Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Ophthalmology, Kitano Hospital, Osaka, Japan.
Retina. 2018 Aug;38(8):1571-1580. doi: 10.1097/IAE.0000000000001749.
To quantitatively assess macular perfusion status using optical coherence tomography angiography in eyes with aflibercept-treated central retinal vein occlusion and resolved macular edema and to investigate the impact of macular morphology and perfusion status on visual function.
This prospective consecutive case series included 23 patients with central retinal vein occlusion. All patients received intravitreal aflibercept injections before analysis. Visual acuity, macular sensitivity, and the macular nonperfusion area (NPA) were evaluated in eyes without macular edema. The macular NPA was evaluated by optical coherence tomography angiography using 3 mm × 3 mm images of the macula. Foveal ellipsoid zone disruption was also analyzed.
The superficial macular NPA measured 4.15 mm ± 0.71 mm (95% confidence interval 3.85-4.46), and the deep macular NPA measured 4.23 mm ± 0.97 mm (95% confidence interval 3.82-4.56). The logarithm of the minimum angle of resolution visual acuity was significantly associated with foveal ellipsoid zone disruption (P = 0.001), the superficial macular NPA (P = 0.015), and the deep macular NPA (P = 0.018). Macular sensitivity correlated negatively with logarithm of the minimum angle of resolution visual acuity (P = 0.007), the superficial macular NPA (P = 0.029), and the deep macular NPA (P = 0.040), but not with the foveal ellipsoid zone disruption (P = 0.435).
Optical coherence tomography angiography is a novel technique that enables segmented evaluation of the macular perfusion status in eyes with central retinal vein occlusion and provides visual prognostic information. Enlargement of the macular NPA in the superficial and deep layers was significantly correlated with impaired visual acuity and with decreased macular sensitivity in patients with aflibercept-treated central retinal vein occlusion and resolved macular edema.
利用光相干断层扫描血管造影术定量评估接受阿柏西普治疗的视网膜中央静脉阻塞伴黄斑水肿消退患者的黄斑灌注状态，并探讨黄斑形态和灌注状态对视功能的影响。
本前瞻性连续病例系列研究纳入 23 例视网膜中央静脉阻塞患者。所有患者在分析前均接受了玻璃体内注射阿柏西普。对无黄斑水肿的眼评估视力、黄斑敏感性和黄斑无灌注区（NPA）。利用黄斑 3mm×3mm 图像的光相干断层扫描血管造影评估黄斑 NPA。还分析了中心凹椭圆体带的破坏情况。
浅层黄斑 NPA 为 4.15mm±0.71mm（95%置信区间 3.85-4.46），深层黄斑 NPA 为 4.23mm±0.97mm（95%置信区间 3.82-4.56）。最小分辨角视力的对数值与中心凹椭圆体带的破坏（P=0.001）、浅层黄斑 NPA（P=0.015）和深层黄斑 NPA（P=0.018）显著相关。黄斑敏感性与最小分辨角视力的对数值呈负相关（P=0.007），与浅层黄斑 NPA（P=0.029）和深层黄斑 NPA（P=0.040）呈负相关，但与中心凹椭圆体带的破坏无相关性（P=0.435）。
光相干断层扫描血管造影术是一种新的技术，可对视网膜中央静脉阻塞伴黄斑水肿消退患者的黄斑灌注状态进行分段评估，并提供视觉预后信息。浅层和深层黄斑 NPA 的扩大与视力受损显著相关，且与接受阿柏西普治疗的视网膜中央静脉阻塞伴黄斑水肿消退患者的黄斑敏感性下降相关。
