State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
The People's Hospital of Gaoyao District, Zhaoqing, China.
Ophthalmologica. 2019;242(2):69-80. doi: 10.1159/000499608. Epub 2019 May 21.
To quantitatively evaluate microvascular changes in eyes with macular oedema due to branch retinal vein occlusion (BRVO) using optical coherence tomography angiography (OCTA) before and after intravitreal conbercept injection and the correlation of such changes with best-corrected visual acuity (BCVA) and retinal thickness.
Twenty-eight eyes of 28 patients treated with a single intravitreal injection of conbercept for macular oedema due to BRVO were included in this study. The automatically measured values of the vessel density in the superficial (SCP) and deep retinal capillary plexus (DCP), the foveal avascular zone (FAZ) area, the FAZ perimeter, the vessel density within a 300 μm wide ring surrounding the FAZ (FD-300), the acircularity index (AI), the choriocapillaris flow area and the retinal thickness were obtained via OCTA before and at 1 month after initial injection and compared with those of age- and sex- matched healthy subjects.
In BRVO eyes, the vascular density in the SCP and DCP, the FD-300 and the flow area of choriocapillaris were significantly lower than those in healthy eyes, while the AI and the retinal thickness were significantly increased. After treatment, the retinal thickness in eyes with BRVO was significantly decreased in all quadrants, and the mean BCVA dramatically increased from 20/162 to 20/78 (p = 0.0017). The mean flow area of choriocapillaris significantly improved after treatment. Moreover, negative correlations between the logMAR BCVA and the whole vascular density in the SCP and DCP as well as the flow area of choriocapillaris were observed.
OCTA enables non-invasive, layer-specific and quantitative assessment of microvascular changes in eyes with BRVO before and after treatment, and it can be used as a valuable imaging tool for the evaluation of the follow-up in BRVO patients.
利用光相干断层扫描血管造影术（OCTA）定量评估视网膜分支静脉阻塞（BRVO）引起的黄斑水肿患者治疗前后的微血管变化，并分析这些变化与最佳矫正视力（BCVA）和视网膜厚度的相关性。
本研究共纳入 28 例（28 只眼）因 BRVO 导致黄斑水肿接受单次玻璃体内康柏西普注射治疗的患者。通过 OCTA 自动测量治疗前后患者的浅层视网膜毛细血管丛（SCP）和深层视网膜毛细血管丛（DCP）血管密度、中心凹无血管区（FAZ）面积、FAZ 周长、FAZ 周围 300μm 环内血管密度（FD-300）、非圆度指数（AI）、脉络膜血流面积和视网膜厚度，并与年龄和性别匹配的健康对照组进行比较。
BRVO 眼的 SCP 和 DCP 血管密度、FD-300 和脉络膜血流面积均显著低于健康对照组，而 AI 和视网膜厚度则显著增加。治疗后，BRVO 眼各象限的视网膜厚度均显著降低，平均 BCVA 从 20/162 显著提高至 20/78（p = 0.0017）。脉络膜血流面积在治疗后也显著改善。此外，logMAR BCVA 与 SCP 和 DCP 整体血管密度以及脉络膜血流面积呈负相关。
OCTA 可无创、分层、定量评估 BRVO 治疗前后的微血管变化，可作为 BRVO 患者随访评估的有价值的影像学工具。
