[1]蔡友欢,刘洪涛,蔡瑞,等.应用炫彩成像技术观察视网膜分支静脉阻塞患者动静脉交叉压迫点的临床意义[J].眼科新进展,2021,41(10):965-968.[doi:10.13389/j.cnki.rao.2021.0203]
 CAI Youhuan,LIU Hongtao,CAI Rui,et al.Clinical significance of arteriovenous crossing pressure points in patients with branch retinal vein occlusion by multicolor imaging[J].Recent Advances in Ophthalmology,2021,41(10):965-968.[doi:10.13389/j.cnki.rao.2021.0203]
点击复制

应用炫彩成像技术观察视网膜分支静脉阻塞患者动静脉交叉压迫点的临床意义/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年10期
页码:
965-968
栏目:
应用研究
出版日期:
2021-10-05

文章信息/Info

Title:
Clinical significance of arteriovenous crossing pressure points in patients with branch retinal vein occlusion by multicolor imaging
作者:
蔡友欢刘洪涛蔡瑞毕业歌李明波郭文骏李阳
563000 贵州省遵义市,遵义医科大学第二附属医院
Author(s):
CAI YouhuanLIU HongtaoCAI RuiBI YegeLI MingboGUO WenjunLI Yang
The Second Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China
关键词:
视网膜分支静脉阻塞共焦扫描激光检眼镜荧光素眼底血管造影彩色眼底照相
Keywords:
branch retinal vein occlusion confocal scanning laser ophthalmoscopy fundus fluorescein angiography color fundus photography
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2021.0203
文献标志码:
A
摘要:
目的 探讨利用炫彩视网膜成像技术观察视网膜分支静脉阻塞(BRVO)患者动静脉交叉压迫点的可行性及其临床意义。方法 前瞻性研究。纳入2019年7月至2020年10月就诊于遵义医科大学第二附属医院眼科门诊的BRVO患者49例49眼。散瞳后分别行传统彩色眼底照相、基于共焦扫描激光检眼镜的海德堡炫彩成像(MultiColor)以及荧光素眼底血管造影(FFA)检查,以FFA图像为依据观察动静脉交叉压迫点,利用Spectralis HRA-2炫彩成像对压迫点所处的血管进行分级评分并测量压迫点距视盘血管发出区的距离。根据FFA结果将BRVO患者分成缺血型组和非缺血型组,对比两组患者上述指标差异。 结果 炫彩成像观察到的BRVO患者动静脉交叉压迫点与FFA图像结果一致,49例患者均为视网膜颞侧分支静脉阻塞,颞上分支阻塞者33例,颞下分支阻塞者16例,缺血型组与非缺血型组患者阻塞部位相比差异无统计学意义(P=0.289)。缺血型组患者压迫点血管分级评分平均为1.0分,与非缺血型患者的血管分级评分平均2.5分相比,差异有统计学意义(P=0.001)。压迫点距视盘血管发出区的距离缺血型组为(2543.00±769.06)μm,非缺血型组为(3505.44±1125.42)μm,两组比较差异有统计学意义(P=0.002),压迫点血管分级评分与BRVO是否发生缺血相关(P=0.003)。结论 基于共焦扫描激光检眼镜的海德堡炫彩成像技术可以直观地观察BRVO患者动静脉交叉压迫点而不受出血的影响,并可以对压迫点血管进行分级评分,有助于为BRVO患者的治疗及预后评估提供更全面准确的信息。
Abstract:
Objective To investigate the feasibility and clinical significance of using multicolor imaging technology to observe the arteriovenous crossing pressure points in patients with retinal branch vein occlusion (BRVO). Methods Prospective research was carried out. The subjects were 49 eyes of 49 patients with BRVO who attended the Department of Ophthalmology of the Second Affiliated Hospital of Zunyi Medical University from July 2019 to October 2020. After dilation of the pupils, all eyes were examined by traditional color fundus photography (CFP), Heidelberg multicolor imaging (MultiColor) based on confocal scanning laser ophthalmoscopy (cSLO) and fundus fluorescein angiography (FFA). The arteriovenous crossing pressure point was observed through FFA imaging, and Spectralis HRA-2 was used to grade the blood vessel where the pressure point was located and measure the distance from the pressure point to optic disc vessel origin. According to the FFA results,BRVO patients were divided into ischemic group and non-ischemic group, and the variables were compared between groups. Results The arteriovenous crossing pressure points observed through MultiColor was consistent with those observed by the FFA imaging. The patients we observed were all diagnosed with retinal temporal branch vein occlusion, including 33 cases of superior temporal branch vein occlusion and 16 cases of inferior temporal branch vein occlusion. There was no statistically significant difference in the proportion of obstructed positions between the ischemic group and the non-ischemic group (P=0.289). The average vascular grading score of the ischemic group was 1.0 point, and compared with the average 2.5 points of the non-ischemic patients, the difference was statistically significant (P=0.001). The distance between the pressure point and optic disc vessel origin was (2543.00±769.06) μm in the ischemic group and (3505.44±1125.42) μm in the non-ischemic group. The difference between the two groups was statistically significant (P=0.002). The blood vessel grading score at the pressure point was correlated with the occurrence of ischemia (P=0.003). Conclusion The Heidelberg MultiColor technology based on cSLO can visually observe the arteriovenous crossing pressure points of BRVO patients without being affected by bleeding, and grade and score the blood vessels where the pressure points are located. Combined with FFA examination, it helps to provide more comprehensive and accurate information for the treatment and prognosis assessment of BRVO.

参考文献/References:

[1] MURAOKA Y,TSUJIKAWA A.Arteriovenous crossing associated with branch retinal vein occlusion[J].Jpn J Ophthalmol,2019,63(5):353-364.
[2] REHAK J,REHAK M.Branch retinal vein occlusion:pathogenesis,visual prognosis,and treatment modalities[J].Curr Eye Res,2008,33(2):111-131.
[3] KHAYAT M,WILLIAMS M,LOIS N.Ischemic retinal vein occlusion:characterizing the more severe spectrum of retinal vein occlusion[J].Surv Ophthalmol,2018,63(6):816-850.
[4] 陈露璐,陈有信.2019年《EURETINA视网膜静脉阻塞诊疗指南》解读[J].中华实验眼科杂志,2020,38(1):60-63.
CHEN L L,CHEN Y X.Interpretation of the 2019 guidelines for the management of retinal vein occlusion by the EURETINA[J].Chin J Exp Ophthalmol,2020,38(1):60-63.
[5] KOGO T,MURAOKA Y,UJI A,OOTO S,MURAKAMI T,KADOMOTO S,et al.Angio-graphic risk factors for recurrence of macular edema associated with branch retinal vein occlusion[J].Retina,2021,41(6):1219-1226.
[6] SAMARA W A,SHAHLAEE A,SRIDHAR J,KHAN M A,HO A C,HSU J.Quantitative optical coherence tomography angiography features and visual function in eyes with branch retinal vein occlusion[J].Am J Ophthalmol,2016,166:76-83.
[7] LI J,PAULUS Y M,SHUAI Y,FANG W,LIU Q,YUAN S.New developments in the classification,pathogenesis,risk factors,natural history,and treatment of branch retinal vein occlu-sion[J].J Ophthalmol,2017,2017:4936924.
[8] HAYREH S S.Ocular vascular occlusive disorders:natural history of visual outcome[J].Prog Retin Eye Res,2014,41:1-25.
[9] POWNER M B,SIM D A,ZHU M,NOBRE-CARDOSO J,JONES R,SYED A,et al.Evaluation of nonperfused retinal vessels in ischemic retinopathy[J].Invest Ophthalmol Vis Sci,2016,57(11):5031-5037.
[10] MURAOKA Y,TSUJIKAWA A,MURAKAMI T,OGINO K,KUMAGAI K,MIYAMOTO K,et al.Morphologic and functional changes in retinal vessels associated with branch retinal vein occlusion[J].Ophthalmology,2013,120(1):91-99.
[11] HIRANO Y,SUZUKI N,TOMIYASU T,KUROBE R,YASUDA Y,ESAKI Y,et al.Multimodal imaging of microvascular abnormalities in retinal vein occlusion[J].J Clin Med,2021,10(3):405.
[12] LEE J J,WU P C,CHEN C H,CHEN Y J,KUO M L,LIU C C,et al.The role of a second isolated retinal artery in branch retinal vein obstruction[J].Ophthalmologica,2005,219(6):386-389.
[13] YAMANE S,KAMEI M,SAKIMOTO S,INOUE M,ARAKAWA A,SUZUKI M,et al.Matched control study of visual outcomes after arteriovenous sheathotomy for branch retinal vein occlusion[J].Clin Ophthalmol,2014,8:471-476.
[14] WANG H,CHANG Y,ZHANG F,YANG R,YAN S,DONG J,et al.Clinical features of combined central retinal artery and vein occlusion[J].J Ophthalmol,2019,2019:7202731.
[15] JAULIM A,AHMED B,KHANAM T,CHATZIRALLI I P.Branch retinal vein occlusion:epidemiology,pathogenesis,risk factors,clinical features,diagnosis,and complications.An update of the literature[J].Retina,2013,33(5):901-910.
[16] KILIC M I,BARTSCH D,BARTESELLI G,GABER R,NEZGODA J,FREEMAN W R.Visualization of macular pucker by multicolor scanning laser imaging[J].Retina,2018,38(2):352-358.
[17] PHILIPPAKIS E,THOUVENIN R,GATTOUSSI S,COUTURIER A,TADAYONI R.Preoperative imaging optimized for epiretinal membrane surgery[J].Int J Retina Vitreous,2021,7(1):32.
[18] EHRT O,BOERGEN K P.Scanning laser ophthalmoscope fundus cyclometry in near-natural viewing conditions[J].Graefes Arch Clin Exp Ophthalmol,2001,239(9):678-682.
[19] TERASAKI H,SONODA S,KAKIUCHI N,SHIIHARA H,YAMASHITA T,SAKAMOTO T.Ability of multicolor scanning laser ophthalmoscope to detect non-glaucomatous retinal nerve fiber layer defects in eyes with retinal diseases[J].BMC Ophthalmol,2018,18(1):324.
[20] KEANE P,SADDA S R.Retinal imaging in the twenty-first century:state of the art and future directions[J].Ophthalmology,2014,121(12):2489-2500.

相似文献/References:

[1]张祺 冯劼 李培凤 金翼.Lucentis联合氪黄激光治疗视网膜分支静脉阻塞黄斑水肿的疗效观察[J].眼科新进展,2013,33(12):000.
[2]曹婷婷,陈桂芬,范玉香,等.视网膜分支静脉阻塞合并黄斑水肿不同治疗方法的疗效观察[J].眼科新进展,2014,34(8):772.[doi:10.13389/j.cnki.rao.2014.0213]
 CAO Ting-Ting,CHEN Gui-Fen,FAN Yu-Xiang,et al.Clinical observation in different treatment methods of branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2014,34(10):772.[doi:10.13389/j.cnki.rao.2014.0213]
[3]傅维娜,陈梅珠,王云鹏. Lucentis联合视网膜光凝治疗视网膜分支静脉阻塞继发黄斑水肿[J].眼科新进展,2015,35(3):270.[doi:10.13389/j.cnki.rao.2015.0072]
 FU Wei-Na,CHEN Mei-Zhu,WANG Yun-Peng. Intravitreal injection with lucentis combined with local retinal photocoagulation for macular edema secondary to branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2015,35(10):270.[doi:10.13389/j.cnki.rao.2015.0072]
[4]董宁,汤欣,肖林,等. 视网膜分支静脉阻塞患者急性期和恢复期血浆同型半胱氨酸水平的变化[J].眼科新进展,2015,35(4):368.[doi:10.13389/j.cnki.rao.2015.0099]
 DONG Ning,TANG Xin,XIAO Lin,et al. Acute and convalescent changes in plasma homocysteine concentrations in branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2015,35(10):368.[doi:10.13389/j.cnki.rao.2015.0099]
[5]李仕永,高瑞莹,陈晖.雷珠单抗联合氩激光视网膜光凝治疗不同时期的视网膜分支静脉阻塞所致黄斑水肿的疗效[J].眼科新进展,2016,36(12):1161.[doi:10.13389/j.cnki.rao.2016.0309]
 LI Shi-Yong,GAO Rui-Ying,CHEN Hui.Effects of ranibizumab ( Lucentis) intravitreal injection combined with retinal argon laser photocoagulation on macular edema secondary to different period of branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2016,36(10):1161.[doi:10.13389/j.cnki.rao.2016.0309]
[6]王维宏,贺圣光,邓爱军,等.EDI-OCT在视网膜分支静脉阻塞患者筛板厚度测量中的应用[J].眼科新进展,2017,37(5):435.[doi:10.13389/j.cnki.rao.2017.0110]
 WANG Wei-Hong,HE Sheng-Guang,DENG Ai-Jun,et al.Application of EDI-OCT in measuring the plate thickness in patients with branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2017,37(10):435.[doi:10.13389/j.cnki.rao.2017.0110]
[7]胡一骏,李冬莉,李国栋,等.视网膜静脉阻塞的危险因素分析[J].眼科新进展,2017,37(6):544.[doi:10.13389/j.cnki.rao.2017.0137]
 HU Yi-Jun,LI Dong-Li,LI Guo-Dong,et al.Risk factors associated with retinal vein occlusion[J].Recent Advances in Ophthalmology,2017,37(10):544.[doi:10.13389/j.cnki.rao.2017.0137]
[8]刘广峰,洪婷婷,苗森,等.玻璃体内注射康柏西普与黄斑区光凝治疗视网膜分支静脉阻塞继发非缺血性黄斑水肿的临床对照研究[J].眼科新进展,2017,37(7):658.[doi:10.13389/j.cnki.rao.2017.0167]
 LIU Guang-Feng,HONG Ting-Ting,MIAO Sen,et al.Comparison of intravitreal injection of conbercept and macular photocoagulation for non-ischemic macular edema secondary to branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2017,37(10):658.[doi:10.13389/j.cnki.rao.2017.0167]
[9]石蕊,肖云芳,王峰,等.糖尿病合并视网膜分支静脉阻塞患者继发黄斑水肿后视力损伤程度及危险因素[J].眼科新进展,2017,37(12):1139.[doi:10.13389/j.cnki.rao.2017.0287]
 SHI Rui,XIAO Yun-Fang,WANG Feng,et al.Vision impairment following macular edema secondary to diabetes combined with branch retinal vein occlusion and its potential risk factors[J].Recent Advances in Ophthalmology,2017,37(10):1139.[doi:10.13389/j.cnki.rao.2017.0287]
[10]江慧娟,庞东渤.视网膜光凝联合玻璃体内注射雷珠单抗治疗缺血型视网膜分支静脉阻塞(BRVO)致黄斑水肿的疗效[J].眼科新进展,2018,38(4):348.[doi:10.13389/j.cnki.rao.2018.0081]
 JIANG Hui-Juan,PANG Dong-Bo.Efficacy of intravitreal ranibizumab combined with laser photocoagulation for the treatment of macular edema induced by ischemic branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2018,38(10):348.[doi:10.13389/j.cnki.rao.2018.0081]

备注/Memo

备注/Memo:
贵州省科技厅一般研究项目(编号:黔科合基础2019 1352号);遵义医科大学硕士启动项目(编号:F-927)
更新日期/Last Update: 2021-10-05