Mao J B, Lao J M, Yu X T, Chen Y Q, Tao J W, Wu H F, Cheng D, Chen H, Shen L J
The Affiliated Eye Hospital of Whenzhou Medical University at Hangzhou, Hangzhou 310020, China.
The People's Hospital of Zhuji, Shaoxin 311800, China.
Zhonghua Yan Ke Za Zhi. 2019 Oct 11;55(10):757-762. doi: 10.3760/cma.j.issn.0412-4081.2019.10.006.
To observe changes in foveal avascular zone(FAZ) and capillary plexus in idiopathic macular epiretinal membrane (IMEM) in optical coherence tomography angiography (OCTA) and analyze their correlation with the visual acuity. Cross-sectional study. 42 patients (15 Males and 27 females, age 64.8) from the Eye Hospital of Wenzhou Medical University were included with 51 eyes diagnosed as IMEM (IMEM group), and 23 normal eyes (9 Males and 14 females, control group). All patients received the examination of fissure lamp combined with fundus pre-set lens, best corrected visual acuity (BCVA), OCT angiography (OCTA) and fundus photo. OCTA was performed on 3 mm× 3 mm sections centred on the fovea. The software automatically measured the superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density(VD) and retinal thickness(RT) and FAZ area. The IMEM eyes were compared with the normal eyes and correlation between the parameters of OCTA and BCVA was analyzed in IMEM. Independent-sample test and MannWhitney test were used for comparison between groups, and Spearman test was used for correlation analysis. LogMAR BCVA in the IMEM group was 0.40(0.15, 0.70), in the control group was 0.10(0.05, 0.22). FAZ area of IMEM group was (0.09±0.05) mm(2), while that of control group was (0.34±0.13)mm(2).Compared with the control group, in IMEM group, the BCVA was worse (-4.443, 0.001), FAZ area was smaller (-9.198, 0.001), RT was increased (0.001), The foveal DCP and SCP vessel density was increased (4.280, 9.079, 0.01), The parafoveal DCP vessel density was decreased (0.05), The parafoveal SCP vessel density was decreased in superior, inferior and nasal side (-2.759, -3.998, -2.108; 0.05). The BCVA was negatively correlated with FAZ area (-0.337, 0.017), positively correlated with center macular thickness (0.324, 0.020). The BCVA was no correlated with foveal VD and parafoveal DCP vessel density (0.05), but correlated with SCP vessel density(0.05). In the IMEM eyes the BCVA was worse, FAZ area was smaller, foveal vessel density was increased and the parafoveal vessel density was decreased compared with the normal eyes. The smaller the FAZ area, the smaller foveal SCP vessel density, the poorer BCVA. There was no correlation between BCVA and DCP vessel density. Changes in VD in IMEM eyes may lead to changes in vision. .
观察光学相干断层扫描血管造影(OCTA)下特发性黄斑视网膜前膜(IMEM)中心凹无血管区(FAZ)及毛细血管丛的变化,并分析其与视力的相关性。横断面研究。纳入温州医科大学附属眼视光医院42例患者(男15例,女27例,年龄64.8岁),其中51只眼诊断为IMEM(IMEM组),23只正常眼(男9例,女14例,对照组)。所有患者均接受裂隙灯联合前置镜眼底检查、最佳矫正视力(BCVA)、OCT血管造影(OCTA)及眼底照相。以黄斑中心凹为中心在3 mm×3 mm区域行OCTA检查。软件自动测量浅表毛细血管丛(SCP)和深部毛细血管丛(DCP)的血管密度(VD)、视网膜厚度(RT)及FAZ面积。将IMEM组患眼与正常眼进行比较,并分析IMEM组中OCTA参数与BCVA的相关性。采用独立样本t检验和Mann-Whitney检验进行组间比较,采用Spearman检验进行相关性分析。IMEM组的LogMAR BCVA为0.40(0.15,0.70),对照组为0.10(0.05,0.22)。IMEM组FAZ面积为(0.09±0.05)mm²,对照组为(0.34±0.13)mm²。与对照组相比,IMEM组BCVA更差(-4.443,0.001),FAZ面积更小(-9.198,0.001),RT增加(0.001),中心凹DCP和SCP血管密度增加(4.280,9.079,0.01),旁中心凹DCP血管密度降低(0.05),旁中心凹SCP血管密度在上方、下方及鼻侧降低(-2.759,-3.998,-2.108;0.05)。BCVA与FAZ面积呈负相关(-0.337,0.017),与黄斑中心厚度呈正相关(0.324,0.020)。BCVA与中心凹VD及旁中心凹DCP血管密度无相关性(0.05),但与SCP血管密度相关(0.05)。与正常眼相比,IMEM组患眼BCVA更差,FAZ面积更小,中心凹血管密度增加,旁中心凹血管密度降低。FAZ面积越小,中心凹SCP血管密度越小,BCVA越差。BCVA与DCP血管密度无相关性。IMEM组患眼VD的变化可能导致视力改变。