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评估伴有分支视网膜静脉阻塞的眼部黄斑缺血:光学相干断层血管造影研究。

EVALUATION OF MACULAR ISCHEMIA IN EYES WITH BRANCH RETINAL VEIN OCCLUSION: An Optical Coherence Tomography Angiography Study.

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Department of Ophthalmology, Kitano Hospital, Osaka, Japan.

出版信息

Retina. 2018 Feb;38(2):272-282. doi: 10.1097/IAE.0000000000001541.

Abstract

PURPOSE

To quantitatively assess macular morphology and perfusion status using optical coherence tomography, and optical coherence tomography angiography in eyes with branch retinal vein occlusion when macular edema has completely resolved, and to investigate the impact on visual function.

METHODS

Thirty consecutive eyes with branch retinal vein occlusion-macular edema that resolved after treatment with intravitreal ranibizumab injections were included. Macular sensitivity was measured by microperimetry; defect length of foveal ellipsoid zone band was measured using optical coherence tomography; foveal avascular zone and parafoveal nonperfusion areas (NPA) were measured by optical coherence tomography angiography.

RESULTS

The logarithm of minimum angle of resolution visual acuity was significantly associated with the defect length of the foveal ellipsoid zone band (P = 0.005), the parafoveal NPA in the superficial capillary plexus (P = 0.007), and the parafoveal NPA in the deep capillary plexus (P = 0.006). Macular sensitivity correlated with parafoveal thickness on the affected side (P = 0.034), the defect length of the foveal ellipsoid zone band (P = 0.048), parafoveal NPA in the superficial capillary plexus (P = 0.008), and parafoveal NPA in the deep capillary plexus (P = 0.012). Multivariate analysis where the only significant parameters in the univariate analyses were used as the independent variables showed that parafoveal NPA was most significantly associated with the logarithm of minimum angle of resolution visual acuity (β = 0.500, P = 0.005) and macular sensitivity (β = -0.480, P = 0.007).

CONCLUSION

In eyes with branch retinal vein occlusion-macular edema resolved by intravitreal ranibizumab treatments, visual function was strongly associated with parafoveal NPA size.

摘要

目的

利用光学相干断层扫描和光学相干断层扫描血管造影定量评估视网膜分支静脉阻塞黄斑水肿完全消退后的黄斑形态和灌注状态,并探讨其对视力功能的影响。

方法

连续纳入 30 例视网膜分支静脉阻塞黄斑水肿患者,经玻璃体腔注射雷珠单抗治疗后水肿消退。采用微视野计测量黄斑敏感度;光学相干断层扫描测量黄斑中心凹外椭圆带缺失长度;光学相干断层扫描血管造影测量中心凹无血管区和旁中心凹无灌注区(NPA)。

结果

最小分辨角视力对数与黄斑中心凹外椭圆带缺失长度(P=0.005)、浅层毛细血管丛旁中心凹 NPA(P=0.007)和深层毛细血管丛旁中心凹 NPA(P=0.006)显著相关。黄斑敏感度与患侧旁中心凹厚度(P=0.034)、黄斑中心凹外椭圆带缺失长度(P=0.048)、浅层毛细血管丛旁中心凹 NPA(P=0.008)和深层毛细血管丛旁中心凹 NPA(P=0.012)相关。多元分析中,仅将单因素分析中有统计学意义的参数作为自变量,结果显示旁中心凹 NPA 与最小分辨角视力对数(β=0.500,P=0.005)和黄斑敏感度(β=-0.480,P=0.007)相关性最强。

结论

在接受玻璃体腔雷珠单抗治疗的视网膜分支静脉阻塞黄斑水肿消退患者中,视力功能与旁中心凹 NPA 大小密切相关。

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