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基于 ATN 分类系统的近视性黄斑病变的变化:一项光相干断层扫描血管造影研究。

CHANGES IN MYOPIC MACULOPATHY BASED ON ATN CLASSIFICATION SYSTEM: An Optical Coherence Tomography Angiography Study.

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

出版信息

Retina. 2022 Apr 1;42(4):679-688. doi: 10.1097/IAE.0000000000003397.

Abstract

PURPOSE

To assess changes in myopic maculopathy based on the ATN classification system with optical coherence tomography angiography.

METHODS

This was a cross-sectional study. The macular choroidal thickness (MCT) and the choriocapillaris flow (CC) were measured with optical coherence tomography angiography. The relationship of MCT and CC with different chorioretinal atrophy (A), myopic foveoschisis (T), and myopic neovascularization (N) grades was investigated.

RESULTS

One hundred and fifty-three participates (219 eyes) were included. MCT and CC had no significant correlation with different T grades (P > 0.05). Choriocapillaris flow had a significant decrease in eyes with lacquer cracks compared with those with no neovascular maculopathy (P < 0.05) and showed a significant increase in active choroidal neovascularization compared with those with lacquer cracks (P < 0.05). Macular choroidal thickness and CC had negative correlations with different A grades (P < 0.001). MCT showed the greatest decrease in the early stage of myopic atrophic maculopathy (P < 0.001), and CC showed the most significant reduction in the late stage (P < 0.001).

CONCLUSION

Choroidal changes in the highly myopic patients were detected by optical coherence tomography angiography. Progressive ischemia in the macula may play an important role in the development of myopic atrophic maculopathy. Active choroidal neovascularization may have manifested as compensation for the decrease in MCT and CC. On the contrary, myopic traction maculopathy had little correlation with choroidal changes.

摘要

目的

通过光相干断层扫描血管造影评估基于 ATN 分类系统的近视性黄斑病变的变化。

方法

这是一项横断面研究。用光学相干断层扫描血管造影测量黄斑脉络膜厚度(MCT)和脉络膜毛细血管血流(CC)。研究了 MCT 和 CC 与不同的脉络膜视网膜萎缩(A)、近视性黄斑劈裂(T)和近视性新生血管(N)分级的关系。

结果

共纳入 153 名参与者(219 只眼)。MCT 和 CC 与不同 T 级无显著相关性(P>0.05)。与无新生血管性黄斑病变的眼相比,漆裂纹眼的脉络膜毛细血管血流明显减少(P<0.05),与漆裂纹眼相比,活跃性脉络膜新生血管的脉络膜毛细血管血流明显增加(P<0.05)。黄斑脉络膜厚度和 CC 与不同 A 级呈负相关(P<0.001)。MCT 在近视性萎缩性黄斑病变的早期阶段下降最大(P<0.001),CC 在晚期阶段下降最显著(P<0.001)。

结论

光学相干断层扫描血管造影检测到高度近视患者的脉络膜变化。黄斑区进行性缺血可能在近视性萎缩性黄斑病变的发展中起重要作用。活跃的脉络膜新生血管可能表现为对 MCT 和 CC 减少的代偿。相反,近视性牵引性黄斑病变与脉络膜变化相关性较小。

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