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早产儿视网膜病变的血管影像学表现。

Vascular imaging findings in retinopathy of prematurity.

机构信息

Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Department of Ophthalmology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA.

出版信息

Acta Ophthalmol. 2024 Jun;102(4):e452-e472. doi: 10.1111/aos.15800. Epub 2023 Oct 24.

Abstract

Retinopathy of prematurity (ROP) is a vascular disease among preterm infants involving incomplete or abnormal retinal vascularization and is a leading cause of preventable blindness globally. Measurements of ocular blood flow originating from a variety of imaging modalities, including colour Doppler imaging (CDI), fluorescein angiography (FA) and ocular coherence tomography angiography (OCTA), have been associated with changes in ROP patients. Herein, we discuss and summarize the relevant current literature on vascular imaging and ROP reviewed through December 2022. Differences in vascular imaging parameters between ROP patients and healthy controls are reviewed and summarized. The available data identify significantly increased peak systolic velocity (PSV) in the central retinal artery and ophthalmic artery as measured by CDI, increased vascular tortuosity as measured by FA, smaller foveal avascular zone (FAZ) as measured by FA and OCTA, and increased foveal vessel density (VD) and reduced parafoveal VD as measured by OCTA in ROP patients compared with controls. None of the above findings appear to reliably correlate with visual acuity. The studies currently available, however, are inconclusive and lack robust longitudinal data. Vascular imaging demonstrates the potential to aid in the diagnosis, management and monitoring of ROP, alongside retinal examination via indirect ophthalmoscopy and fundus photography.

摘要

早产儿视网膜病变(ROP)是一种早产儿血管疾病,涉及视网膜血管的不完全或异常发育,是全球可预防失明的主要原因。来自各种成像方式的眼血流测量,包括彩色多普勒成像(CDI)、荧光素血管造影(FA)和眼部相干断层扫描血管造影(OCTA),与 ROP 患者的变化有关。在此,我们讨论并总结了截至 2022 年 12 月关于血管成像和 ROP 的相关文献。我们综述并总结了 ROP 患者与健康对照组之间血管成像参数的差异。CDI 测量的中央视网膜动脉和眼动脉收缩期峰值流速(PSV)增加,FA 测量的血管迂曲度增加,FA 和 OCTA 测量的中心凹无血管区(FAZ)减小,FA 和 OCTA 测量的中心凹血管密度(VD)增加,旁中心凹 VD 减少,这些都表明 ROP 患者与对照组相比存在差异。上述发现似乎都与视力无法可靠相关。然而,目前的研究尚无定论,且缺乏强有力的纵向数据。血管成像显示有潜力通过间接检眼镜和眼底摄影的视网膜检查来辅助 ROP 的诊断、管理和监测。

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