甲状腺相关眼病的脉络膜毛细血管减少：关注伴有和不伴有视盘水肿的脉络膜视网膜皱褶。
Decreased macular choriocapillaris in thyroid-associated ophthalmopathy: focusing on chorioretinal folds with and without optic disc edema.
机构信息
Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
出版信息
Front Endocrinol (Lausanne). 2023 Apr 21;14:1123820. doi: 10.3389/fendo.2023.1123820. eCollection 2023.
PURPOSE
The aim of this study was to evaluate the vessel density (VD) of the macular choriocapillaris (CC) and retina in thyroid-associated ophthalmopathy (TAO) patients with chorioretinal folds (CRFs) with and without optic disc edema (ODE) and the correlations of these characteristics with visual function.
METHOD
This was a cross-sectional study. Twenty TAO patients with CRFs (35 eyes) and 20 normal subjects (normal group, 40 eyes) were recruited at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from March 2018 to October 2022. Then, CRF patients were divided into two groups, the ODE and non-ODE groups (NODE), based on the presence or absence of ODE. All the patients underwent optical coherence tomography angiography (OCTA) and the VD of the macular CC and retina was computed. The correlation of VD and visual function was analyzed.
RESULTS
Compared with the normal group, the macular whole-image VD in the retinal superficial layer (SLR-mwiVD: 49.82 ± 3.38 in the normal group, 42.44 ± 5.40 in the NODE group, and 42.51 ± 5.37 in the ODE group), deep layer (DLR-mwiVD: 51.05 ± 6.23 in the normal group, 45.71 ± 6.66 in the NODE group, and 46.31 ± 5.48 in the ODE group), and CC (CC-mwiVD: 70.23 ± 2.47 in the normal group, 68.04 ± 3.73 in the NODE group, and 63.09 ± 6.51 in the ODE group) was decreased in the NODE (all < 0.05) and ODE group (all < 0.01). There was no difference in these parameters except CC-mwiVD between the ODE and NODE groups. The CC-mwiVD in the ODE group (63.09 ± 6.51) was significantly reduced compared with that in the NODE group (68.04 ± 3.73, = 0.004). All these VD parameters were negatively correlated with BCVA, VF-PSD, and P100 latency and positively associated with VF-MD, P100 amplitude, and HRR scores (all < 0.05).
CONCLUSIONS
There was a significant decrease in the VD of the macular CC and retina of patients with CRFs with or without ODE, which was correlated with visual dysfunction. The VD of the macular CC in CRF patients with ODE was significantly reduced compared with that in the NODE group, but similar results were not observed in the retina.
目的
本研究旨在评估伴有或不伴有视盘水肿（ODE）的甲状腺相关眼病（TAO）患者的脉络膜视网膜皱褶（CRF）患者黄斑脉络膜毛细血管（CC）和视网膜的血管密度（VD），以及这些特征与视觉功能的相关性。
方法
这是一项横断面研究。2018 年 3 月至 2022 年 10 月，中山大学孙逸仙纪念医院眼科部门招募了 20 名 TAO 伴 CRF 患者（35 只眼）和 20 名正常对照者（正常组，40 只眼）。然后，根据是否存在 ODE，将 CRF 患者分为 ODE 组和非 ODE 组（NODE 组）。所有患者均行光学相干断层扫描血管造影（OCTA）检查，并计算黄斑 CC 和视网膜的 VD。分析 VD 与视觉功能的相关性。
结果
与正常组相比，视网膜浅层全像 VD（SLR-mwiVD：正常组为 49.82 ± 3.38，NODE 组为 42.44 ± 5.40，ODE 组为 42.51 ± 5.37）、深层全像 VD（DLR-mwiVD：正常组为 51.05 ± 6.23，NODE 组为 45.71 ± 6.66，ODE 组为 46.31 ± 5.48）和 CC 全像 VD（CC-mwiVD：正常组为 70.23 ± 2.47，NODE 组为 68.04 ± 3.73，ODE 组为 63.09 ± 6.51）在 NODE 组（均<0.05）和 ODE 组（均<0.01）均降低。除 CC-mwiVD 外，ODE 组和 NODE 组之间的这些参数没有差异。ODE 组的 CC-mwiVD（63.09 ± 6.51）明显低于 NODE 组（68.04 ± 3.73， = 0.004）。所有这些 VD 参数与 BCVA、VF-PSD 和 P100 潜伏期呈负相关，与 VF-MD、P100 幅度和 HRR 评分呈正相关（均<0.05）。
结论
伴有或不伴有 ODE 的 CRF 患者黄斑 CC 和视网膜的 VD 显著降低，与视觉功能障碍有关。伴有 ODE 的 CRF 患者黄斑 CC 的 VD 明显低于 NODE 组，而视网膜未见类似结果。
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