光学相干断层扫描血管造影在慢性缺血性视网膜病变黄斑区毛细血管血流变化诊断中的应用

[Optical coherence tomography angiography in diagnosis of changes in macular capillary blood flow in chronic ischemic retinopathy].

作者信息

Tuzlaev V V, Kolenko O V, Egorov V V, Kravchenko I Z, Smolyakova G P, Yarovaya A V, Breev D V

机构信息

Khabarovsk branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Khabarovsk, Russia.

Postgraduate Institute for Public Health Workers, Khabarovsk, Russia.

出版信息

Vestn Oftalmol. 2023;139(2):17-27. doi: 10.17116/oftalma202313902117.

DOI:10.17116/oftalma202313902117

PMID:37067928

Abstract

PURPOSE

Assessment of the indices of macular capillary blood flow and subfoveal choroidal thickness (SCT) using optical coherence tomography angiography in patients with retinal manifestations of ocular ischemic syndrome (RMOIS) associated with atherosclerotic internal carotid artery stenosis.

MATERIAL AND METHODS

The study included 34 patients (68 eyes): 21 men, 13 women with RMOIS in one eye. All patients were divided into 2 groups depending on the severity of atherosclerotic internal carotid artery stenosis and ophthalmoscopic picture of the fundus. To obtain objective information we analyzed the degree of decrease in the main indices characterizing macular microcirculation and SCT depending on the severity of RMOIS.

RESULTS AND DISCUSSION

Analysis of the results showed relationship between the severity of RMOIS and the deficit in macular microcirculation. The macula of the patients with mild RMOIS was characterized by a decrease in the density of superficial vascular plexus (SVP) and the density of deep capillary plexus (DCP) by 13.5% and 10.5% compared to the controls, respectively; in moderate RMOIS - by 19.7% and 14.6%; in severe RMOIS - by 35.9% and 28%, respectively. With an increase in the severity of RMOIS, the area of the foveal avascular zone increased too: in mild degree RMOIS - by 19%, in moderate - by 38.6%, in severe - by 51%. In proportion to the severity of RMOIS, SCT was reduced: in mild degree RMOIS - by only 8%, in moderate - by 22%, and in severe - by 29.8% of the control.

CONCLUSION

The conducted research indicates that pathological changes in RMOIS extend to the entire capillary network of the macula and SCT. With increase in the degree of RMOIS, ischemic changes in all capillary layers of the central parts of the retina proportionally increase in comparison with the control group by 1.15 times in mild degree, by 1.24 times in moderate degree, and by 1.5 times in severe RMOIS.

摘要

目的

利用光学相干断层扫描血管造影术评估伴有动脉粥样硬化性颈内动脉狭窄的眼部缺血综合征视网膜表现（RMOIS）患者的黄斑区毛细血管血流指数和中心凹下脉络膜厚度（SCT）。

材料与方法

该研究纳入34例患者（68只眼）：21例男性，13例女性，均为单眼患有RMOIS。所有患者根据动脉粥样硬化性颈内动脉狭窄的严重程度和眼底检眼镜图像分为2组。为获取客观信息，我们分析了根据RMOIS严重程度表征黄斑微循环和SCT的主要指标的下降程度。

结果与讨论

结果分析显示RMOIS的严重程度与黄斑微循环缺陷之间存在关联。轻度RMOIS患者的黄斑区，其浅表血管丛（SVP）密度和深层毛细血管丛（DCP）密度相较于对照组分别降低了13.5%和10.5%；中度RMOIS患者中，分别降低了19.7%和14.6%；重度RMOIS患者中，分别降低了35.9%和28%。随着RMOIS严重程度的增加，中心凹无血管区面积也增加：轻度RMOIS时增加19%，中度时增加38.6%，重度时增加51%。与RMOIS严重程度成比例，SCT降低：轻度RMOIS时仅降低8%，中度时降低22%，重度时降低29.8%（相对于对照组）。