光学相干断层扫描评价血清同型半胱氨酸升高对视网膜血管结构的影响

目的通过光学相干断层扫描(OCT)评价血清同型半胱氨酸(Hcy)升高对视网膜血管结构的影响。方法2014年4月至2018年12月期间眼科门诊行双眼OCT检查的受试者115例,根据血清Hcy水平将受试者分为高Hcy组(观察组,37例)和非高Hcy组(对照组,78例)。对照组进一步分成Hcy轻度升高亚组(28例)和Hcy低水平亚组(50例)。分析比较性别、年龄、BMI、吸烟情况、基础疾病、血脂及双眼OCT检查视网膜血管计量参数。结果糖尿病及冠心病占比观察组显著高于对照组(P<0.05)。视网膜血管定量参数中动脉壁厚度、动脉壁/管腔比值比及动脉横截面面积观察组[(21.69±3.22)μm,(0.32±0.04),(7974.35±1706.88)μm2]均显著大于对照组[(16.23±3.62)μm,(0.24±0.05),(6056.05±1465.72)μm2],动脉内径[(94.81±13.98)μm]小于对照组[(102.55±13.43)μm],差异均有统计学意义(均P<0.05)。动静脉内径比观察组显著小于对照组[(0.69±0.09)比(0.75±0.12),P<0.05]。Hcy轻度升高亚组和Hcy低水平亚组视网膜静脉外径[(170.82±24.71)μm比(159.74±18.82)μm]、静脉壁厚度[(13.77±4.16)μm比(12.75±2.27)μm]及静脉横截面面积[(6703.14±1742.75)μm2比(5528.54±1087.07)μm2]差异均有统计学意义(均P<0.05)。结论Hcy水平升高可影响视网膜血管结构,初期以视网膜静脉结构改变为主,后期以视网膜动脉结构改变为主。

The effect of increased homocysteine on retinal vascular structure evaluated by optical coherence tomography

Objective To evaluate the effect of increased homocysteine(Hcy)on retinal vascular structure by optical coherence tomography(OCT).Methods A total of 115 subjects underwent OCT scan at the ophthalmology clinic from April 2014 to December 2018 were enrolled and divided into high Hcy group(observation group)(n=37)and normal Hcy group(control group)(n=78).Control group was further divided into mildly elevated Hcy group(n=28)and low-level Hcy group(n=50).Gender,age,BMI,smoking status,underlying diseases,lipid level and quantitative parameters of retinal blood vessels were compared between the two groups.Results The ratio of diabetes and coronary heart disease was significantly higher in observation group than in control group(P<0.05).The retinal artery diameter[(94.81±13.98)μm vs.(102.55±13.43)μm],arterial wall thickness[(21.69±3.22)μm vs.(16.23±3.62)μm],arterial wall/lumen ratio[(0.32±0.04)vs.(0.24±0.05)],arterial cross-sectional area[(7974.35±1706.88)μm2 vs.(6056.05±1465.72)μm2]were significantly higher in observation group than control group.Retinal arterio-venous diameter ratio was significantly lower in observation than control group[(0.69±0.09)vs.(0.75±0.12),P<0.05].The external diameter of retinal vein[(170.82±24.71)μm vs.(159.74±18.82)μm],vein wall thickness[(13.77±4.16)μm vs.(12.75±2.27)μm]and cross sectional area of vein[(6703.14±1742.75)μm2 vs.(5528.54±1087.07)μm2]were significantly different between mildly elevated Hcy group and Low-level Hcy group(all P<0.05).Conclusion The increase of serum Hcy can affect retinal vascular structure with vein structure changes in initial stage and artery structure changes in later stage.