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使用光学相干断层扫描血管造影术评估白内障超声乳化手术后视神经乳头血管密度变化

Evaluation of optic nerve head vessels density changes after phacoemulsification cataract surgery using optical coherence tomography angiography.

作者信息

Zhu Ze-Hui, Zhao Yin-Ying, Zou Rui, Zou Han, Fang Jia-Yan, Chang Ping-Jun, Zhao Yun-E

机构信息

Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.

National Clinical Research Center for Ocular Diseases, Wenzhou 325000, Zhejiang Province, China.

出版信息

Int J Ophthalmol. 2023 Jun 18;16(6):884-890. doi: 10.18240/ijo.2023.06.08. eCollection 2023.

Abstract

AIM

To evaluate optic nerve head (ONH) vessel density (VD) changes after cataract surgery using optical coherence tomography angiography (OCTA).

METHODS

This was a prospective observational study. Thirty-four eyes with mild/moderate cataracts were included. ONH scans were obtained before and 3mo after cataract surgery using OCTA. Radial peripapillary capillary (RPC) density, all VD, large VD and retinal nerve fiber layer thickness (RNFLT) in total disc, inside disc, and different peripapillary sectors were assessed and analyzed. Image quality score (QS), fundus photography grading and best-corrected visual acuity (BCVA) were also collected, and correlation analyses were performed between VD change and these parameters.

RESULTS

Compared with baseline, both RPC and all VD increased in inside disc area 3mo postoperatively (from 47.5%±5.3% to 50.2%±3.7%, and from 57.87%±4.30% to 60.47%±3.10%, all <0.001), but no differences were observed in peripapillary area. However, large VD increased from 5.63%±0.77% to 6.47%±0.72% in peripapillary ONH region (<0.001). RPC decreased in inferior and superior peripapillary ONH parts (=0.019, <0.001 respectively). There were obvious negative correlations between RPC change and large VD change in inside disc, superior-hemi, and inferior-hemi (=-0.419, -0.370, and -0.439, =0.017, 0.044, and 0.015, respectively). No correlations were found between VD change and other parameters including QS change, fundus photography grading, postoperative BCVA, and postoperative peripapillary RNFLT.

CONCLUSION

RPC density and all VD in the inside disc ONH region increase 3mo after surgery in patients with mild to moderate cataract. No obvious VD changes are found in peripapillary area postoperatively.

摘要

目的

使用光学相干断层扫描血管造影(OCTA)评估白内障手术后视神经乳头(ONH)血管密度(VD)的变化。

方法

这是一项前瞻性观察研究。纳入34只患有轻度/中度白内障的眼睛。在白内障手术前和术后3个月使用OCTA对视神经乳头进行扫描。评估并分析视盘周围放射状毛细血管(RPC)密度、总血管密度、大血管密度以及视盘整体、视盘内部和不同视盘周围区域的视网膜神经纤维层厚度(RNFLT)。还收集了图像质量评分(QS)、眼底照相分级和最佳矫正视力(BCVA),并对VD变化与这些参数进行相关性分析。

结果

与基线相比,术后3个月视盘内部区域的RPC和总血管密度均增加(分别从47.5%±5.3%增至50.2%±3.7%,以及从57.87%±4.30%增至60.47%±3.10%,均P<0.001),但视盘周围区域未观察到差异。然而,视盘周围ONH区域的大血管密度从5.63%±0.77%增至6.47%±0.72%(P<0.001)。视盘周围ONH的下方和上方部分RPC降低(分别P=0.019,P<0.001)。视盘内部、上方半区和下方半区的RPC变化与大血管密度变化之间存在明显的负相关(分别r=-0.419,-0.370和-0.439,P=0.017,0.044和0.015)。未发现VD变化与其他参数之间存在相关性,包括QS变化、眼底照相分级、术后BCVA和术后视盘周围RNFLT。

结论

轻度至中度白内障患者术后3个月视盘内部ONH区域的RPC密度和总血管密度增加。术后视盘周围区域未发现明显的VD变化。

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