非缺血型视网膜中央静脉阻塞患者黄斑区血管密度

目的　采用ＯＣＴ血管成像系统对非缺血型视网膜中央静脉阻塞（ｃｅｎｔｒａｌｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＣＲＶＯ）患者黄斑区血管密度进行观察研究。方法　对确诊为非缺血型ＣＲＶＯ的３２例（３２眼）患者双眼均行ＯＣＴ血管成像检查，分别获得患眼与健眼黄斑区３ｍｍ×３ｍｍ范围表层、深层血管密度及视网膜厚度，比较患眼与健眼黄斑区表层血管密度的差异；分析患眼黄斑区表层血管密度与视网膜水肿的相关性；探讨非缺血型ＣＲＶＯ黄斑区表层及深层血管密度变化与疾病病程的关系。结果　非缺血型ＣＲＶＯ患眼整体范围表层血管密度为（４４．７３±３．２４）％，健眼为（５１．２４±２．４５）％，患眼与健眼整体范围及各象限表层血管密度差异均有统计学意义（均为Ｐ＜０．０５），非缺血型ＣＲＶＯ患眼黄斑区周围表层血管密度较健眼明显降低。非缺血型ＣＲＶＯ患眼黄斑区表层血管密度与视网膜厚度（即水肿程度）呈负相关（Ｙ＝－０．４６２Ｘ＋５５．０４７，Ｒ２＝０．８４２）。病程１周、１个月、２个月的非缺血型ＣＲＶＯ患眼表层血管密度分别为:（４７．４７±２．９０）％、（４２．３７±２．７４）％、（３８．５４±３．９０）％，而深层血管密度分别为:（４２．８７±２．１５）％、（３９．４９±２．３４）％、（３８．３２±３．０２）％，表层血管密度随病程延长逐渐降低，而深层血管密度在病变初期即出现明显下降。结论　非缺血型ＣＲＶＯ眼黄斑区血管密度较健眼明显降低，且与黄斑区水肿程度呈负相关，同时其深层血管密度降低可能早于表层血管。

Density of macular blood vessels in nonischemic central retinal vein occlusion

Objective To observe the density of blood vessels in the nonischemic central retinal vein occlusion ( CRVO) by optical coherence tomography ( OCT) . Methods Thirty-two noruschemic CRVO patients (32 eyes) were examined by OCT. The density of blood vessels in surface and deeper retina and retinal thickness in the macular area 3 mm diameter range of retina were acquired respectively,and the density of blood vessels in sick eyes and healthy eyes in the macular was compared,the correlation of blood vessels in the surface and retinal edema in the macular was analyzed,and the relation of density change of blood vessels in surface and deep retina in the macular and disease progression for the nonischemic CRVO eyes was discussed. Results The average density of blood vessels in the whole range for 32 patients ( 32 eyes) with nonischemic CRVO was (44. 73 + 3. 24) % ,and the healthy eyes was ( 51. 24 + 2. 45 ) % , and there were differences in the density of blood vessels among both whole range and each region ( all P < 0. 05 ). There was negative relation between the average density of blood vessels and thickness of retina ( retinal ederua, Y = - 0. 462X + 55. 047,R2 = 0. 842). For different disease progression:At l week,l month and 2 months,the average density(% ) of blood vessels on the surface of the macular for the nonischenuc CRVO eyes were (47. 47 +2. 90) % ,( 42. 37 +2. 74 )% , (38. 54 + 3. 90)% ,and the average density of deeper blood vessels in the macular were ( 42. 87 + 2. 15 ) % , ( 39. 49 + 2. 34 ) % , (38. 32 + 3. 02) % ,then the average density of blood vessels on the surface decreased with the disease progression,while the density of deeper blood vessels sigruficantly reduced at the beginning of the course of disease. Conclusion The density of blood vessels in the macular for the nonischemic CRVO eyes is less than that for healthy eyes,and it shows a negative relation between the average density of blood vessels and macular edema; Meanwhile, the decrease of the density in deeper retina may be earlier than the blood vessels on the surface.