早产儿视网膜病变自然消退患儿黄斑光学相干断层扫描血管成像(OCTA)变化
|
摘要
目的使用光学相干断层扫描血管成像(optical coherence tomographic angiography,OCTA)观察早产儿视网膜病变(retinopathy of prematurity,ROP)自然消退患儿的黄斑形态与血流的变化。方法采用横断面研究。收集自然消退的轻度ROP患儿6例(12眼)为ROP自然消退组,同时收集年龄匹配的足月产健康儿童8例(16眼)为对照组。使用OCTA的3 mm×3 mm扫描模式获得两组儿童的黄斑中心凹无血管区(foveal avascular zone,FAZ)面积、FAZ形态指数、表层视网膜血管密度及表层视网膜灌注密度,利用SD-OCT测量黄斑中心凹视网膜厚度(central foveal thickness,CFT),并对比两组儿童的最佳矫正视力(best corrected visual acuity,BCVA)。采用两独立样本t检验进行统计分析。结果 ROP自然消退组与对照组的FAZ面积分别为(0.135±0.121)mm~2和(0.316±0.080)mm~2,CFT分别为(193.77±17.92)μm和(164.29±20.21)μm,两组相比差异均有统计学意义(均为P<0.001)。ROP自然消退组与对照组的FAZ形态指数、表层视网膜血管密度、表层视网膜灌注密度及BCVA的差异均无统计学意义(均为P>0.05)。结论 ROP自然消退患儿黄斑区形态结构及血流有明显改变,FAZ面积偏小,CFT增厚,但BCVA未受明显影响。
Objective To observe the change in macular morphology and blood flow in children with spontaneously regressed retinopathy of prematurity ROP by optical coherence tomographic angiography(OCTA).Methods The spontaneously regressed ROP children(spontaneously regressed ROP group,12 eyes of 6 patients) and full-term healthy children(control group,16 eyes of 8 patients) were collected by cross-section study.The subjects were examined by OCTA(Zeiss Cirrus HD 5000) in 3 mm×3 mm scanning mode.The parameters including the area of foveal avascular zone(FAZ),FAZ morphological index,retinal vascular density(VD),retinal perfusion density(PD),central foveal thickness(CFT)and the best corrected visual acuity(BCVA) were compared.Two independent sample t-test was used for statistical analysis.Results The area of FAZ in spontaneously regressed ROP group was(0.135±0.121)mm~2,which was significantly less than that in control group [(0.316±0.080)mm~2](P<0.001).The CFT in spontaneously regressed ROP group was(193.77±17.92)μm,which was significantly thicker than that in control group [(164.29±20.21)μm](P<0.001),but there was no significant difference in FAZ morphological index,retinal vascular density,retinal perfusion density and BCVA between the two groups.Conclusion The vascular morphology and blood flow of macular in spontaneously regressed ROP children show significant changes.FAZ area is smaller and CFT is thicker in spontaneously regressed ROP children,while the BCVA is not affected.
Objective To observe the change in macular morphology and blood flow in children with spontaneously regressed retinopathy of prematurity ROP by optical coherence tomographic angiography(OCTA).Methods The spontaneously regressed ROP children(spontaneously regressed ROP group,12 eyes of 6 patients) and full-term healthy children(control group,16 eyes of 8 patients) were collected by cross-section study.The subjects were examined by OCTA(Zeiss Cirrus HD 5000) in 3 mm×3 mm scanning mode.The parameters including the area of foveal avascular zone(FAZ),FAZ morphological index,retinal vascular density(VD),retinal perfusion density(PD),central foveal thickness(CFT)and the best corrected visual acuity(BCVA) were compared.Two independent sample t-test was used for statistical analysis.Results The area of FAZ in spontaneously regressed ROP group was(0.135±0.121)mm~2,which was significantly less than that in control group [(0.316±0.080)mm~2](P<0.001).The CFT in spontaneously regressed ROP group was(193.77±17.92)μm,which was significantly thicker than that in control group [(164.29±20.21)μm](P<0.001),but there was no significant difference in FAZ morphological index,retinal vascular density,retinal perfusion density and BCVA between the two groups.Conclusion The vascular morphology and blood flow of macular in spontaneously regressed ROP children show significant changes.FAZ area is smaller and CFT is thicker in spontaneously regressed ROP children,while the BCVA is not affected.
引文
[1] HARTNETT M E,PENN J S.Mechanisms and management of retinopathy of prematurity[J].Surv Anesthesiol,2013,57(5):239-243.
[2] FALAVARJANI K G,IAFE N A,VELEZ F G,SCHWARTZ S D,SADDA S R,SARRAF D,et al.Optical coherence tomography angiography of the fovea in children born preterm[J].Retina,2017,37(12):1.
[3] ZHANG A,ZHANG Q,CHEN C L,WANG R K.Methods and algorithms for optical coherence tomography-based angiography:a review and comparison[J].J Biomed Opt,2015,20(10):100901.
[4] ZHAO Q,YANG W L,WANG X N,WANG R K,YOU Q S,CHU Z D,et al.Repeatability and reproducibility of quantitative assessment of the retinal microvasculature using optical coherence tomography angiography based on optical microangiography[J].Biomed Environ Sci,2018,31(6):473-478.
[5] QUINN G.The international classification of retinopathy of prematurity revisited[J].Arch Ophthalmol-Chic,2005,123(7):991-999.
[6] SCHAFFER D B,PALMER E A,PLOTSKY D F,METZ H S,FLYNN J T,TUNG B,et al.Prognostic factors in the natural course of retinopathy of prematurity.The cryotherapy for retinopathy of prematurity cooperative group[J].Ophthalmology,1993,100(2):230-237.
[7] LI H L,ZHANG G M,ZHANG F Y,SU K J,CHEN Y,ZENG J.The fundus angiographic features of wide-angle fluorescein in spontaneously regressed retinopathy of prematurity[J].Chin J Ocul Fundus Dis,2016,32(4):430-431.李慧林,张国明,张福燕,苏康进,陈懿,曾键.退行期早产儿视网膜病变广角荧光素眼底血管造影特征[J].中华眼底病杂志,2016,32(4):430-431.
[8] NONOBE N,KANEKO H,ITO Y,TAKAYAMA K,KATAOKA K,TSUNEKAWA T,et al.Optical coherence tomography angiography of the foveal avascular zone in children with a history of treatment-requiring retinopathy of prematurity[J].Retina,2019,39(1):111-117.
[9] MINTZ-HITTNER H A,KNIGHT-NANAN D M,SATRIANO D R,KRETZER F L.A small foveal avascular zone may be an historic mark of prematurity[J].Ophthalmology,1999,106(7):1409-1413.
[10] ENGERMAN R L.Development of the macular circulation[J].Invest Ophthalmol,1976,15(15):835-840.
[11] KOZULIN P,NATOLI R,BRIENK M B,MADIGAN M C,PROVIS J M.Differential expression of anti-angiogenic factors and guidance genes in the developing macula[J].Mol Vis,2009,15(3-5):45-59.
[12] FLOWER R W,MCLEOD D S,LUTTY G A,GOLDBERG B,WAJER S D.Postnatal retinal vascular development of the puppy[J].Invest Ophthalmol Vis Sci,1985,26(7):957-968.
[13] SPRINGER A D,HENDRICKSON A E.Development of the primate area of high acuity.1.Use of finite element analysis models to identify mechanical variables affecting pit formation[J].Vis Neurosci,2004,21(1):53-62.
[14] SPRINGER A D,HENDRICKSON A E.Development of the primate area of high acuity.2.Quantitative morphological changes associated with retinal and pars plana growth[J].Vis Neurosci,2004,21(5):775-790.
[15] SPRINGER A D,HENDRICKSON A E.Development of the primate area of high acuity.3.Temporal relationships between pit formation,retinal elongation and cone packing[J].Vis Neurosci,2005,22(2):171-185.
[16] VILLEGAS V M,CAPó H,CAVUOTO K,MCKEOWN C A,BERROCAL A M.Foveal structure-function correlation in children with history of retinopathy of prematurity[J].Am J Ophthalmol,2014,158(3):508-512.
[17] WANG J,SPENCER R,LEFFLER J N,BIRCH E E.Critical period for foveal fine structure in children with regressed retinopathy of prematurity[J].Retina,2012,32(2):330-339.
[18] YANNI S E,WANG J,CHAN M,CARROLL J,FARSIU S,LEFFLER J N,et al.Foveal avascular zone and foveal pit formation after preterm birth[J].Br J Ophthalmol,2012,96(7):961.
[19] LENG Y X,ZHANG L,ZHANG M,CAI C,REN G L,et al.Observation of central macular retinal microvascular network morphology of retinopathy of prematurity by optical coherence tomography angiography[J].Rec Adv Ophthalmol,2018,38(4):357-360.冷云霞,张柳,张蒙,吴敏,蔡诚,任国梁,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):357-360.
[2] FALAVARJANI K G,IAFE N A,VELEZ F G,SCHWARTZ S D,SADDA S R,SARRAF D,et al.Optical coherence tomography angiography of the fovea in children born preterm[J].Retina,2017,37(12):1.
[3] ZHANG A,ZHANG Q,CHEN C L,WANG R K.Methods and algorithms for optical coherence tomography-based angiography:a review and comparison[J].J Biomed Opt,2015,20(10):100901.
[4] ZHAO Q,YANG W L,WANG X N,WANG R K,YOU Q S,CHU Z D,et al.Repeatability and reproducibility of quantitative assessment of the retinal microvasculature using optical coherence tomography angiography based on optical microangiography[J].Biomed Environ Sci,2018,31(6):473-478.
[5] QUINN G.The international classification of retinopathy of prematurity revisited[J].Arch Ophthalmol-Chic,2005,123(7):991-999.
[6] SCHAFFER D B,PALMER E A,PLOTSKY D F,METZ H S,FLYNN J T,TUNG B,et al.Prognostic factors in the natural course of retinopathy of prematurity.The cryotherapy for retinopathy of prematurity cooperative group[J].Ophthalmology,1993,100(2):230-237.
[7] LI H L,ZHANG G M,ZHANG F Y,SU K J,CHEN Y,ZENG J.The fundus angiographic features of wide-angle fluorescein in spontaneously regressed retinopathy of prematurity[J].Chin J Ocul Fundus Dis,2016,32(4):430-431.李慧林,张国明,张福燕,苏康进,陈懿,曾键.退行期早产儿视网膜病变广角荧光素眼底血管造影特征[J].中华眼底病杂志,2016,32(4):430-431.
[8] NONOBE N,KANEKO H,ITO Y,TAKAYAMA K,KATAOKA K,TSUNEKAWA T,et al.Optical coherence tomography angiography of the foveal avascular zone in children with a history of treatment-requiring retinopathy of prematurity[J].Retina,2019,39(1):111-117.
[9] MINTZ-HITTNER H A,KNIGHT-NANAN D M,SATRIANO D R,KRETZER F L.A small foveal avascular zone may be an historic mark of prematurity[J].Ophthalmology,1999,106(7):1409-1413.
[10] ENGERMAN R L.Development of the macular circulation[J].Invest Ophthalmol,1976,15(15):835-840.
[11] KOZULIN P,NATOLI R,BRIENK M B,MADIGAN M C,PROVIS J M.Differential expression of anti-angiogenic factors and guidance genes in the developing macula[J].Mol Vis,2009,15(3-5):45-59.
[12] FLOWER R W,MCLEOD D S,LUTTY G A,GOLDBERG B,WAJER S D.Postnatal retinal vascular development of the puppy[J].Invest Ophthalmol Vis Sci,1985,26(7):957-968.
[13] SPRINGER A D,HENDRICKSON A E.Development of the primate area of high acuity.1.Use of finite element analysis models to identify mechanical variables affecting pit formation[J].Vis Neurosci,2004,21(1):53-62.
[14] SPRINGER A D,HENDRICKSON A E.Development of the primate area of high acuity.2.Quantitative morphological changes associated with retinal and pars plana growth[J].Vis Neurosci,2004,21(5):775-790.
[15] SPRINGER A D,HENDRICKSON A E.Development of the primate area of high acuity.3.Temporal relationships between pit formation,retinal elongation and cone packing[J].Vis Neurosci,2005,22(2):171-185.
[16] VILLEGAS V M,CAPó H,CAVUOTO K,MCKEOWN C A,BERROCAL A M.Foveal structure-function correlation in children with history of retinopathy of prematurity[J].Am J Ophthalmol,2014,158(3):508-512.
[17] WANG J,SPENCER R,LEFFLER J N,BIRCH E E.Critical period for foveal fine structure in children with regressed retinopathy of prematurity[J].Retina,2012,32(2):330-339.
[18] YANNI S E,WANG J,CHAN M,CARROLL J,FARSIU S,LEFFLER J N,et al.Foveal avascular zone and foveal pit formation after preterm birth[J].Br J Ophthalmol,2012,96(7):961.
[19] LENG Y X,ZHANG L,ZHANG M,CAI C,REN G L,et al.Observation of central macular retinal microvascular network morphology of retinopathy of prematurity by optical coherence tomography angiography[J].Rec Adv Ophthalmol,2018,38(4):357-360.冷云霞,张柳,张蒙,吴敏,蔡诚,任国梁,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):357-360.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |