13 patients (26 eyes) with sporadic RP who met the inclusion criteria and exclusion criteria were enrolled in this study. Angio-OCT was used to detect the retinal and choroidal blood of RP patients before and after treatment. Result: The retinal blood flow density, choroidal blood flow area and blood flow density of 13 patients (26 eyes) with RP were higher than those before treatment, but the difference was not statistically significant (P 0.05). After treatment, the best corrected visual acuity and visual acuity were improved (P 0.05). 05). Conclusion: The treatment of integrated traditional Chinese and Western medicine has obvious effect on improving the visual function of RP patients, but the changes of fundus retina and choroidal blood flow are not obvious.
【學位授予單位】：中國中醫(yī)科學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R774.1
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