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采用光学相干断层扫描血管造影术定量分析儿童多系统炎症综合征(MIS-C)的眼部微血管变化。

Quantitative analysis of preclinical ocular microvascular changes in Multisystemic Inflammatory Syndrome in Children (MIS-C) detected by optical coherence tomography angiography.

机构信息

Kocaeli University, Department of Ophthalmology, Kocaeli, Turkey.

Kocaeli University, Division of Pediatrics, Department of Pediatric Rheumatology, Kocaeli, Turkey.

出版信息

Eye (Lond). 2023 Feb;37(3):566-573. doi: 10.1038/s41433-022-02081-8. Epub 2022 Apr 29.

Abstract

OBJECTIVES

To evaluate the macular and optic nerve head (ONH) vascular density, foveal avascular zone area, and outer retina and choriocapillaris flow in Multisystemic Inflammatory Syndrome in Children (MIS-C) using optical coherence tomography angiography (OCTA).

METHODS

Thirty-four eyes of 34 patients with MIS-C and 36 age and sex-matched healthy controls were investigated in this prospective, cross-sectional study. The superficial capillary plexus (SCP) and deep capillary plexus (DCP), ONH, FAZ parameters, the flow area of the outer retina, and choriocapillaris were evaluated using OCTA.

RESULTS

All VD parameters in SCP were significantly lower in MIS-C patients. There was no significant difference between the groups in VD parameters of both DCP and ONH, as well as FAZ area and FAZ perimeter. However, foveal density (FD-300) was significantly decreased in the MIS-C group. (p = 0.024). The outer retina flow area at 1 mm, 2 mm, and 3 mm radius and CC flow area at 1 mm and 2 mm radius were significantly lower in the MIS-C group than in the control group. Although CC flow area at 3 mm radius was decreased in the MIS-C group compared to healthy controls, the difference was not statistically significant.

CONCLUSIONS

We demonstrated a decreased vessel density in SCP, choriocapillaris flow area, and outer retinal flow area in MIS-C patients. Hence, we proposed that OCTA could reveal retinal and choroidal microvascular changes in MIS-C patients who were completely healthy before the diagnosis of MIS-C.

摘要

目的

使用光学相干断层扫描血管造影术(OCTA)评估儿童多系统炎症综合征(MIS-C)的黄斑和视神经头(ONH)血管密度、中心凹无血管区面积以及外层视网膜和脉络膜毛细血管血流。

方法

本前瞻性、横断面研究共纳入 34 例 MIS-C 患者的 34 只眼和 36 名年龄和性别匹配的健康对照者。使用 OCTA 评估浅层毛细血管丛(SCP)和深层毛细血管丛(DCP)、ONH、FAZ 参数、外层视网膜和脉络膜的血流面积。

结果

MIS-C 患者的 SCP 中所有血管密度(VD)参数均显著降低。两组间 DCP 和 ONH 的 VD 参数以及 FAZ 面积和 FAZ 周长均无显著差异。然而,MIS-C 组的黄斑中心凹密度(FD-300)显著降低(p=0.024)。MIS-C 组 1mm、2mm 和 3mm 半径处的外层视网膜血流面积和 1mm 和 2mm 半径处的脉络膜毛细血管血流面积均显著低于对照组。尽管与健康对照组相比,MIS-C 组的 3mm 半径处脉络膜毛细血管血流面积减少,但差异无统计学意义。

结论

我们发现 MIS-C 患者的 SCP 血管密度、脉络膜毛细血管血流面积和外层视网膜血流面积降低。因此,我们提出 OCTA 可以揭示在 MIS-C 诊断前完全健康的 MIS-C 患者的视网膜和脉络膜微血管变化。

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