| 单眼弱视患儿黄斑区微血管结构和血流密度改变及视觉质量分析 |
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| 引用本文： | 田敏,张熙伯,熊鑫,王勇,罗林碧,张沛霖,吕红彬.单眼弱视患儿黄斑区微血管结构和血流密度改变及视觉质量分析[J].眼科新进展,2022,0(11):893-899. |
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| 作者姓名： | 田敏 张熙伯 熊鑫 王勇 罗林碧 张沛霖 吕红彬 |
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| 作者单位： | 646000 四川省泸州市，西南医科大学附属医院眼科 |
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| 摘 要： | 目的 观察黄斑区视网膜微血管结构、血流密度、视觉质量及黄斑区视网膜厚度在单眼弱视儿童中的特点，并评价其在单眼弱视儿童中的作用。方法 选取2019年10月至2021年3月于西南医科大学附属医院眼科就诊的单眼弱视患儿81例。使用光学相关断层扫描（OCT）测量黄斑区视网膜厚度；通过光学相干断层扫描血管造影术（OCTA）测量黄斑区视网膜浅层毛细管丛的微血管结构和血流密度；使用双通道视觉质量分析系统（OQASⅡ）对患者视觉质量进行客观评估。结果 在81例单眼弱视儿童中，屈光参差性弱视47例，斜视性弱视34例。弱视眼黄斑区视网膜在外环上、外环下和外环平均值均较对侧眼厚，差异均有统计学意义（均为P<0.05）；在3 mm×3 mm范围黄斑扫描中，弱视眼的血管线性密度（VD）1 mm ×1 mm、VD1 mm ×3 mm、VD3 mm ×3 mm均小于对侧眼（P<0.05），其中屈光参差性弱视眼的VD1 mm ×1 mm小于斜视性弱视眼（均为P<0.05），差异均有统计学意义；弱视眼的血流灌注密度（PD）1 mm ×1 mm、PD1 mm ×3 mm、PD3 mm ×3 mm均小于对侧眼（均为P<0.05），差异均有统计学意义，其中屈光参差性弱视眼的PD1 mm ×1 mm小于斜视性弱视眼，差异均有统计学意义（均为P<0.05）；在6 mm×6 mm范围黄斑扫描中，弱视眼的VD1 mm ×1 mm、VD1 mm ×3 mm均小于对侧眼（均为P<0.05），差异均有统计学意义，其中屈光参差性弱视眼的VD1 mm ×1 mm小于斜视性弱视眼，差异均有统计学意义（均为P<0.05）；弱视眼的PD1 mm ×1 mm、PD1 mm ×3 mm均小于对侧眼（均为P<0.05），差异均有统计学意义，其中屈光参差性弱视眼的PD1 mm ×1 mm小于斜视性弱视眼，差异均有统计学意义（均为P<0.05）；弱视眼的截止空间频率(MTF cutoff)、斯特列尔比值(SR)及对比度为100%、20%、9%时的OV值(OV100%、OV20%和 OV9%)低于对侧眼，弱视眼的客观散射指数(OSI)高于对侧眼，其中屈光参差性弱视眼的MTF cutoff、OV100%低于斜视性弱视眼，OSI高于斜视性弱视眼，差异均具有统计学意义（均为P<0.05）。结论 黄斑区OCT和OCTA对评估单眼弱视患儿视网膜的结构和血流变化有一定意义，其中屈光参差性弱视较斜视性弱视变化更大；弱视眼的视觉质量较正常对侧眼降低，屈光参差性弱视较斜视性弱视的视觉质量稍差，OQASⅡ能客观全面获取单眼弱视儿童视网膜成像质量的信息。
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| 关 键 词： | 弱视 光学相干断层扫描 光学相干断层扫描血管造影术 双通道视觉质量分析系统 |
Changes in macular microvascular structure and vessel density and visual quality in children with monocular amblyopia |
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| TIAN Min,ZHANG Xibo,XIONG Xin,WANG Yong,LUO Linbi,ZHANG Peilin,L Hongbin.Changes in macular microvascular structure and vessel density and visual quality in children with monocular amblyopia[J].Recent Advances in Ophthalmology,2022,0(11):893-899. |
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| Authors: | TIAN Min ZHANG Xibo XIONG Xin WANG Yong LUO Linbi ZHANG Peilin L Hongbin |
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| Affiliation: | Department of Ophthalmology，the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China |
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| Abstract: | Objective To analyze the characteristics of the macular microvascular structure, vessel density (VD), visual quality, and macular retinal thickness in children with monocular amblyopia, and evaluate their effects. Methods A total of 81 children with monocular amblyopia who were admitted to the Department of Ophthalmology, Affiliated Hospital of Southwest Medical University were included in this study. Their macular retinal thickness was measured by optical coherence tomography (OCT). Their microvascular structures and VDs at the superficial capillary plexus (SCP) in the macular area were detected by optical coherence tomography angiography (OCTA). Their visual quality was evaluated using the dual-channel optical quality analysis system (OQAS-Ⅱ). Results Among the 81 children, 47 suffered from anisometropic amblyopia, and 34 suffered from strabismic amblyopia. The macular retina of the amblyopic eyes was thicker than that of the contralateral eyes in the superior and inferior quadrants of the outer ring, and the average macular retinal thickness of the amblyopic eyes was also higher than that of the contralateral eyes in the outer ring (all P<0.05). In the 3 mm×3 mm macular scan area, the VD1 mm×1 mm, VD1 mm×3 mm, and VD3 mm×3 mm of the amblyopic eyes were smaller than those of the contralateral eyes (all P<0.05), and the VD1 mm×1 mm of the anisometropic amblyopia eyes was less than that of the strabismic amblyopia eyes (P<0.05); the perfusion density (PD)1 mm×1 mm, PD1 mm×3 mm, and PD3 mm×3 mm of the amblyopic eyes were smaller than those of the contralateral eyes (all P<0.05), and the PD1 mm×1 mm of anisometropic amblyopia eyes was less than that of the strabismic amblyopia eyes (P<0.05). In the 6 mm×6 mm macular scan area, the VD1 mm×1 mm and VD1 mm×3 mm of the amblyopic eyes were smaller than those of the contralateral eyes (both P<0.05), and the VD1 mm×1 mm of the anisometropic amblyopia eyes was less than that of the strabismic amblyopia eyes (P<0.05); the PD1 mm×1 mm and PD1 mm×3 mm of the amblyopic eyes were smaller than those of the contralateral eyes (both P<0.05), and the PD1 mm×1 mm of the anisometropic amblyopia eyes was less than that of the strabismic amblyopia eyes (P<0.05). The MTF cutoff, Strehl ratio (SR), OV100%, OV20%, and OV9% of the amblyopic eyes were lower than those of the contralateral eyes, while the objective scatter index (OSI) of the amblyopic eyes was higher than that of the contralateral eyes. The MTF cutoff and OV100% of the anisometropic amblyopia eyes were lower than those of the strabismic amblyopia eyes, while the OSI was higher than that of the strabismic amblyopia eyes (all P<0.05). Conclusion OCT and OCTA can effectively evaluate the retinal structure and VD changes in children with monocular amblyopia. The changes are more significant in anisometropic amblyopia eyes than in strabismic amblyopia eyes. The visual quality of amblyopic eyes decreases compared with the normal contralateral eyes, and it worsens in anisometropic amblyopia eyes than in strabismic amblyopia eyes. OQAS-Ⅱ can objectively and comprehensively obtain information on the retinal imaging quality of children with monocular amblyopia. |
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| Keywords: | amblyopia optical coherence tomography optical coherence tomography angiography dual-channel optical quality analysis system |
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