Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2023 Feb;37(1):62-69. doi: 10.3341/kjo.2022.0081. Epub 2023 Feb 3.
To investigate the effect of blunt ocular trauma (BOT) on foveal circulation, and in particular the foveal avascular zone (FAZ), using optical coherence tomography angiography (OCTA).
This retrospective study consisted of 96 eyes (48 traumatized eyes and 48 nontraumatized eyes) from 48 subjects with BOT. We analyzed the FAZ area of deep capillary plexus (DCP) and superficial capillary plexus (SCP) immediately after BOT and at 2 weeks after BOT. We also evaluated the FAZ area of DCP and SCP in patients with and without blowout fracture (BOF).
There were no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP in the initial test. In traumatized eyes, the FAZ area at SCP was significantly reduced on follow-up when compared to initial test (p = 0.01). In case of eyes with BOF, there was no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP on initial test. No significant difference of FAZ area was found on follow-up relative to the initial test, whether in the DCP or SCP. In case of eyes without BOF, there was no significant differences of FAZ area between traumatized and nontraumatized eyes at DCP and SCP in initial test. Also, no significant difference of FAZ area at DCP was found on follow-up test compared to initial test. However, the FAZ area at SCP was significantly reduced in follow-up test compared with that in the initial test (p = 0.04).
Temporary microvascular ischemia occurs in the SCP of patients after BOT. Patients should be warned of transient ischemic changes that may occur after trauma. OCTA can provide useful information regarding the subacute changes in the FAZ at SCP after BOT, even without evident findings of structural damage on fundus examination.
利用光相干断层扫描血管造影术（OCTA）研究钝挫伤性眼外伤（BOT）对黄斑中心凹循环的影响，特别是黄斑中心凹无血管区（FAZ）。
本回顾性研究纳入了 48 例 BOT 患者的 96 只眼（48 只伤眼和 48 只未伤眼）。我们分析了伤后即刻和伤后 2 周时深层毛细血管丛（DCP）和浅层毛细血管丛（SCP）的 FAZ 面积。我们还评估了伴有和不伴有爆裂性眼眶骨折（BOF）的患者的 DCP 和 SCP 的 FAZ 面积。
在初始检查时，伤眼和未伤眼的 DCP 和 SCP 的 FAZ 面积无显著差异。在伤眼中，与初始检查相比，SCP 的 FAZ 面积在随访时显著减小（p = 0.01）。在伴有 BOF 的眼中，在初始检查时，伤眼和未伤眼的 DCP 和 SCP 的 FAZ 面积无显著差异。无论是在 DCP 还是 SCP，随访时与初始检查相比，FAZ 面积均无显著差异。在不伴有 BOF 的眼中，在初始检查时，伤眼和未伤眼的 DCP 和 SCP 的 FAZ 面积无显著差异。同样，与初始检查相比，随访时 DCP 的 FAZ 面积无显著差异。然而，SCP 的 FAZ 面积在随访时明显小于初始检查（p = 0.04）。
BOT 后患者的 SCP 出现短暂性微血管缺血。应警告患者注意创伤后可能发生的短暂性缺血性改变。即使在眼底检查未发现明显结构损伤的情况下，OCTA 也可以提供关于 BOT 后 SCP 黄斑中心凹无血管区亚急性变化的有用信息。
