OCTA观察BRVO患者黄斑区微血管的改变及其与预后的关系

目的：应用光学相干断层扫描血管造影(OCTA)观察视网膜分支静脉阻塞(BRVO)患者黄斑区微血管参数的变化及其与最佳矫正视力(BCVA)的相关性。

方法：采用OCTA对29例BRVO患者双眼后极部视网膜浅层毛细血管层进行扫描，获取基线、1、6mo复查时不同区域的血管线性密度(VD)、血流灌注密度(PD)、黄斑中心凹无血管区域(FAZ)面积和形态指数。

结果：BRVO组FAZ面积为0.32±0.08mm²，大于健侧眼组FAZ面积0.21±0.06mm²(t=-6.958，P<0.001)； BRVO组与健侧眼组在3mm×3mm及6mm×6mm分析模式中比较全部区域的VD均有差异(P<0.05)； BRVO组与健侧眼组在3mm×3mm分析模式中比较PD，中心环区和内环区均有差异(P<0.001)，6mm×6mm分析模式中中心环区、外环区和完整区均有差异(P<0.05)。基线BCVA与6mo复查时BCVA比较有差异(t=2.43，P<0.05)； BCVA(LogMAR)与3mm×3mm VD中心环区、PD中心环区及6mm×6mm PD中心环区、PD完整区呈正相关，与6mm×6mm PD外环区呈负相关。

结论：作为非侵入性检查手段，OCTA能够某种程度上反映BRVO患者黄斑区血流改变情况，黄斑区微血管的改变可能与预后存在相关。

Observation on the changes of macular microvessels in BRVO patients and its relationship with prognosis by using OCTA

AIM: To observe the changes of macular microvascular parameters and their correlation with best corrected visual acuity(BCVA)in patients with branch retinal vein occlusion(BRVO)by using optical coherence tomography angiography(OCTA).

METHODS: The superficial retinal capillary layer in the posterior pole of 29 patients with BRVO was scanned by OCTA. Macular vascular density including vessel density(VD), perfusion density(PD), foveal avascular zone(FAZ), and morphological index were obtained at baseline, 1 and 6mo respectively.

RESULTS: The FAZ area in BRVO group was 0.32±0.08mm², significantly larger when compared to the fellow eyes(0.21±0.06mm²)(t=-6.958, P<0.001). The VD of full area of 3mm×3mm and 6mm×6mm was lower in BRVO eyes compared to fellow eyes(P<0.05). As for PD, a difference was found between the two groups in the central and inter area in the 3mm×3mm scan pattern(P<0.001), while a significant difference was found in central, the outer, and the full area in the 6mm×6mm scan pattern(P<0.05). The BCVA at baseline was significantly better than that at 6mo(t=2.43, P<0.05); BCVA(LogMAR)was positively correlated with VD and PD of centre area in 3mm×3mm mode, and PD of central and full area in 6mm×6mm model, but negatively correlated with PD in the outer area in 6mm×6mm mode.

CONCLUSION: As a non-invasive examination, quantitative OCTA measurements confirm vascular density changes in the superficial vascular networks in eyes with BRVO. Moreover, vascular density and FAZ area appear to correlate with visual function.