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单纯白内障手术后炎症的早期视网膜和脉络膜 OCT 和 OCT 血管造影表现。

Early retinal and choroidal OCT and OCT angiography signs of inflammation after uncomplicated cataract surgery.

机构信息

Department of Ophthalmology, University of Padova, Padova, Italy.

Fondazione Bietti, IRCCS, Rome, Italy.

出版信息

Br J Ophthalmol. 2019 Jul;103(7):1001-1007. doi: 10.1136/bjophthalmol-2018-312461. Epub 2018 Aug 20.

Abstract

PURPOSE

To evaluate, by means of optical coherence tomography (OCT) and OCT angiography (OCTA), early retinal, choroidal and macular perfusion changes induced by a local inflammatory reaction secondary to uncomplicated cataract surgery.

METHODS

Selected eyes undergoing cataract surgery were enrolled in a prospective study. OCT and OCTA were performed before cataract surgery (T0) and at day: 1 (T1), 7 (T7), 30 (T30) and 90 (T90). Inner (IR) and outer retinal (OR) volumes, choroidal volume, hyper-reflective retinal spots (HRS) in IR and OR changes were measured at OCT. Macular perfusion was analysed in superficial (SCP), intermediate (ICP) and deep retinal capillary plexuses (DCP).

RESULTS

Nine eyes of nine selected patients were consecutively enrolled. Mean IR volume changed after surgery (p=0.0001), increasing progressively from 4.391±0.231 mm³ at T0 to 4.573±0.241 mm³ at T30, p=0.0002. Both mean OR and choroidal volume increased, mainly at T30, but not significantly (p=0.4360 and p=0.2300, respectively). Mean HRS changed during follow-up, increasing at first in IR and later in OR (at T1 and T7, respectively, both p<0.0001). Macular ICP and DCP perfusion increased at T1, whereas macular SCP perfusion did not change. At T90, all OCT and OCTA parameters had almost reached baseline levels.

CONCLUSIONS

The increase of HRS at first in IR and later in OR seems to confirm their inflammatory nature. Early OCTA changes (underline) underscore a selective susceptibility of DCP and ICP to a localised inflammatory reaction induced by cataract surgery.

摘要

目的

通过光学相干断层扫描(OCT)和 OCT 血管造影(OCTA)评估单纯白内障手术后局部炎症反应引起的早期视网膜、脉络膜和黄斑灌注变化。

方法

入选接受白内障手术的患者进行前瞻性研究。在白内障手术前(T0)以及术后第 1 天(T1)、第 7 天(T7)、第 30 天(T30)和第 90 天(T90)进行 OCT 和 OCTA 检查。在 OCT 上测量内层(IR)和外层视网膜(OR)容积、脉络膜容积、IR 和 OR 中高反射视网膜点(HRS)的变化。分析浅层(SCP)、中间层(ICP)和深层视网膜毛细血管丛(DCP)的黄斑灌注。

结果

连续入选 9 例患者的 9 只眼。手术后 IR 容积发生变化(p=0.0001),从 T0 时的 4.391±0.231mm³逐渐增加至 T30 时的 4.573±0.241mm³,p=0.0002。OR 和脉络膜容积均增加,主要发生在 T30,但无统计学意义(p=0.4360 和 p=0.2300)。HRS 随时间推移而变化,IR 中首先增加,然后在 OR 中增加(分别在 T1 和 T7,均 p<0.0001)。T1 时黄斑 ICP 和 DCP 灌注增加,而黄斑 SCP 灌注无变化。T90 时,所有 OCT 和 OCTA 参数几乎恢复至基线水平。

结论

IR 中 HRS 首先增加,然后在 OR 中增加,这似乎证实了它们的炎症性质。早期 OCTA 变化(下划线)强调 DCP 和 ICP 对白内障手术后局部炎症反应的选择性易感性。

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