基于OCTA的白内障超声乳化术后黄斑区视网膜厚度和血管密度分析

目的　利用光学相干断层扫描血管成像（optical coherence tomography angiography，OCTA）评估白内障超声乳化术后黄斑区视网膜厚度和血管密度的改变。方法　纳入47例（57眼）白内障患者，分别在白内障超声乳化术前及术后1周、1个月和3个月使用OCTA检查患眼黄斑中心凹、黄斑中心凹旁、黄斑中心凹周边视网膜厚度和黄斑区视网膜浅层、深层的微血管密度以及黄斑中心凹无血管区（foveal avascular zone，FAZ）面积的变化。结果　与术前相比，术后1个月和3个月黄斑中心凹、黄斑中心凹旁和黄斑中心凹周边视网膜全层厚度均显著增加（均为P<0.05），主要表现在内层视网膜的增加上。术后1周、1个月、3个月，黄斑中心凹旁及黄斑中心凹周边视网膜浅层血管密度与术前相比差异均无统计学意义（均为P>0.05），仅术后1个月视网膜深层黄斑中心凹周边血管密度显著高于术前（P<0.05）。术后1个月和3个月黄斑FAZ面积分别为（0.42±0.23)mm²和（0.34±0.17)mm²,显著低于术前的（0.73±0.91)mm²，差异均有统计学意义（均为P<0.05）。结论　白内障超声乳化术后患者黄斑区视网膜厚度增加以及FAZ面积降低，黄斑中心凹周边视网膜血管密度无明显改变。

Changes of macular retinal thickness and vessel density after phacoemulsification using optical coherence tomography angiography

Objective To evaluate the changes of macular retinal thickness and vessel density after phacoemulsification using optical coherence tomography angiography(OCTA).Methods Totally 57 eyes of 47 cataract patients were enrolled,and received OCTA to measure changes of the foveal,parafoveal and perifoveal retinal thickness,microvessel density,and area of foveal avascular zone(FAZ)at retinal superficial layer and deep layer in macular region before phacoemulsification,and 1 week,1 month and 3 months after phacoemulsification.Results Compared with that before surgery,foveal,parafoveal and perifoveal retinal thickness at all layers significantly increased at 1 month and 3 months after surgery(all P<0.05),mainly in the inner retina.Compared with that before surgery,there was no significant difference in vessel density at parafoveal and perifoveal retinal superficial layer at 1 week,1 month and 3 months after surgery(all P>0.05).Only at 1 month after operation,the perifoveal vessel density at the retinal deep layer was significantly higher than that before surgery(P<0.05).In addition,the FAZ areas were(0.42±0.23)mm2 at 1 month after surgery and(0.34±0.17)mm2 at 3 months after surgery,both of which were significantly lower than(0.73±0.91)mm2 before surgery(both P<0.05).Conclusion The retinal thickness at macular region increases,FAZ area reduces,and perifoveal retinal vessel density has no significant change after phacoemulsification.