眼科 ›› 2021, Vol. 30 ›› Issue (6): 425-429.doi: 10.13281/j.cnki.issn.1004-4469.2021.06.004

• 论著 • 上一篇    下一篇

非动脉炎性前部缺血性视神经病变患者OCTA视盘量化参数及其与病程、视力预后的关系

张秋阳 赵玥 姚进 蒋沁   

  1. 南京医科大学附属眼科医院210029
  • 收稿日期:2020-09-20 出版日期:2021-11-25 发布日期:2021-12-10
  • 通讯作者: 蒋沁,Email:jqin710@vip.sina.com E-mail:jqin710@vip.sina.com
  • 基金资助:
    国家自然科学基金(81870679)

Quantitative optical coherence tomography angiography characteristics and relation with vision and course of disease in non-arteritic anterior ischemic optic neuropathy

Zhang Qiuyang, Zhao Yue, Yao Jin, Jiang Qin   

  1. Eye Hospital, Nanjing Medical University, Nanjing 210029, China
  • Received:2020-09-20 Online:2021-11-25 Published:2021-12-10
  • Contact: Jiang Qin, Email: jqin710@vip.sina.com E-mail:jqin710@vip.sina.com
  • Supported by:
    National Natural Science Foundation of China (81870679)

摘要: 目的 应用相干光断层扫描血管成像(OCTA)研究不同病程的非动脉炎性前部缺血性视神经病(NA-AION)的影像特征及视盘量化参数,并探讨其与病程、视力预后之间的关系。设计 回顾性病例系列。研究对象 2019年1-6月就诊于南京医科大学附属眼科医院的NA-AION患者24例(24眼)。方法 回顾分析临床确诊为NA-AION患者(24例24眼)的临床资料。所有患者均进行最佳矫正视力(BCVA)(LogMAR)、OCTA检查并于1、3个月时复诊。比较不同病程患眼BCVA(LogMAR)、平均视盘视网膜神经纤维层(RNFL)厚度、放射状视盘周围毛细血管(RPC)血流密度的变化,并将OCTA量化参数与BCVA(LogMAR)、病程进行相关因素分析。主要指标 BCVA(LogMAR)、RNFL厚度、RPC血流密度。结果 首诊时患眼RNFL厚度(315.76±21.45 μm)较对照组(108.67±3.02 μm)显著增厚,RPC血流密度(45.49%±1.60%)较对照组(50.64%±0.74%)显著降低(P均<0.05)。与病程≤7天的患眼比较,>7天的患眼缺血区与非缺血区间的RPC血流密度差异更为显著(P<0.05)。1个月及3个月时BCVA均较基线时提高(P<0.05),1个月与3个月的BCVA无显著差异(P=0.329)。与基线值相比,1个月及3个月的RNFL厚度、RPC血流密度逐渐递减,差异具有统计学意义(P<0.05)。BCVA与RNFL厚度、RPC血流密度呈显著正相关关系(r=0.527,0.550;P<0.05)。结论 OCTA可以观察NA-AION视盘RNFL厚度及RPC血流密度变化,视力预后与视盘RNFL及血流密度显著相关。(眼科,2021, 30: 425-429)

关键词: 非动脉炎性前部缺血性视神经病变, 相干光断层扫描血管成像, 病程, 视力预后

Abstract: Objective To observe the characteristics in non-arteritic anterior ischemic optic neuropathy (NA-AION) using optical coherence tomography angiography (OCTA), and investigate the relation with course of disease and visual prognosis. Design Retrospective case series. Participants 24 eyes (24 cases) of NA-AION in Eye Hospital affiliated to Nanjing Medical University from January to June 2019. Methods At the baseline, one month and six months, comprehensive ophthalmologic examinations were performed, including best corrected visual acuity (BCVA) (LogMAR) and OCTA. The characteristics of (BCVA) (LogMAR) and the average retinal nerve fiber layer (RNFL) thickness and the vessel flow density of radial peripapillary capillary (RPC) with different courses of disease were compared, and related factors were analyzed with BCVA (LogMAR) and course of disease. Main Outcome Measures BCVA (LogMAR), RNFL thickness, vessel flow density of RPC. Results Compared with the control group(108.67±3.02 μm), the RNFL thickness of NA-AION group(315.76±21.45 μm) was significantly thicker, and the vessel flow density of RPC was lower at baseline, the difference were statistically significant (all P<0.05). Compared to the eyes with disease duration≤7 days, there were more significant differences in the vessel flow density of RPC between ischemic and non-ischemic areas in the eyes with disease duration>7 days (P<0.05). The BCVA (LogMAR) was improved at 1 month and 3 months after onset, but there was no significant difference in BCVA (LogMAR) between 1 month and 3 months (P=0.329). Compared with the baseline, the RNFL thickness and the vessel flow density of RPC were decreased gradually at 1 month and 3 months the differences were statistically significant (P<0.05). The BCVA (LogMAR) was significantly positively correlated with RNFL thickness and the vessel flow density of RPC (r= 0.527, 0.550; P<0.05). Conclusion We can observe the change of optic disc RNFL thickness and the vessel flow density of RPC in NA-AION by OCTA, and the visual prognosis is significantly correlated with RNFL thickness and the optic disc vessel flow density. (Ophthalmol CHN, 2021, 30: 425-429)

Key words: non-arteritic anterior ischemic optic neuropathy, optical coherence tomography angiography, course of disease, vision prognosis