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视网膜静脉阻塞患者眼中黄斑水肿与循环状态之间的关联:一项自适应光学扫描激光眼科检查研究

ASSOCIATIONS BETWEEN MACULAR EDEMA AND CIRCULATORY STATUS IN EYES WITH RETINAL VEIN OCCLUSION: An Adaptive Optics Scanning Laser Ophthalmoscopy Study.

作者信息

Iida Yuto, Muraoka Yuki, Uji Akihito, Ooto Sotaro, Murakami Tomoaki, Suzuma Kiyoshi, Tsujikawa Akitaka, Arichika Shigeta, Takahashi Ayako, Miwa Yuko, Yoshimura Nagahisa

机构信息

*Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; and †Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan.

出版信息

Retina. 2017 Oct;37(10):1896-1904. doi: 10.1097/IAE.0000000000001433.

Abstract

PURPOSE

To investigate associations between parafoveal microcirculatory status and foveal pathomorphology in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO).

METHODS

Ten consecutive patients (10 eyes) with acute retinal vein occlusion were enrolled, 9 eyes of which received intravitreal ranibizumab (IVR) injections. Foveal morphologic changes were examined via optical coherence tomography (OCT), and parafoveal circulatory status was assessed via adaptive optics scanning laser ophthalmoscopy (AO-SLO).

RESULTS

The mean parafoveal aggregated erythrocyte velocity (AEV) measured by adaptive optics scanning laser ophthalmoscopy in eyes with retinal vein occlusion was 0.99 ± 0.43 mm/second at baseline, which was significantly lower than that of age-matched healthy subjects (1.41 ± 0.28 mm/second, P = 0.042). The longitudinal adaptive optics scanning laser ophthalmoscopy examinations of each patient showed that parafoveal AEV was strongly inversely correlated with optical coherence tomography-measured central foveal thickness (CFT) over the entire observation period. Using parafoveal AEV and central foveal thickness measurements obtained at the first and second examinations, we investigated associations between differences in parafoveal AEV and central foveal thickness, which were significantly and highly correlated (r = -0.84, P = 0.002).

CONCLUSION

Using adaptive optics scanning laser ophthalmoscopy in eyes with retinal vein occlusion macular edema, we could quantitatively evaluate the parafoveal AEV. A reduction or an increase in parafoveal AEV may be a clinical marker for the resolution or development/progression of macular edema respectively.

摘要

目的

研究视网膜静脉阻塞(RVO)继发黄斑水肿(ME)患者的黄斑旁微循环状态与黄斑区病理形态学之间的关联。

方法

连续纳入10例急性视网膜静脉阻塞患者(10只眼),其中9只眼接受了玻璃体内注射雷珠单抗(IVR)。通过光学相干断层扫描(OCT)检查黄斑形态学变化,通过自适应光学扫描激光检眼镜(AO-SLO)评估黄斑旁循环状态。

结果

视网膜静脉阻塞患者的黄斑旁聚集红细胞速度(AEV)在基线时通过自适应光学扫描激光检眼镜测量为0.99±0.43毫米/秒,显著低于年龄匹配的健康受试者(1.41±0.28毫米/秒,P = 0.042)。对每位患者的纵向自适应光学扫描激光检眼镜检查显示,在整个观察期内,黄斑旁AEV与光学相干断层扫描测量的中央黄斑厚度(CFT)呈强烈负相关。利用首次和第二次检查时获得的黄斑旁AEV和中央黄斑厚度测量值,我们研究了黄斑旁AEV和中央黄斑厚度差异之间的关联,二者显著且高度相关(r = -0.84,P = 0.002)。

结论

在视网膜静脉阻塞性黄斑水肿患者中使用自适应光学扫描激光检眼镜,我们可以定量评估黄斑旁AEV。黄斑旁AEV的降低或升高可能分别是黄斑水肿消退或发展/进展的临床标志物。

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