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玻璃体切除术后孔源性视网膜脱离患者黄斑灌注变化的光学相干断层扫描血管造影评估

Macular perfusion changes assessed with optical coherence tomography angiography after vitrectomy for rhegmatogenous retinal detachment.

作者信息

Wang Hong, Xu Xun, Sun Xiaodong, Ma Yingyan, Sun Tao

机构信息

Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, 100 Hai Ning Road, Shanghai, 200080, China.

Shanghai Key Laboratory of Fundus Diseases, Shanghai, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2019 Apr;257(4):733-740. doi: 10.1007/s00417-019-04273-7. Epub 2019 Feb 22.

Abstract

PURPOSE

To explore macular perfusion changes in patients with rhegmatogenous retinal detachment (RRD) involved the macula following successful surgery and to evaluate the correlation between macular blood flow density and visual outcomes using optical coherence tomography angiography (OCTA).

METHODS

This retrospective study included 14 eyes (14 patients) with macular-off RRD that underwent a standard three-port 23-gauge pars plana vitrectomy (PPV) and intraocular gas tamponade combined with phacoemulsification, aspiration, and intraocular lens implantation. OCTA was used to evaluate the macular perfusion changes throughout postoperative 12 weeks in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillary plexus (CCP). The fellow unaffected eyes were used as controls for comparison.

RESULTS

A significant increase in the superficial capillary plexus flow density (SCPFD) (P = 0.000) was observed over time in RRD eyes with successful PPV, as well as the deep capillary plexus flow density (DCPFD) (P = 0.000) and the choriocapillary plexus flow density (CCPFD) (P = 0.000). Final best-corrected visual acuity (BCVA) was positively associated with CCPFD (r = - 0.577, P = 0.031) and non-correlated with SCPFD and DCPFD (P > 0.05).

CONCLUSIONS

Macular perfusion gradually recovered following successful RRD repair by PPV. OCTA provided a non-invasive method to explore the underlying reason for different postoperative visual outcomes in macular-off RRD patients.

摘要

目的

探讨黄斑受累的孔源性视网膜脱离(RRD)患者手术后黄斑灌注的变化,并使用光学相干断层扫描血管造影(OCTA)评估黄斑血流密度与视力结果之间的相关性。

方法

这项回顾性研究纳入了14例黄斑脱离的RRD患者的14只眼,这些患者接受了标准的三通道23G玻璃体切除术(PPV)、眼内气体填塞,并联合了超声乳化、抽吸和人工晶状体植入术。使用OCTA评估术后12周内浅表毛细血管丛(SCP)、深层毛细血管丛(DCP)和脉络膜毛细血管丛(CCP)的黄斑灌注变化。将对侧未受影响的眼作为对照进行比较。

结果

成功进行PPV的RRD眼中,随着时间的推移,浅表毛细血管丛血流密度(SCPFD)(P = 0.000)、深层毛细血管丛血流密度(DCPFD)(P = 0.000)和脉络膜毛细血管丛血流密度(CCPFD)(P = 0.000)均显著增加。最终最佳矫正视力(BCVA)与CCPFD呈正相关(r = -0.577,P = 0.031),与SCPFD和DCPFD无相关性(P > 0.05)。

结论

PPV成功修复RRD后,黄斑灌注逐渐恢复。OCTA提供了一种非侵入性方法,用于探究黄斑脱离RRD患者术后不同视力结果的潜在原因。

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