使用光学相干断层扫描血管造影术对Leber遗传性视神经病变患者视网膜微血管进行定量评估及其与视力的相关性研究

Quantitative assessment of retinal microvasculature using optical coherence tomography angiography and correlation with visual acuity in leber's hereditary optic neuropathy.

作者信息

Zhao Qi, Ma Ya, Zhou Xiao, Wang Ruikang, Yang Wenli, Peng Xiaoyan, Wei Wenbin

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Key Laboratory of Intelligent Diagnosis, Treatment and Prevention of Blinding Eye Diseases, Capital Medical University, Beijing, 100730, China.

Beijing Aier Eye Hospital, Beijing, 100101, China.

出版信息

Int Ophthalmol. 2025 Sep 6;45(1):376. doi: 10.1007/s10792-025-03619-x.

DOI:10.1007/s10792-025-03619-x

PMID:40913669

Abstract

PURPOSE

To analyze macular microvascular networks and investigate correlations between visual acuity and quantitative parameters in patients with Leber's hereditary optic neuropathy (LHON) using optical coherence tomography angiography (OCTA).

METHODS

An observational, cross-sectional study was conducted, including 25 eyes from 25 genetically confirmed chronic LHON patients and 25 eyes from 25 age-matched healthy controls. Images were obtained using a spectral domain OCTA system. Student's t-test for independent variables was employed to compare continuous variables between the LHON and control groups. Pearson correlation coefficients were calculated to analyze the correlation between best-corrected visual acuity (BCVA) and OCTA parameters, which included vessel area density (VAD), vessel skeleton density (VSD), vessel diameter index (VDI), vessel complexity index (VCI), flux, foveal avascular zone (FAZ) parameters, and the thickness of the general ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) in LHON patients.

RESULTS

LHON eyes exhibited significant reductions in VAD, VSD, and flux across all sectors in the foveal region. VAD, VSD, VCI, and flux decreased in all sectors, while VDI increased in all sectors except the temporal sector in the parafovea, based on the traditional four sectors. In the six sectors matched with the GCC, VAD, VSD, and flux decreased in all sectors; VDI increased in the superonasal, inferior, and inferotemporal sector, while VCI decreased except in the inferotemporal sector. The circularity of FAZ decreased. BCVA was correlated with VAD in the inferotemporal, inferior, and inferonasal sector, VSD in all sectors, and GCC thickness only in the inferonasal sector.

CONCLUSION

LHON is characterized by diffuse impairment of the retinal microvasculature, predominantly affecting the macular region and corresponding to the papillomacular bundle. Furthermore, BCVA demonstrated significant correlations with retinal blood flow and structural parameters.

摘要

目的

使用光学相干断层扫描血管造影（OCTA）分析Leber遗传性视神经病变（LHON）患者的黄斑微血管网络，并研究视力与定量参数之间的相关性。

方法

进行了一项观察性横断面研究，包括来自25例基因确诊的慢性LHON患者的25只眼和来自25例年龄匹配的健康对照者的25只眼。使用光谱域OCTA系统获取图像。采用独立变量的学生t检验比较LHON组和对照组之间的连续变量。计算Pearson相关系数以分析最佳矫正视力（BCVA）与OCTA参数之间的相关性，这些参数包括血管面积密度（VAD）、血管骨架密度（VSD）、血管直径指数（VDI）、血管复杂性指数（VCI）、血流量、黄斑无血管区（FAZ）参数，以及LHON患者的总体神经节细胞复合体（GCC）和视网膜神经纤维层（RNFL）的厚度。

结果

LHON患眼在黄斑区所有象限的VAD、VSD和血流量均显著降低。基于传统的四个象限，所有象限的VAD、VSD、VCI和血流量均降低，而除黄斑旁颞侧象限外，所有象限的VDI均升高。在与GCC匹配的六个象限中，所有象限的VAD、VSD和血流量均降低；鼻上、下方和颞下方象限的VDI升高，而除颞下方象限外，VCI降低。FAZ的圆形度降低。BCVA与颞下方象限、下方象限和鼻下方象限的VAD、所有象限的VSD以及仅鼻下方象限的GCC厚度相关。