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[一项运用频域光学相干断层扫描观察甲状腺相关性眼病患者黄斑中心脉络膜厚度的研究]

[A study on observing the central macular choroidal thickness of thyroid-associated ophthalmopathy patients with spectral-domain optical coherence tomography].

作者信息

Zhu Y, Song Y, Cai Q, Zhou Y, Li J J

机构信息

Department of Ophthalmology, First People's Hospital of Nantong, Nantong 226000, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2018 Sep 11;54(9):688-693. doi: 10.3760/cma.j.issn.0412-4081.2018.09.010.

Abstract

To compare the differences in the central macular choroidal thickness (CMCT) between thyroid-associated ophthalmopathy (TAO) patients in active and inactive stages, and the healthy subjects used spectral-domain optical coherence tomography (SD-OCT) and assess the potential of using CMCT as an indicator for follow-up of TAO patients. Cross-sectional study. Eleven active stage TAO patients (22 eyes, active TAO group) and 21 inactive stage TAO patients (42 eyes, inactive TAO group) who received treatment at the Department of Ophthalmology, First People's Hospital of Nantong during January 2015 and December 2017 were enrolled. Twenty-three healthy subjects (46 eyes) with comparable ages to the two TAO groups were enrolled in the healthy control group. TAO activity was assessed using the TAO clinical activity score (CAS) system. All subjects underwent best corrected visual acuity, slit lamp examination, Goldmann tonometer for intraocular pressure measurement, direct ophthalmoscopy, A-superelocular measurement, ocular protrusion measurement, and SD-OCT detection of CMCT. The variance analysis was used to compare the differences of intraocular pressure, eyeball protrusion and CMCT between the three groups. The correlation between CMCT and various clinical indicators was analyzed by univariate linear regression analysis and multivariate linear regression analysis. The intraocular pressure and eyeball protrusion indicators of the active TAO group, the inactive TAO group, and the control group were (20.16±3.49) mmHg (1 mmHg=0.133 kPa) and (18.68±1.64) mm, (15.42±2.49) mmHg and (15.64±1.01) mm, (15.72±2.38) mmHg and (12.02±0.83) mm, respectively. The intraocular pressure and ocular protrusion of the active TAO group were higher than those of the inactive TAO group and the healthy control group, the differences between the groups are of statistical significance (all 0.001). The CMCT value of the active TAO group, the inactive TAO group and the healthy control group were (391.27±33.89) μm, (317.31±29.62) μm, and (304.26±42.26) μm, respectively. The CMCT of the active TAO group was significantly higher than the inactive group and the healthy control group, the differences between the groups are of statistical significance (all 0.001). Based on univariate analysis, thicker CMCT was significantly associated with intraocular pressure (4.600, 0.001); after correction of intraocular pressure, thicker CMCT was significantly associated with CAS (β=0.848, 95 15.608-21.499, 0.001). Multivariate analysis showed a correlation between thicker CMCT and CAS scores (0.001), thyroid function (0.001), and intraocular pressure(0.039). The CMCT in the eyes of active TAO patients is higher than that of the inactive TAO patients and healthy people. The CMCT examination is of referential value, and may be used as a tool for assessing the activity of lesions in patients with TAO and clinical follow-up. .

摘要

为比较甲状腺相关性眼病(TAO)活动期与非活动期患者黄斑中心脉络膜厚度(CMCT)的差异,并以健康受试者作为对照,采用频域光学相干断层扫描(SD - OCT)评估CMCT作为TAO患者随访指标的潜力。横断面研究。纳入2015年1月至2017年12月在南通市第一人民医院眼科接受治疗的11例活动期TAO患者(22只眼,活动期TAO组)和21例非活动期TAO患者(42只眼,非活动期TAO组)。选取年龄与两组TAO患者相近的23例健康受试者(46只眼)作为健康对照组。采用TAO临床活动评分(CAS)系统评估TAO活动度。所有受试者均接受最佳矫正视力、裂隙灯检查、Goldmann眼压计测量眼压、直接检眼镜检查、A超测量、眼球突出度测量以及SD - OCT检测CMCT。采用方差分析比较三组间眼压、眼球突出度和CMCT的差异。通过单因素线性回归分析和多因素线性回归分析CMCT与各项临床指标的相关性。活动期TAO组、非活动期TAO组和对照组的眼压及眼球突出度指标分别为(20.16±3.49)mmHg(1 mmHg = 0.133 kPa)和(18.68±1.64)mm、(15.42±2.49)mmHg和(15.64±1.01)mm、(15.72±2.38)mmHg和(12.02±0.83)mm。活动期TAO组的眼压和眼球突出度高于非活动期TAO组和健康对照组,组间差异具有统计学意义(均P < 0.001)。活动期TAO组、非活动期TAO组和健康对照组的CMCT值分别为(391.27±33.89)μm、(317.31±29.62)μm和(304.26±42.26)μm。活动期TAO组的CMCT显著高于非活动期组和健康对照组,组间差异具有统计学意义(均P < 0.001)。单因素分析显示,CMCT增厚与眼压显著相关(β = 4.600,P = 0.001);校正眼压后,CMCT增厚与CAS显著相关(β = 0.848,95%CI:15.608 - 21.499,P = 0.001)。多因素分析显示,CMCT增厚与CAS评分(P = 0.001)、甲状腺功能(P = 0.001)和眼压(P = 0.039)相关。活动期TAO患者眼内的CMCT高于非活动期TAO患者和健康人。CMCT检查具有参考价值,可作为评估TAO患者病变活动度及临床随访的工具。

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