[1]罗嘉婧,段虎成,陈瑞,等.特发性黄斑前膜患者的光学相干断层扫描血流成像和微视野检查指标与视力的相关性[J].眼科新进展,2021,41(12):1169-1174.[doi:10.13389/j.cnki.rao.2021.0244]
 LUO Jiajing,DUAN Hucheng,CHEN Rui,et al.Correlation between measurements of optical coherence tomography angiography combined with microperimetry and visual acuity of patients with idiopathic macular epiretinal membrane[J].Recent Advances in Ophthalmology,2021,41(12):1169-1174.[doi:10.13389/j.cnki.rao.2021.0244]
点击复制

特发性黄斑前膜患者的光学相干断层扫描血流成像和微视野检查指标与视力的相关性/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年12期
页码:
1169-1174
栏目:
应用研究
出版日期:
2021-12-05

文章信息/Info

Title:
Correlation between measurements of optical coherence tomography angiography combined with microperimetry and visual acuity of patients with idiopathic macular epiretinal membrane
作者:
罗嘉婧段虎成陈瑞吕依洋吕红玲晏世刚孔祥斌宁晓梅
528000 广东省佛山市,佛山市第二人民医院眼科中心
Author(s):
LUO JiajingDUAN HuchengCHEN RuiL YiyangL HonglingYAN ShigangKONG XiangbinNING Xiaomei
Ophthalmic Center of the Second People’s Hospital of Foshan,Foshan 528000,Guangdong Province,China
关键词:
特发性黄斑前膜光学相干断层扫描血管成像微视野视网膜平均光敏感度
Keywords:
idiopathic macular epiretinal membrane optical coherence tomography angiography microperimetry mean retinal sensitivity
分类号:
R774.5
DOI:
10.13389/j.cnki.rao.2021.0244
文献标志码:
A
摘要:
目的 观察特发性黄斑前膜(IMEM)患者微视野和光学相干断层扫描血管成像(OCTA)的微血管变化及与视力的相关性。方法 横断面研究。选择2019年10月至2020年10月来我院就诊的IMEM患者37例(72眼),根据Gass分期分为A组(2期IMEM 23眼)和B组(0期、1期IMEM 25眼)及C组(健康对侧眼24眼)。另选择健康对照组13人26眼为D组。利用OCTA检测所有受试者视网膜厚度、黄斑区中心凹视网膜浅层血流密度(FSVD)、黄斑中心凹视网膜厚度(CMT)、黄斑中心凹脉络膜厚度、黄斑中心凹无血管区(FAZ)面积和FAZ 300 μm宽度内血流密度(FD-300)。微视野计检查各组受检眼黄斑中心6°范围的视觉敏感度(MS),分析不同组别受检眼OCTA检测指标、MS与视力的相关性。结果 A组患眼BCVA大于B组、C组和D组,B组大于D组;A组患眼CMT大于B组,B组大于C组、D组;5个方位视网膜厚度中央视网膜厚度A组大于B组、C组和D组,B组大于D组,上方、下方、鼻侧、颞侧视网膜厚度A组大于B组、C组和D组。5个方位MS A组小于D组。A组FSVD大于B组;各组间黄斑中心凹下脉络膜厚度无显著差异;FAZ面积A组、B组小于C组、D组;A组FD-300大于B组、C组和D组,B组大于D组。BCVA(logMAR)与视网膜中央厚度和FD-300均呈正相关(r=0.719,P<0.01;r=0.407,P<0.01),与视网膜中央MS呈负相关(r=-0.564,P<0.01),与FSVD不相关(r=0.267,P=0.066),与FAZ面积不相关(r=-0.004,P=0.978)。IMEM患眼中央、上方、颞侧、下方、鼻侧视网膜厚度与其所对应的MS均呈负相关(均为P<0.05)。结论 IMEM引起的黄斑区视网膜厚度和血流改变会导致患者视力和MS的改变。
Abstract:
Objective To explore the microvascular changes of patients with idiopathic macular epiretinal membrane (IMEM) based on microperimetry and optical coherence tomography angiography (OCTA) and their correlation with visual acuity. Methods This study was a cross-sectional study. Totally 37 patients (72 eyes) treated in our hospital from October 2019 to October 2020 and 13 healthy individuals (26 eyes) were included. All eyes were divided into group A (23 eyes of IMEM in stage 2), group B (25 eyes of IMEM in stage 0 and 1), group C (24 healthy fellow eyes), and group D (26 normal eyes of controls). The retinal thickness, foveal superficial vessel density (FSVD), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), foveal avascular zone (FAZ), and vessel density within a 300 μm-wide annulus surrounding FAZ (FD-300) were measured by OCTA. The mean sensitivity (MS) within the central 6° was measured by microperimetry. Based on these results, the correlations between the OCTA measurements, MS and the visual acuity were analyzed. Results BCVA in group A was higher than groups B, C, and D, and that in group B was higher than group D. CMT in group A was higher than group B, and that in group B was higher than groups C and D. The retinal thickness in the central, superior, inferior, nasal, and temporal sides in group A was higher than groups B, C, and D, and that in the central side in group B was higher than group D. The retinal MS in the central, superior, inferior, nasal, and temporal sides in group A was lower than group D. FSVD in group A was increased compared with group B. SFCT showed no statistically significant difference among these groups. FAZ areas in group A and B were smaller than group C and D. FD-300 in group A was higher than groups B, C, and D, and that in group B was higher than group D. The logMAR BCVA was positively correlated with CMT and FD-300 (r=0.719, P<0.01; r=0.407, P<0.01), and was negatively correlated with MS in the center of retina (r=-0.564, P<0.01). It was not correlated with FSVD (r=0.267, P=0.066) and FAZ area (r=-0.004, P=0.978). The retinal thickness in the central, superior, temporal, inferior, and nasal sides was negatively correlated with their corresponding MS (all P<0.05).Conclusion Changes in the macular retinal thickness and blood flow induced by IMEM affect patients’ visual acuity and MS.

参考文献/References:

[1] NG C H,CHEUNG N,WANG J J,ISLAM A F,KAWASAKI R,MEUER S M,et al.Prevalence and risk factors for epiretinal membranes in a multi-ethnic United States population[J].Ophthalmology,2011,118(4):694-699.
[2] 王建伟,接传红.微视野计在糖尿病视网膜病变的临床应用[J].眼科新进展,2019,39(5):486-490.
WANG J W,JIE C H.Application of microperimetry in diabetic retinopathy[J].Rec Adv Ophthalmol,2019,39(5):486-490.
[3] GASS J.Atlas of macular diseases:diagnosis and treatment[M].St Louis:Mosby,1997:760-763.
[4] LEE S M,PAK K Y,KWON H J,PARK S W,LEE J E,BYON I S.Association between tangential contraction and early vision loss in idiopathic epiretinal membrane[J].Retina,2018,38(3):541-549.
[5] DELL’OMO R,CIFARIELLO F,DELL’OMO E,DE LENA A,DI IORIO R,FILIPPELLI M,et al.Influence of retinal vessel printings on metamorphopsia and retinal architectural abnormalities in eyes with idiopathic macular epiretinal membrane[J].Invest Ophthalmol Vis Sci,2013,54(12):7803-7811.
[6] GASS J D M.Macular dysfunction caused by vitreous and vitreoretinal interface abnormalities[M].4th ed.St Louis:Mosby,1996:938-951.
[7] GAO M,WANG Y,LIU W,LIU L,YAN W,LIU J,et al.Assessment of macular function in patients with idiopathic epiretinal membrane by multifocal electroretinography:correlation with visual acuity and optical coherence tomography[J].BMC Ophthalmol,2017,17(1):221.
[8] SUH M H,SEO J M,PARK K H,YU H G.Association between macular findings by optical coherence tomography and visual outcomes after epiretinal membrane removal[J].Am J Ophthalmol,2009,147:473-480.
[9] KOFOD M,LA COUR M.Quantification of retinal tangential movement in epiretinal membranes[J].Ophthalmology,2012,119(9):1886-1891.
[10] CHEN L,LIU M,XIE A M,LIU Y.A study on change of macular retinal thickness and its relationship with vision before and after operation to idiopathic macular epiretinal membranes[J].Int J Clin Exp Med,2015,8(10):18571-18580.
[11] 梁曦达,王怡,刘丽梅,高萌,郁艳萍,王曾仪,等.特发性黄斑前膜手术前后视物变形变化及影响因素[J].中华实验眼科杂志,2019,37(1):21-28.
LIANG X D,WANG Y,LIU L M,GAO M,YU Y P,WANG Z Y,et al.Metamorphopsia change and influence factors before and after idiopathic epiretinal membrane surgery[J].Chin J Exp Ophthalmol,2019,37(1):21-28.
[12] KIM D Y,YANG H S,KOOK Y J,LEE J Y.Association between microperimetric parameters andoptical coherent tomographic findings in various macular diseases[J].Korean J Ophthalmol,2015,29(2):92-101.
[13] TANIKAWA A,HORIGUCHI M,KONDO M,SUZUKI S,TERASAKI H,MIYAKE Y.Abnormal focal macular electroretinograms in eyes with idiopathic epimacular membrane[J].Am J Ophthalmol,1999,127(5):559-564.
[14] PILLI S,LIM P,ZAWADZKI R J,CHOI S S,WERNER J S,PARK S S.Fourier-domain optical coherence tomography of eyes with idiopathic epiretinal membrane:correlation between macular morphology and visual function[J].Eye (Lond),2011,25(6):775-783.
[15] ARICHIKA S,HANGAI M,YOSHIMURA N.Correlation between thickening of the inner and outer retina and visual acuity in patients with epiretinal membrane[J].Retina,2010,30(3):503-508.
[16] 陈薪如,叶波.微视野计的临床应用[J].国际眼科纵览,2019,43(3):210-216.
CHEN X R,YE B.Clinical practice of microperimetry[J].Int Rev Ophthalmol,2019,43(3):210-216.
[17] DRUAZ A,MATTER M,WHATHAM A R,GOLDSCHMIDT M,DURET F,ISSENHUTH M,et al.Can fixation instability improve text perception during eccentric fixation in patients with central scotomas?[J].Br J Ophthalmol,2004,88(4):461-463.
[18] DRUAZ A,MATTER M,WHATHAM A R,GOLDSCHMIDT M,DURET F,ISSENHUTH M,et al.Foveal avascular zone area analysis using optical coherence tomography angiography before and after idiopathic epiretinal membrane surgery[J].Retina,2019,39(2):339-346.
[19] 曾苗,陈晓,洪玲,蔡春艳,晏颖,黄志刚,等.特发性黄斑前膜患眼黄斑中心凹无血管区面积与视力及视物变形的相关性研究[J].中华眼底病杂志,2018,34(1):8-12.
ZENG M,CHEN X,HONG L,CAI C Y,YAN Y,HUANG Z G,et al.Correlation of foveal avascular zone size with visual acuity and metamorphopsia in idiopathic macular epiretinal membrane eyes using optical coherence tomography angiography[J].Chin J Ocul Fundus Dis,2018,34(1):8-12.
[20] NELIS P,ALTEN F,CLEMENS C R,HEIDUSCHKA P,ETER N.Quantification of changes in foveal capillary architecture caused by idiopathic epiretinal membrane using OCT angiography[J].Graefes Arch Clin Exp Ophthalmol,2017,255(7):1319-1324.
[21] 韩晓蕾,郝玉华,周娜磊,丁恩亮.特发性黄斑裂孔患眼手术前后黄斑区脉络膜毛细血管血流面积和密度的初步观察[J].中华眼底病杂志,2019,35(6):588-592.
HAN X L,HAO Y H,ZHOU N L,DING E L.Preliminary observation of choroidal capillary flow area and density in patients with idiopathic macular hole before and after surgery[J].Chin J Ocul Fundus Dis,2019,35(6):588-592.
[22] SCARINCI F,JAMPOL L M,LINSENMEIER R A,FAWZI A A.Association of diabetic macular nonperfusion with outer retinal disruption on optical coherence tomography[J].JAMA Ophthalmol,2015,133(9):1036-1044.

相似文献/References:

[1]毛新帮 游志鹏 赵菊莲.应用25G经结膜无缝合玻璃体切割系统治疗特发性黄斑前膜[J].眼科新进展,2013,33(3):000.
[2]刘菊,刘武.特发性黄斑前膜术后解剖与功能恢复的预期影响因素[J].眼科新进展,2014,34(8):798.[doi:10.13389/j.cnki.rao.2014.0221]
 LIU Ju,LIU Wu.Prognostic effective factors for visual function and macular anatomy recovery after idiopathic epiretinal membrane surgery[J].Recent Advances in Ophthalmology,2014,34(12):798.[doi:10.13389/j.cnki.rao.2014.0221]
[3]刘明,谢安明,陈丽. 特发性黄斑前膜术后视功能及黄斑区形态结构的变化[J].眼科新进展,2014,34(9):872.[doi:10.13389/j.cnki.rao.2014.0241]
[4]赵婷婷,周民稳,施靖容,等.特发性黄斑前膜术后黄斑区结构改变与视功能的相关性[J].眼科新进展,2016,36(6):536.[doi:10.13389/j.cnki.rao.2016.0142]
 ZHAO Ting-Ting,ZHOU Min-Wen,SHI Jing-Rong,et al.Correlation between macular structure and visual function after idiopathic epiretinal membrane surgery[J].Recent Advances in Ophthalmology,2016,36(12):536.[doi:10.13389/j.cnki.rao.2016.0142]
[5]董秀芬,钟华.Angio-OCT在眼科疾病临床应用中研究进展[J].眼科新进展,2016,36(7):697.[doi:10.13389/j.cnki.rao.2016.0185]
 DONG Xiu-Fen,ZHONG Hua.Application of Angio-OCT in ophthalmic diseases[J].Recent Advances in Ophthalmology,2016,36(12):697.[doi:10.13389/j.cnki.rao.2016.0185]
[6]郁艳萍,刘武.脉络膜厚度与特发性黄斑裂孔和黄斑前膜关系的研究进展[J].眼科新进展,2016,36(9):898.[doi:10.13389/j.cnki.rao.2016.0241]
 YU Yan-Ping,LIU Wu.Research progress on relationship between choroidal thickness and idiopathic macular hole , epiretinal membrane[J].Recent Advances in Ophthalmology,2016,36(12):898.[doi:10.13389/j.cnki.rao.2016.0241]
[7]刘青,艾明.光学相干断层扫描血管成像(OCTA)和荧光素血管造影(FFA)对比观察增生型糖尿病视网膜病变(PDR)[J].眼科新进展,2017,37(1):052.[doi:10.13389/j.cnki.rao.2017.0014]
 LIU Qing,AI Ming.Characteristics of proliferative diabetic retinopathy observed by optical coherence tomography angiography and fundus fluorescein angiography[J].Recent Advances in Ophthalmology,2017,37(12):052.[doi:10.13389/j.cnki.rao.2017.0014]
[8]陈懿,曾键,郑磊,等.黄斑前膜分级法对特发性黄斑前膜手术效果的评估:基于OCT图像的研究[J].眼科新进展,2018,38(3):262.[doi:10.13389/j.cnki.rao.2018.0061]
 CHEN Yi,ZENG Jian,ZHENG Lei,et al.Assessment of outcomes of idiopathic macular epiretinal membrane based on preoperative classification of the epiretinal membrane with OCT[J].Recent Advances in Ophthalmology,2018,38(12):262.[doi:10.13389/j.cnki.rao.2018.0061]
[9]仲妍,车慧欣.光学相干断层扫描血管成像(OCTA)在原发性青光眼患者中的检测价值[J].眼科新进展,2018,38(4):352.[doi:10.13389/j.cnki.rao.2018.0082]
 ZHONG Yan,CHE Hui-Xin.Detective values of optical coherence tomography angiographyfor primary glaucoma[J].Recent Advances in Ophthalmology,2018,38(12):352.[doi:10.13389/j.cnki.rao.2018.0082]
[10]冷云霞,张柳,张蒙,等.早产儿视网膜病变黄斑中心视网膜微血管形态特征:基于光学相干断层扫描血管成像(OCTA)的观察[J].眼科新进展,2018,38(4):357.[doi:10.13389/j.cnki.rao.2018.0083]
 LENG Yun-Xia,ZHANG Liu,ZHANG Meng,et al.Observation of central macular retinal microvascular network morphology of retinopathy of prematurity by optical coherence tomography angiography[J].Recent Advances in Ophthalmology,2018,38(12):357.[doi:10.13389/j.cnki.rao.2018.0083]

备注/Memo

备注/Memo:
广东省基础与应用基础研究联合基金重点项目(编号:2019B1515120011);佛山市科技局项目(编号:1920001000811)
更新日期/Last Update: 2021-12-05