摘要
目的使用光学相干断层扫描血管成像(OCTA)检测屈光参差性弱视儿童黄斑区视网膜厚度及微血管系统的差异,探究屈光参差性弱视的发病机制。方法纳入2020年6月至12月在南昌大学第二附属医院儿童眼科门诊就诊的4~14岁屈光参差性弱视儿童41例及正常视力儿童22例,将屈光参差性弱视患儿的弱视眼纳入为弱视眼组,非弱视眼纳入为对侧眼组,正常视力儿童的右眼为正常对照组。使用OCTA扫描三组入选眼的眼底黄斑部3 mm×3 mm的范围,经ImageJ处理后获得浅层视网膜毛细血管丛血流密度(SCPVD)和深层视网膜毛细血管丛血流密度(DCPVD),采用ETDRS分区扫描模式扫描黄斑部,得出黄斑部以黄斑中心凹为中心,直径分别为1 mm圆形(中心区)及>1~3 mm、>3~6 mm环形区的视网膜厚度。分析比较三组之间黄斑区SCPVD、DCPVD及视网膜厚度之间的差异。结果弱视眼组、对侧眼组和正常对照组入选眼的SCPVD分别为(25.01±6.00)%、(29.34±4.23)%和(30.16±2.90)%,DCPVD分别为(27.87±4.12)%、(30.30±2.72)%和(30.65±2.38)%,弱视眼组的SCPVD和DCPVD均较对侧眼组、正常对照组明显降低,差异均具有统计学意义(均为P<0.05),对侧眼组入选眼的SCPVD和DCPVD与正常对照组相比差异均无统计学意义(均为P=1.00)。弱视眼组、对侧眼组和正常对照组入选眼黄斑中心区视网膜厚度分别为(265.78±21.10)μm、(260.94±18.97)μm和(263.59±14.71)μm,三组间黄斑中心区视网膜厚度差异均无统计学意义(均为P>0.05);弱视眼组、对侧眼组和正常对照组入选眼黄斑区平均视网膜厚度分别为(321.13±10.83)μm、(316.19±11.80)μm和(314.85±10.81)μm,弱视眼组入选眼黄斑区平均视网膜厚度均较对侧眼组、正常对照组明显增厚,差异均具有统计学意义(均为P<0.05),对侧眼组与正常对照组入选眼的平均视网膜厚度差异无统计学意义(P=0.77)。结论屈光参差性弱视患儿的弱视眼黄斑区视网膜厚度及微血管系统均存在异常,提示黄斑区视网膜参与屈光参差性弱视的发病过程。
Objective To obverse the changes in retinal thickness and microvascular system of the macula in children with anisometropic amblyopia using optical coherence tomography angiography(OCTA),and to explore the pathoge-nesis of anisometropic amblyopia.Methods From June 2020 to December 2020,41 children with anisometropic amblyopia from 4 to 14 years old and 22 children visiting a doctor in the Pediatric Ophthalmology Clinic of the Second Affiliated Hospital of Nanchang University with normal vision were included in this study.The amblyopic eyes of subjects with anisometropic amblyopia were included in the amblyopic group,the non-amblyopic eyes were in the fellow group,and the right eyes of children with normal vision were in the control group.The macular area of the fundus of three groups of selected eyes was scanned by OCTA in the range of 3 mm×3 mm,followed that the superficial retinal capillary plexus vessel density(SCPVD)and the deep retinal capillary plexus vessel density(DCPVD)were obtained after ImageJ processing.The macula area was scanned by ETDRS partition scan mode to obtain the retinal thickness of each area,that is,the macular area was centered on the macular fovea,with a diameter of 1 mm circle(central area)and the ring area>1-3 mm and>3-6 mm,respectively.The differences in the macular SCPVD,DCPVD and retinal thickness between the three groups were analyzed and compared.Results The SCPVD of the amblyopic group,fellow group and control group were(25.01±6.00)%,(29.34±4.23)%,and(30.16±2.90)%,respectively,and the DCPVD were(27.87±4.12)%,(30.30±2.72)%and(30.65±2.38)%,respectively.The SCPVD and DCPVD of the amblyopic eyes was significantly reduced compared with the fellow eyes and control eyes,and the differences were statistically significant(all P<0.05).The SCPVD and DCPVD of the fellow eye were reduced compared with the normal control eye,but the differences were not statistically significant(both P=1.00).The amblyopic group,the fellow group and control group had a macular foveal retinal thickness being(265.78±21.10)μm,(260.94±18.97)μm,and(263.59±14.71)μm,respectively.There were no significant differences in the thickness of the foveal retina among the three groups(all P>0.05).The average retinal thickness was(321.13±10.83)μm,(316.19±11.80)μm and(314.85±10.81)μm,in the amblyopic group,the fellow group and control group respectively.The average retinal thickness of the amblyopic eyes was significantly thicker than that of the fellow eyes and control eyes,and the differences were statistically significant(both P<0.05),but there was no significant difference in the average retinal thickness between the fellow eye and the control eye(P=0.77).Conclusion There are abnormalities in the retinal thicknessand retinal microvascular system in the macular area of the amblyopic eyes of anisometropic amblyopia,which suggests the macular retina is involved in the pathogenesis of anisometropic amblyopia.
作者
封炎
张凌月
郑卓涛
卢红薇
邓燕
熊伟伟
付燕梅
李双莲
殷小龙
FENG Yan;ZHANG Lingyue;ZHENG Zhuotao;LU Hongwei;DENG Yan;XIONG Weiwei;FU Yanmei;LI Shuanglian;YIN Xiaolong(Department of Pediatric Ophthalmology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China)
出处
《眼科新进展》
CAS
北大核心
2021年第6期570-574,共5页
Recent Advances in Ophthalmology
