肝硬化患者黄斑区视网膜和脉络膜厚度的变化
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摘要
目的:分析肝硬化患者和健康人的黄斑区视网膜厚度、视网膜体积和脉络膜厚度的差异,初步探讨肝硬化患者视网膜和脉络膜的改变。方法:采用横断面观察研究。将2015-01/2018-03我院肝硬化患者84例168眼和健康人50例100眼(正常对照组)纳入研究,其中肝硬化患者包括肝硬化代偿期组34例68眼,肝硬化失代偿期组50例100眼。采用OCT对所有受检眼测量黄斑区视网膜厚度和体积。采用EDI-OCT行脉络膜厚度扫描,以Bruch膜强反射线到脉络膜巩膜交界面强反射线的垂直距离作为脉络膜厚度。分析三组受检眼黄斑区视网膜厚度、视网膜体积和脉络膜厚度的差异。结果:三组受检者黄斑区各象限视网膜厚度和视网膜体积无差异(P>0.05)。三组中心凹下脉络膜厚度分别为338.50±70.44、357.00±89.16、319.53±74.37μm(P>0.05)。三组间中心凹鼻侧脉络膜厚度有差异(P<0.05);肝硬化失代偿组与正常对照组比较,鼻侧脉络膜偏厚(P<0.05)。结论:肝硬化失代偿期患者较健康者中心凹鼻侧脉络膜偏厚,肝硬化患者与健康人黄斑区视网膜厚度、视网膜体积无明显差异。
AIM:To analyze the differences of retinal thickness, retinal volume and choroidal thickness in the macular area in healthy people and patients with liver cirrhosis, and to explore the morphologic changes of retina and choroid in liver cirrhosis.METHODS: A cross-sectional study. From January 2015 to March 2018, 168 eyes of 84 patients with liver cirrhosis and 100 eyes of 50 healthy people were included. Healthy people were the normal control group. The patients were divided into two groups, including compensated cirrhosis group(68 eyes of 34 patients) and decompensated cirrhosis group(100 eyes of 50 patients). All eyes underwent OCT examination to measure the retinal thickness and retinal volume in the macular area. EDI-OCT was used for choroidal thickness scanning, and the vertical distance between the strong reflection of Bruch film and the strong reflection of the choroidal sclera interface was defined as the choroidal thickness. The retinal thickness, retinal volume and choroidal thickness in the macular area in the three groups were compared and analyzed.RESULTS: The differences in retinal thickness and retinal volume between three groups were not significant(P>0.05). The subfoveal choridal thickness(SFCT) of three groups were 338.50±70.44, 357.00±89.16, 319.53±74.37μm(P>0.05). There was a statistically significant difference in nasal choroid thickness between the three groups(P<0.05). The choridal thickness in nasal area to fovea in the patients with decompensated cirrhosis was increased than that in healthy people(P<0.05).CONCLUSION: The choridal thickness in nasal area to fovea in the patients with decompensated cirrhosis is thicker than that in healthy people. There are no significant differences in retinal thickness or retinal volume in macular area between healthy people and patients with liver cirrhosis.
AIM:To analyze the differences of retinal thickness, retinal volume and choroidal thickness in the macular area in healthy people and patients with liver cirrhosis, and to explore the morphologic changes of retina and choroid in liver cirrhosis.METHODS: A cross-sectional study. From January 2015 to March 2018, 168 eyes of 84 patients with liver cirrhosis and 100 eyes of 50 healthy people were included. Healthy people were the normal control group. The patients were divided into two groups, including compensated cirrhosis group(68 eyes of 34 patients) and decompensated cirrhosis group(100 eyes of 50 patients). All eyes underwent OCT examination to measure the retinal thickness and retinal volume in the macular area. EDI-OCT was used for choroidal thickness scanning, and the vertical distance between the strong reflection of Bruch film and the strong reflection of the choroidal sclera interface was defined as the choroidal thickness. The retinal thickness, retinal volume and choroidal thickness in the macular area in the three groups were compared and analyzed.RESULTS: The differences in retinal thickness and retinal volume between three groups were not significant(P>0.05). The subfoveal choridal thickness(SFCT) of three groups were 338.50±70.44, 357.00±89.16, 319.53±74.37μm(P>0.05). There was a statistically significant difference in nasal choroid thickness between the three groups(P<0.05). The choridal thickness in nasal area to fovea in the patients with decompensated cirrhosis was increased than that in healthy people(P<0.05).CONCLUSION: The choridal thickness in nasal area to fovea in the patients with decompensated cirrhosis is thicker than that in healthy people. There are no significant differences in retinal thickness or retinal volume in macular area between healthy people and patients with liver cirrhosis.
引文
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2张静,郭小兵,王润兰,等.彩色多普勒超声对肝硬化患者眼血流动力学研究.中国实验诊断学2010;14(5):720-721
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5 ünlü C, Erdogan G,Gunay BO,et al. Subfoveal choroidal thickness changes after intravitreal bevacizumab injection for neovascular age-related macular degeneration and diabetic macular edema. Int Ophthalmol 2017;37(1):147-158
6 Xu Q, Li Y, Cheng Y, et al. Assessment of the effect of age on macular layer thickness in a healthy Chinese cohort using spectral-domain optical coherence tomography. BMC Ophthalmol 2018;18(1):169
7张蓉,陈伟,江嫒.海德堡OCT测量正常人后极部视网膜厚度价值的研究.中国实用眼科杂志2014;32(12):1420-1423
8 Sezgin Akcay BI,Gunay BO,Kardes E,et al. Evaluation of ganglion cell complex and retinal nerve fiber layer in low,moderate,and high myopia:a study by RTVue spectral domain optical coherence tomography. Semin Ophthalmol 2017;32(6):682-688
9 Fujiwara A, Shiragami C, Shirakata Y, et al. Enhanced depth imaging spectral-domain optical coherence tomography of subfoveal chornidal thickness in normal Japanese eyes. Jpn J Ophthalmol 2012;56(3):230-235
10 Li XQ, Larsen M, Munch IC. Subfoveal choroidal thickness in relation to sex and axial length in 93 Danish university students. Invest Ophthalmol Vis Sci 2011;52(11):8438-8441
11 Sogawa K, Nagaoka T, Takahashi A, et al. Relationship between choroidal thickness and choroidal circulation in healthy young subjects. Am J Ophthalmol 2012;153(6):1129-1132
12何吕福.脉络膜厚度研究进展.中华实验眼科杂志 2017;35(10):949-954
13 Strobbe E, Cellini M, Campos EC. Aqueous flare and choroidal thickness in patients with chronic hepatitis C virus infection: a pilot study. Ophthalmology 2013;120(11):2258-2263
14 Ahmad M, Tsui E, Smith RT. Choroidal Osteoma Deossification Visualized by Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography. Ophthalmic Surg Lasers Imaging Retina 2017;48(1):87-90
15郑祥榕,滕娟,陈小红,等.非增生型糖尿病视网膜病变患者黄斑区脉络膜厚度的临床观察.国际眼科杂志 2018;18(11):2035-2038
2张静,郭小兵,王润兰,等.彩色多普勒超声对肝硬化患者眼血流动力学研究.中国实验诊断学2010;14(5):720-721
3 Shao L,Xu L,Zhang J,et al. Subfoveal choroidal thickness and cataract:the Beijing Eye Study 2011. Invest Ophthalmol Vis Sci 2015;56(2):810-815
4 Pang CE, Sarraf D, Freund KB. Extreme choroidal thinning in high mypoia. Retina 2015;35(3):407-415
5 ünlü C, Erdogan G,Gunay BO,et al. Subfoveal choroidal thickness changes after intravitreal bevacizumab injection for neovascular age-related macular degeneration and diabetic macular edema. Int Ophthalmol 2017;37(1):147-158
6 Xu Q, Li Y, Cheng Y, et al. Assessment of the effect of age on macular layer thickness in a healthy Chinese cohort using spectral-domain optical coherence tomography. BMC Ophthalmol 2018;18(1):169
7张蓉,陈伟,江嫒.海德堡OCT测量正常人后极部视网膜厚度价值的研究.中国实用眼科杂志2014;32(12):1420-1423
8 Sezgin Akcay BI,Gunay BO,Kardes E,et al. Evaluation of ganglion cell complex and retinal nerve fiber layer in low,moderate,and high myopia:a study by RTVue spectral domain optical coherence tomography. Semin Ophthalmol 2017;32(6):682-688
9 Fujiwara A, Shiragami C, Shirakata Y, et al. Enhanced depth imaging spectral-domain optical coherence tomography of subfoveal chornidal thickness in normal Japanese eyes. Jpn J Ophthalmol 2012;56(3):230-235
10 Li XQ, Larsen M, Munch IC. Subfoveal choroidal thickness in relation to sex and axial length in 93 Danish university students. Invest Ophthalmol Vis Sci 2011;52(11):8438-8441
11 Sogawa K, Nagaoka T, Takahashi A, et al. Relationship between choroidal thickness and choroidal circulation in healthy young subjects. Am J Ophthalmol 2012;153(6):1129-1132
12何吕福.脉络膜厚度研究进展.中华实验眼科杂志 2017;35(10):949-954
13 Strobbe E, Cellini M, Campos EC. Aqueous flare and choroidal thickness in patients with chronic hepatitis C virus infection: a pilot study. Ophthalmology 2013;120(11):2258-2263
14 Ahmad M, Tsui E, Smith RT. Choroidal Osteoma Deossification Visualized by Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography. Ophthalmic Surg Lasers Imaging Retina 2017;48(1):87-90
15郑祥榕,滕娟,陈小红,等.非增生型糖尿病视网膜病变患者黄斑区脉络膜厚度的临床观察.国际眼科杂志 2018;18(11):2035-2038