Yun Cheolmin, Ahn Jaemoon, Kim Mingue, Kim Jee Taek, Hwang Soon-Young, Kim Seong-Woo, Oh Jaeryung
Department of Ophthalmology, Korea University College of Medicine, 126-1 Anam-dong 5-ga, Sungbuk-gu, Seoul, 136-705, South Korea.
Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2017 Oct;255(10):1923-1934. doi: 10.1007/s00417-017-3742-6. Epub 2017 Jul 25.
The purpose of our study was to investigate characteristics of retinal vessels in eyes with surgically closed macular holes (MH).
We included patients who underwent surgery for idiopathic MH and a follow-up examination using optical coherence tomography angiography (OCTA). The area of the foveal avascular zone (FAZ) and retinal vascular densities of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were calculated on the postoperative OCTA images and compared with those of age-matched normal controls.
Twenty-eight patients with MH and 28 controls were included. Mean postoperative FAZ areas of SCP and DCP (0.317 ± 0.129 mm and 0.500 ± 0.174 mm) were smaller than those of normal controls (0.406 ± 0.131 mm and 0.687 ± 0.147 mm) (P = 0.013 and P < 0.001, respectively). Retinal vascular densities of SCP and DCP in the MH group (32.23 ± 1.45% and 31.85 ± 1.28%) were lower than those of the control group (33.26 ± 1.71% and 33.18 ± 1.89%) (P = 0.019 and P = 0.003, respectively). The retinal vascular densities of SCP and DCP were associated with postoperative mean ganglion cell-inner plexiform layer (GC-IPL) thickness (P = 0.033 and P = 0.035, respectively). The vascular densities were horizontally asymmetric and related to asymmetric distribution of GC-IPL thickness in the MH group.
Surgically closed MH eyes had remodeled retinal vascular patterns, which were related to morphologic changes in the inner retinal layer. The healing process after MH surgery may be involved in asymmetric change in anatomy and hemodynamics of the inner retina.
本研究旨在调查手术封闭黄斑裂孔(MH)眼的视网膜血管特征。
我们纳入了接受特发性MH手术并使用光学相干断层扫描血管造影(OCTA)进行随访检查的患者。在术后OCTA图像上计算黄斑无血管区(FAZ)的面积以及浅表毛细血管丛(SCP)和深部毛细血管丛(DCP)的视网膜血管密度,并与年龄匹配的正常对照进行比较。
纳入了28例MH患者和28例对照。SCP和DCP术后平均FAZ面积(0.317±0.129mm和0.500±0.174mm)小于正常对照(0.406±0.131mm和0.687±0.147mm)(P分别为0.013和P<0.001)。MH组SCP和DCP的视网膜血管密度(32.23±1.45%和31.85±1.28%)低于对照组(33.26±1.71%和33.18±1.89%)(P分别为0.019和P=0.003)。SCP和DCP的视网膜血管密度与术后平均神经节细胞-内丛状层(GC-IPL)厚度相关(P分别为0.033和P=0.035)。MH组血管密度呈水平不对称,且与GC-IPL厚度的不对称分布有关。
手术封闭的MH眼具有重塑的视网膜血管模式,这与视网膜内层的形态学变化有关。MH手术后的愈合过程可能涉及视网膜内层解剖结构和血流动力学的不对称变化。