Koca Semra, Bozkurt Erhan, Dogan Mustafa, Yavasoglu Filiz, Erogul Özgür, Bulut Ayten Kocaman
Department of Ophthalmology, Kayseri City Education and Research Hospital, Kocasinan/Kayseri, Turkey.
Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
Klin Monbl Augenheilkd. 2023 Jan;240(1):92-98. doi: 10.1055/a-1738-9941. Epub 2022 Mar 23.
To evaluate the macular and optic disc vascular changes in vitamin B12 deficiency anemia.
A total of 24 patients with vitamin B12 deficiency anemia and 24 healthy controls were involved in this study. All participants were evaluated for central macular thickness (CMT), peripapillary retina nerve fiber layer (RNFL) thickness, foveal avascular zone (FAZ) area, macular vessel density (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP), choriocapillaris flow area, and optic disc radial peripapillary capillary (RPC) VD using optic coherence tomography (OCT) and optic coherence tomography angiography (OCTA). Metabolic parameters were also noted.
Temporal RNFL thickness significantly decreased in the B12 deficiency anemia group (p = 0.04). Choriocapillaris flow area (p = 0.045) and macular vessel density in both SCP (p = 0.022) and DCP (p = 0.018) markedly declined in the study group. Optic disc RPC VD in the B12 deficiency anemia group was lower in all regions compared to that of the control group, but the difference was not statistically significant (p > 0.05). There were significant positive correlations between choriocapillaris flow area, macular VD, vitamin B12, and hemoglobin.
Retinal vascular alterations were observed in B12 deficiency anemia, and OCTA may be beneficial in the diagnosis and follow-up of ocular complications in these cases.
评估维生素B12缺乏性贫血患者黄斑和视盘的血管变化。
本研究纳入了24例维生素B12缺乏性贫血患者和24名健康对照者。所有参与者均使用光学相干断层扫描(OCT)和光学相干断层扫描血管造影(OCTA)评估中心黄斑厚度(CMT)、视乳头周围视网膜神经纤维层(RNFL)厚度、黄斑无血管区(FAZ)面积、浅表毛细血管丛(SCP)和深部毛细血管丛(DCP)的黄斑血管密度(VD)、脉络膜毛细血管血流面积以及视盘放射状视乳头周围毛细血管(RPC)VD。同时记录代谢参数。
维生素B12缺乏性贫血组颞侧RNFL厚度显著降低(p = 0.04)。研究组脉络膜毛细血管血流面积(p = 0.045)以及SCP(p = 0.022)和DCP(p = 0.018)的黄斑血管密度均明显下降。维生素B12缺乏性贫血组视盘RPC VD在所有区域均低于对照组,但差异无统计学意义(p > 0.05)。脉络膜毛细血管血流面积、黄斑VD、维生素B12和血红蛋白之间存在显著正相关。
维生素B12缺乏性贫血患者存在视网膜血管改变,OCTA可能有助于这些病例眼部并发症的诊断和随访。