OCTA在视网膜静脉阻塞诊疗中的应用价值

目的：探讨OCTA检查在视网膜静脉阻塞诊疗中的重要应用价值。

方法：采用回顾性病例对照研究，选取2018-01/10于大连市第三人民医院眼科门诊确诊为视网膜静脉阻塞的患者38例38眼，其患病眼为A组，对侧健康眼为B组。所有患者均接受OCTA对黄斑区视网膜行3mm×3mm范围的模式扫描，获得表层视网膜、深层视网膜、外层视网膜及脉络膜毛细血管层4个层面黄斑血流密度图，测量表层视网膜中心凹无血管区面积(FAZ)，Image J软件计算4个层面黄斑区血流密度(MVD)，OCT模式测量黄斑中心凹的水平厚度与垂直厚度(CFT)。

结果：A组和B组浅层视网膜FAZ、水平CFT及垂直CFT测量均有差异(P<0.01)。A组和B组表层视网膜及深层视网MVD均有差异(P<0.01)，外层视网膜层MVD、脉络膜毛细血管层MVD结果无差异(P=0.542、0.489)。BCVA(LogMAR)分别与表层视网膜FAZ、水平CFT及垂直CFT呈正相关(r=0.482、0.652、0.621，均P<0.01)，与表层视网膜MVD及深层视网膜MVD呈负相关(r=-0.486、-0.465，均P<0.01)。

结论：应用OCTA检查对提示视网膜静脉阻塞患者黄斑区视网膜的微循环障碍和视力预后有重要指导意义。

Application value of OCTA examination in diagnosis and treatment of retinal vein occlusion

AIM: To evaluate the value of OCTA in the diagnosis and treatment of retinal vein occlusion.

METHODS: A retrospective case-control study was conducted to select 38 patients(38 eyes)with retinal vein occlusion diagnosed in ophthalmology clinic of Dalian Third People''s Hospital from January to October 2018. The affected eyes were group A and the contralateral healthy eyes were group B. All patients underwent OCTA mode scanning of macular retina in the range of 3 mm×3 mm. Four layers of macular blood flow density maps were obtained, including surface retina, deep retina, outer retina and choroidal capillary layer. The area of vascularized area(FAZ)in the central fovea of the surface retina was measured. Image J software was used to calculate four layers of macular blood. Flow density(MVD)and OCT were used to measure the horizontal and vertical fovea thickness(CFT).

RESULTS: There were differences in FAZ measurements in superficial retina between group A and group B(P<0.01), and in horizontal and vertical CFT measurements(P<0.01). There were differences in MVD between group A and group B(P<0.01). There was no difference in MVD results in outer retina(P=0.542)and choroidal capillary layer(P=0.489). BCVA was positively correlated with surface retinal FAZ, horizontal CFT and vertical CFT, and negatively correlated with surface retinal MVD and deep retinal MVD, respectively(r=-0.486, -0.465,all P<0.01).

CONCLUSION: The application of OCTA examination has important guiding significance in indicating macular retinal microcirculation disorder and visual prognosis in patients with retinal vein occlusion.