Ophthalmology, Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Shenzhen University School of Medicine, Shenzhen, Guangdong, China.
Ophthalmology, Guizhou Medical University, Guiyang, Guizhou, China.
Br J Ophthalmol. 2020 Nov;104(11):1556-1560. doi: 10.1136/bjophthalmol-2019-315520. Epub 2020 Feb 12.
To compare the foveal microvascular structure characteristics in children with a history of intravitreal injection of ranibizumab (IVR) versus laser photocoagulation (LP) for retinopathy of prematurity by optical coherence tomography angiography (OCTA).
In this cross-sectional study, a total of 17 children (28 eyes) underwent IVR and 20 children (37 eyes) underwent LP were recruited. The age of doing OCTA examination of the two groups are 5.4±1.1 years and 6.3±1.8 years, respectively (p=0.07). Spectral-domain OCTA was performed for all the eyes with a scan size of 3×3 mm. The data of the superficial retinal layer were analysed. The foveal avascular zone (FAZ) and vessel density (including vessel length density (VLD) and perfusion density (PD)) were measured using the software of OCTA (Cirrus AngioPlex 5000, Carl Zeiss, Meditec, Dubin, California, USA). The central foveal thicknesses (CFT) were measured by cross-sectional OCT.
In the central fovea, the retinal VLD and PD of patients with IVR were 13.82±2.99 mm/mm and 0.25±0.05 mm/mm, respectively, which were significantly lower than those of the LP group (15.64±2.71 mm/mm and 0.28±0.05 mm/mm, p=0.01 and p=0.006). The FAZ area of patients with IVR and LP were 0.13±0.09 mm and 0.09±0.07 mm, respectively (p=0.048). The CFT of patients with IVR and LP were 200.7±16.7 µm and 220.9±22.7 µm, respectively (p<0.01). The logarithm of the minimal angle of resolution best-corrected visual acuity of patients with IVR and LP were 0.2±0.1 and 0.1±0.1, respectively (p=0.01). There was no significant difference in the parafoveal and foveal VLD and PD, FAZ morphological index and spherical equivalent refraction (SER) between the two groups.
The IVR might contribute to microvascular changes in the macular zone, such as reducing the central foveal VLD and PD, while the LP might contribute to microstructural changes, such as smaller FAZ and thicker CFT.
通过光相干断层扫描血管造影术(OCTA)比较接受雷珠单抗玻璃体内注射(IVR)和激光光凝(LP)治疗的早产儿视网膜病变儿童的黄斑区微血管结构特征。
在这项横断面研究中,共招募了 17 名儿童(28 只眼)接受 IVR 和 20 名儿童(37 只眼)接受 LP。两组行 OCTA 检查的年龄分别为 5.4±1.1 岁和 6.3±1.8 岁(p=0.07)。所有眼均进行了 3×3mm 的光谱域 OCTA 扫描。分析视网膜浅层的数据。使用 OCTA 软件(Cirrus AngioPlex 5000,Carl Zeiss,Meditec,Dubin,California,USA)测量黄斑中心无血管区(FAZ)和血管密度(包括血管长度密度(VLD)和灌注密度(PD))。通过横断面 OCT 测量中心凹视网膜厚度(CFT)。
在中心凹,IVR 患者的视网膜 VLD 和 PD 分别为 13.82±2.99mm/mm 和 0.25±0.05mm/mm,明显低于 LP 组(15.64±2.71mm/mm 和 0.28±0.05mm/mm,p=0.01 和 p=0.006)。IVR 和 LP 患者的 FAZ 面积分别为 0.13±0.09mm 和 0.09±0.07mm(p=0.048)。IVR 和 LP 患者的 CFT 分别为 200.7±16.7µm 和 220.9±22.7µm(p<0.01)。IVR 和 LP 患者最小分辨角视力对数矫正的最佳视力分别为 0.2±0.1 和 0.1±0.1(p=0.01)。两组间旁中心区和中心区 VLD、PD、FAZ 形态指数和等效球镜度(SER)无显著差异。
IVR 可能导致黄斑区微血管发生变化,如降低中心凹 VLD 和 PD,而 LP 可能导致微结构发生变化,如 FAZ 更小、CFT 更厚。