摘要
目的观察并分析家族性渗出性玻璃体视网膜病变(FEVR)患眼黄斑微血管改变。方法横断面临床病例对照研究。2019年11月至2020年11月于潍坊眼科医院检查确诊的FEVR患者21例41只眼(FEVR组)以及同期年龄、性别与之匹配的健康志愿者17名28只眼(正常对照组)纳入研究。FEVR组依据患眼最佳矫正视力(BCVA)1.0、<1.0再分为视力正常组、视力下降组,分别为27、14只眼。受检者均行BCVA、光相干断层扫描血管成像(OCTA)检查。采用国际标准视力表行BCVA检查,统计时换算为最小分辨角对数(logMAR)视力。采用OCTA仪对所有受检眼黄斑区3 mm×3 mm、6 mm×6 mm范围进行扫描,测量3 mm×3 mm、6 mm×6 mm范围内血管密度(VD)、血流灌注密度(PD)以及6 mm×6 mm范围内中心凹无血管区(FAZ)面积、周长、形态指数。组间定量资料比较采用独立样本t检验;计数资料比较采用χ^(2)检验。根据受试者工作特征曲线(ROC曲线)确定各指标的曲线下面积(AUC),评估各指标的预测价值。结果黄斑区6 mm×6 mm范围,FEVR组患眼VD、PD以及FAZ面积、周长均小于正常对照组,差异有统计学意义(t=-3.350、-2.387、-3.519、-3.029,P<0.05)。黄斑区3 mm×3 mm、6 mm×6 mm范围,与视力正常组比较,视力下降组患眼VD、PD均下降,差异有统计学意义(t=2.088、2.114、2.160、2.545,P<0.05);黄斑区6 mm×6mm范围,两组患眼FAZ形态指数比较,差异有统计学意义(t=2.409,P<0.05)。ROC曲线分析结果显示,所有指标对FEVR的诊断价值较低(AUC<0.5)。结论FEVR患眼黄斑区存在微血管异常;VD降低及FAZ形态改变可能与视力下降有关。
Objective To evaluate macular microvessel changes in familial exudative vitreoretinopathy(FEVR)by optical coherence tomography angiography.Methods Cross-sectional clinical case-control study.From November 2019 to November 2020,21 FEVR patients(41 eyes)from Weifang Eye Hospital were selected;17 healthy volunteers(28 eyes)with the same age and gender as FEVR group were selected as normal control group.According to the best corrected visual acuity(BCVA)1.0 and<1.0,FEVR group was divided into normal visual acuity group(27 eyes)and visual acuity decreased group(14 eyes).All enrollees received BCVA and OCTA.BCVA was performed with an international standard visual acuity chart,which was converted to logarithm of the minimum angle of resolution(logMAR)vision.The OCTA instrument was used to scan the macular area of all the examined eyes in the range of 3 mm×3 mm,6 mm×6 mm,and the blood vessel density(VD)and blood perfusion density(PD)within the range of 3 mm×3 mm,6 mm×6 mm were measured and the area,circumference,and morphological index of the foveal avascular zone(FAZ)within the range of 6 mm×6 mm.Quantitative data were compared between groups by independent sample t test.Statistical data were compared byχ^(2) test.The area under curve(AUC)of each index was determined according to receiver operating characteristic curve(ROC curve),and the predictive value of each index was evaluated.Results In the macular area of 6 mm×6 mm,VD,PD,FAZ area and FAZ perimeter of FEVR group were all lower than those of normal control group,and the differences were statistically significant(t=-3.350,-2.387,-3.519,-3.029;P<0.05).In macular area of 3 mm×3 mm and 6 mm×6 mm,compared with normal vision group and vision loss group,both VD and PD decreased.The differences were statistically significant(t=2.088,2.114,2.160,2.545;P<0.05).In the macular area of 6 mm×6 mm,the FAZ morphological index of the two groups was significantly different(t=2.409,P<0.05).ROC curve analysis showed that all the indicators had low diagnostic value for FEVR(AUC<0.5).Conclusion There are microvascular abnormalities in macular area in FEVR patients,and the decrease of blood vessels and the change of FAZ shape may be related to the loss of visual acuity.
作者
王文亭
李姝婵
蒋可可
冉宏运
艾朝晖
张杰
刘丽峰
Wang Wenting;Li Shuchan;Jiang Keke;Ran Hongyun;Ai Zhaohui;Zhang Jie;Liu Lifeng(Weifang Eye Hospital,Weifang 261000,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第12期932-936,共5页
Chinese Journal of Ocular Fundus Diseases
基金
潍坊市卫健委项目(WFWSJK-2021-158)。
关键词
视网膜疾病
眼疾病
遗传性
体层摄影术
光学相干
局部血流
Retinal diseases
Eye diseases,hereditary
Tomography,optical coherence
Regional blood flow
作者简介
通信作者:张杰,Email:zhangjie9jiezuo@126.com。
