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利用光学相干断层扫描血管造影术对免疫球蛋白A肾病患者黄斑和视盘微血管参数进行定量分析。

Quantitative analysis of macular and optic disc microvascular parameters in patients with immunoglobulin A nephropathy using optical coherence tomography angiography.

作者信息

Qiu Chen, Wu Guihong, Zhang Xueqin, Kang Ting, Zhang Dongmei, Cao Mengxia, Zeng Shuhan, Wang Rui, Yao Tianyu, Chen Jie, Ou Santao, He Yue

机构信息

Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

出版信息

Quant Imaging Med Surg. 2025 Sep 1;15(9):7803-7819. doi: 10.21037/qims-24-2113. Epub 2025 Aug 19.

Abstract

BACKGROUND

Immunoglobulin A nephropathy (IgAN) is a common chronic glomerulonephritis. The kidneys and eyes have structural and developmental similarities, but ocular microvascular changes in IgAN, especially in the macular and optic disc, are poorly studied. This study aimed to assess these microvascular parameters in IgAN patients using optical coherence tomography (OCT) and OCT angiography (OCTA) and explore their associations with clinical data.

METHODS

This is a case-control study. Fifteen patients with IgAN and 15 healthy controls (HCs) who attended The Affiliated Hospital of Southwest Medical University between July 2022 and December 2023 were selected. OCT and OCTA were used to assess macular thickness, retinal nerve fiber layer (RNFL) thickness, the vascular density (VD) and perfusion density (PD) of macular and optic disc, and foveal avascular zone (FAZ). In addition, we analyzed the association between OCT and OCTA parameters and clinical data in patients with IgAN.

RESULTS

VD and PD were significantly lower in the macular area in the IgAN group than the HCs (VD: 18.270±0.683 18.943±0.357, P<0.001; PD: 0.447±0.019 0.464±0.009, P<0.001). VD and PD in the macular area were negatively correlated with urine protein levels (VD: ρ=-0.604, P=0.017; PD: ρ=-0.551, P=0.033) and urine microalbumin levels (VD: ρ=-0.762, P=0.001; PD: ρ=-0.751, P=0.001). The FAZ area was positively correlated with 24-h urine volume (ρ=0.651, P=0.009).

CONCLUSIONS

Compared with HCs, the status of macular microcirculation in the IgAN group was significantly decreased, and some microvascular parameters were significantly correlated with the clinical data.

摘要

背景

免疫球蛋白A肾病(IgAN)是一种常见的慢性肾小球肾炎。肾脏和眼睛在结构和发育上具有相似性,但IgAN患者的眼部微血管变化,尤其是黄斑和视盘处的变化,研究较少。本研究旨在使用光学相干断层扫描(OCT)和OCT血管造影(OCTA)评估IgAN患者的这些微血管参数,并探讨它们与临床数据的关联。

方法

这是一项病例对照研究。选取了2022年7月至2023年12月期间在西南医科大学附属医院就诊的15例IgAN患者和15例健康对照者(HCs)。使用OCT和OCTA评估黄斑厚度、视网膜神经纤维层(RNFL)厚度、黄斑和视盘的血管密度(VD)和灌注密度(PD)以及中心凹无血管区(FAZ)。此外,我们分析了IgAN患者的OCT和OCTA参数与临床数据之间的关联。

结果

IgAN组黄斑区的VD和PD显著低于HCs(VD:18.270±0.683对18.943±0.357,P<0.001;PD:0.447±0.019对0.464±0.009,P<0.001)。黄斑区的VD和PD与尿蛋白水平呈负相关(VD:ρ=-0.604,P=0.017;PD:ρ=-0.551,P=0.033)以及尿微量白蛋白水平呈负相关(VD:ρ=-0.762,P=0.001;PD:ρ=-0.751,P=0.001)。FAZ面积与24小时尿量呈正相关(ρ=0.651,P=0.009)。

结论

与HCs相比,IgAN组黄斑微循环状态显著降低,且一些微血管参数与临床数据显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3108/12397639/a0c4337025e5/qims-15-09-7803-f1.jpg

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