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视网膜脱离手术后微血管变化与视力预后的关系。

Association of Microvasculature Changes with Visual Outcomes after Successful Retinal Detachment Surgery.

机构信息

Department of Ophthalmology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.

Department of Biostatistics and Data Management, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandœuvre-lès-Nancy, France.

出版信息

Ophthalmol Retina. 2022 Oct;6(10):886-892. doi: 10.1016/j.oret.2022.04.020. Epub 2022 May 4.

Abstract

PURPOSE

To evaluate macular microvascular changes and their correlation with visual outcomes after rhegmatogenous retinal detachment (RRD) surgery.

DESIGN

Retrospective case series.

PARTICIPANTS

The study included 74 eyes successfully operated for RRD.

METHODS

The foveal avascular zone area in the superficial capillary plexus, the vessel density (VD) in the superficial capillary plexus, vessel density deep capillary plexus (VD DCP), and choriocapillary plexus were evaluated using octangiography at 1 and 6 months postoperatively. The fellow eyes were used as controls for comparison.

MAIN OUTCOME MEASURES

The correlation between octangiography parameters and postoperative best-corrected visual acuity (BCVA) was assessed using a hybrid linear mixed model. We also analyzed the relationship between octangiography parameters and the integrity of the external limiting membrane (ELM) and ellipsoid zone (EZ) of photoreceptors.

RESULTS

The median VD DCP was significantly decreased in RRD eyes at 1 month (P = 0.019), but gradually improved over time to reach the value of the fellow eyes at 6 months (P = 1). There was no significant difference between the 2 groups in median foveal avascular zone area, superficial capillary plexus, and choriocapillary plexus (P = 0.579, P = 0.618, P = 0.068 and P = 0.819, P = 1, and P = 1, respectively) at both 1 and 6 months postoperatively. Postoperative BCVA was positively correlated with VD DCP (P = 0.009) in multivariate analysis. Eyes with low 1-month VD DCP tended to have worse final BCVA (P = 0.067). There was no correlation between VD DCP and ELM and/or EZ integrity at both 1 (P = 0.156) and 6 months postoperatively (P = 0.161). Eyes with intact ELM and EZ at 6 months, however, had significantly higher 1-month VD DCP than those with disrupted ELM and/or EZ (P = 0.027).

CONCLUSION

The VD DCP was affected in RRD eyes as well as strongly associated with postoperative BCVA and the restoration of photoreceptor layers. It might thus serve as a predictor for visual recovery following successful RRD surgery.

摘要

目的

评估孔源性视网膜脱离(RRD)手术后黄斑微血管变化及其与视力结果的相关性。

设计

回顾性病例系列。

参与者

本研究纳入 74 只成功接受 RRD 手术的眼。

方法

使用 OCT 血管造影术在术后 1 个月和 6 个月评估浅层毛细血管丛的中心无血管区面积、浅层毛细血管丛的血管密度(VD)、深层毛细血管丛的血管密度(VD DCP)和脉络膜毛细血管丛。对侧眼用作对照进行比较。

主要观察指标

采用混合线性混合模型评估 OCT 血管造影参数与术后最佳矫正视力(BCVA)之间的相关性。我们还分析了 OCT 血管造影参数与外部限制膜(ELM)和光感受器椭圆体区(EZ)完整性之间的关系。

结果

RRD 眼在术后 1 个月时 VD DCP 中位数显著降低(P=0.019),但随时间逐渐改善,6 个月时达到对侧眼水平(P=1)。术后 1 个月和 6 个月时,两组间中心无血管区面积、浅层毛细血管丛和脉络膜毛细血管丛的 VD DCP 中位数差异均无统计学意义(P=0.579,P=0.618,P=0.068,P=0.819,P=1,P=1)。多元分析显示,术后 BCVA 与 VD DCP 呈正相关(P=0.009)。1 个月时 VD DCP 较低的眼最终 BCVA 较差的趋势(P=0.067)。术后 1 个月(P=0.156)和 6 个月(P=0.161)时,VD DCP 与 ELM 和/或 EZ 完整性均无相关性。然而,6 个月时 ELM 和 EZ 完整的眼 1 个月时 VD DCP 显著高于 ELM 和/或 EZ 中断的眼(P=0.027)。

结论

RRD 眼的 VD DCP 受到影响,与术后 BCVA 和光感受器层的恢复密切相关。因此,它可能成为成功 RRD 手术后视力恢复的预测指标。

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