视网膜静脉阻塞黄斑区的血流密度变化及其与视功能的相关性

Changes of Blood Flow Density in Macular Area of Retinal Vein Occlusion and Its Correlation with Visual Function

摘要: 目的：利用光学相干断层扫描血管成像技术(OCTA)观察视网膜静脉阻塞患者黄斑区浅层和深层视网膜毛细血管丛血流密度、中心凹无血管区(FAZ)面积、黄斑中心凹厚度(CMT)等的变化，并分析其与视功能的相关性。方法：本组54例(眼)视网膜静脉阻塞(RVO)患者，其中34例(眼)视网膜分支静脉阻塞，20例(眼)视网膜中央静脉阻塞；健康对照组19例(眼)，通过OCTA在以视网膜黄斑中心凹为中心的3 mm × 3 mm区域进行扫描，比较分析患眼、对侧眼及健康对照眼在FAZ面积、黄斑区血流密度、CMT的变化，分析其与最佳矫正视力(BCVA)的相关性。结果：患眼的FAZ面积均大于对侧眼和对照眼(P < 0.01, P < 0.05)，且FAZ面积与logMAR BCVA呈正相关；患眼黄斑区浅层和深层的血流密度明显低于对侧眼和对照眼(P < 0.001, P < 0.001)，且浅层及深层的血流密度均与logMAR BCVA呈负相关；患眼的CMT均较对侧眼及正常眼增厚(P < 0.001, P < 0.001)。结论：OCTA对于检测RVO黄斑区浅层和深层视网膜血流密度、FAZ面积等相关指标具有无创、便捷、准确的优点。RVO患者患眼较对侧眼及正常对照眼在浅层及深层视网膜血流密度和浅层FAZ面积均有改变，且FAZ面积和血流密度与RVO眼的最佳矫正视力相关。

Abstract: Purpose: Optical coherence tomography angiography (OCTA) was used to observe the changes in the superficial and deep retinal capillary plexus blood flow density, foveal avascular zone (FAZ) area, and central macular thickness (CMT) in patients with retinal vein occlusion, and an-alyze its correlation with visual function. Method: We collected 54 (eyes) patients with retinal vein occlusion (RVO), of which 34 (eyes) had branch retinal vein occlusion and 20 (eyes) had central retinal vein occlusion; 19 (eyes) in the healthy control group, OCTA was used to scan the 3 mm × 3 mm area with the foveal fovea as the center, and the changes of FAZ area, macular blood flow density, and CMT in affected eyes, contralateral eyes, and healthy control eyes were compared and analyzed correlation of the best corrected visual acuity (BCVA). Result: The FAZ area of the affected eye was larger than that of the contralateral and control eyes (P < 0.01, P < 0.05), and the FAZ area was positively correlated with logMAR BCVA. The blood density in the superficial and deep layers of the macular area of the affected eye was significantly lower than that of the contralateral eye. Compared with control eyes (P < 0.001, P < 0.001), the blood flow density in the superficial and deep layers was negatively correlated with logMAR BCVA; the CMT in the affected eyes was thicker than those in the contralateral and normal eyes (P < 0.001, P < 0.001). In Conclusion: OCTA has the advantages of non-invasive, convenient and accurate detec-tion of related indexes such as the superficial and deep retinal blood flow density and FAZ area in the macular area of RVO. The eyes of RVO patients had changes in the superficial and deep retinal blood flow density and superficial FAZ area compared with the contralateral and normal control eyes, and the FAZ area and blood flow density were related to the best corrected visual acuity of RVO eyes.