弱视眼视网膜微血管特征分析：一项荟萃分析。

Analysis of Retinal Microvasculature Features in Amblyopic Eyes: A Meta-Analysis.

机构信息

Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China.

出版信息

Ophthalmic Res. 2023;66(1):131-143. doi: 10.1159/000526531. Epub 2022 Aug 23.

DOI:10.1159/000526531

PMID:35998587

Abstract

BACKGROUND

Amblyopia is a common cause of visual disorder with several changes in retinal structure and vessel. To date, alterations in retinal microvasculature features in amblyopia have yielded inconsistent results.

OBJECTIVES

This meta-analysis aimed to evaluate retinal vessel density (VD) in amblyopic patients using optical coherence tomography angiography (OCTA).

METHODS

PubMed, Web of Science, Embase, and Cochrane Library databases were systematically searched for published articles comparing retinal microvasculature characteristics in patients with amblyopia and controls. Continuous variable outcomes were assessed using the mean difference (MD) with a 95% confidence interval. Review Manager Version 5.30 was used for the analysis.

RESULTS

Thirteen qualified articles were pooled in this meta-analysis. Compared with controls, the foveal whole en face VD of superficial capillary plexus (SCP) and deep capillary plexus (DCP) of patients as measured by 3 × 3-mm scans were significantly lower in amblyopia eyes (MD: -1.37, p = 0.0003; MD: 1.70, p < 0.00001, respectively). Similarly, in the 6 × 6-mm scans, foveal whole en face VD of the SCP and DCP were remarkably lower in amblyopia eyes than in controls (MD: -2.24, p = 0.03; MD: -5.08, p = 0.04, respectively). The parafoveal VD of SCP in 3 × 3-mm scans (MD: -1.96, p < 0.00001) was also lower in amblyopic patients than in controls. Similarly, in 6 × 6-mm scans, amblyopia eyes showed a significant decrease and a trending decrease in the parafoveal VD of the SCP (MD: -3.85, p = 0.007) and DCP (MD: -3.03, p = 0.10), respectively. For whole radial peripapillary capillary (RPC), VD was significantly reduced in amblyopic patients compared to controls (MD = -0.83, p < 0.00001). In addition, the deep foveal avascular zone (FAZ) was larger in amblyopic eyes than in the controls (MD = 0.55, p = 0.007).

CONCLUSIONS

Our data suggest that whole foveal and parafoveal VD and RPC whole VD were reduced in patients with amblyopia. Moreover, our results reveal that the FAZ is larger in amblyopic patients. Consequently, OCTA may have the potential for diagnosing and monitoring patients with amblyopia.

摘要

背景

弱视是一种常见的视觉障碍疾病，其视网膜结构和血管会发生多种变化。迄今为止，弱视患者的视网膜微血管特征变化的研究结果并不一致。

目的

本荟萃分析旨在使用光相干断层扫描血管造影术（OCTA）评估弱视患者的视网膜血管密度（VD）。

方法

系统检索 PubMed、Web of Science、Embase 和 Cochrane Library 数据库中比较弱视患者和对照组视网膜微血管特征的已发表文章。使用均数差（MD）及其 95%置信区间评估连续变量的结果。采用 Review Manager Version 5.30 进行分析。

结果

本荟萃分析共纳入 13 篇符合条件的文章。与对照组相比，3×3mm 扫描时弱视眼的浅层毛细血管丛（SCP）和深层毛细血管丛（DCP）的黄斑区全视盘 VD 显著降低（MD：-1.37，p=0.0003；MD：1.70，p<0.00001）。同样，在 6×6mm 扫描中，弱视眼的 SCP 和 DCP 的黄斑区全视盘 VD 也明显低于对照组（MD：-2.24，p=0.03；MD：-5.08，p=0.04）。3×3mm 扫描时 SCP 的旁黄斑区 VD（MD：-1.96，p<0.00001）也低于对照组。同样，在 6×6mm 扫描中，弱视眼的 SCP 和 DCP 的旁黄斑区 VD 分别呈显著下降和下降趋势（MD：-3.85，p=0.007；MD：-3.03，p=0.10）。全视盘周径毛细血管（RPC）的全径向 VD 在弱视患者中明显低于对照组（MD=-0.83，p<0.00001）。此外，弱视眼的深层黄斑无血管区（FAZ）大于对照组（MD=0.55，p=0.007）。