单侧先天性白内障形觉剥夺性弱视眼、对侧眼与同龄正常眼黄斑区血流密度特征对比分析

目的　应用OCTA对比分析单侧先天性白内障形觉剥夺性弱视眼、对侧眼与同龄正常眼黄斑区血流密度特征。方法　选取2014年1月至2019年12月在我院行单侧先天性白内障摘出术,且伴有形觉剥夺性弱视的患者20例20眼。本研究受试对象分为3组,观察组为单侧先天性白内障形觉剥夺性弱视眼,自身对照组为其对侧眼,正常对照组受试者为在我院眼科进行视力检查的正常人20人20眼。应用蔡司公司Cirrus 5000-HD-OCT仪对患者进行OCTA检测,测量受试眼视网膜浅层黄斑区血管长度密度、血管灌注密度及黄斑中心凹无血管区（FAZ）面积、周长、形态指数等参数。比较三组受试眼各参数的差异,并分析弱视眼最佳矫正视力（BCVA）与双眼血流各参数差值之间的相关性。结果　观察组受试眼BCVA明显低于自身对照组、正常对照组,差异均有统计学意义（均为P<0.001）。观察组受试眼视网膜浅层黄斑区中心、内层、外层、完整区域血管长度密度、血管灌注密度均明显低于自身对照组、正常对照组,差异均有统计学意义（均为P<0.05）。自身对照组与正常对照组相比,受试眼视网膜浅层黄斑区中心、内层、外层、完整区域血管长度密度、血管灌注密度,差异均无统计学意义（均为P>0.05）。观察组受试眼视网膜浅层FAZ面积、周长均明显小于自身对照组、正常对照组,差异均有统计学意义（均为P<0.05）。自身对照组与正常对照组相比,受试眼视网膜浅层FAZ面积、周长差异均无统计学意义（均为P>0.05）。三组间视网膜浅层FAZ形态指数差异均无统计学意义（均为P>0.05）。单侧先天性白内障形觉剥夺性弱视眼BCVA与双眼FAZ面积差值、周长差值均呈负相关(r=-0.464,P=0.045;r=-0.548,P=0.015）。结论　单侧先天性白内障形觉剥夺性弱视眼血流密度明显低于对侧眼及正常同龄眼,FAZ面积、周长明显小于对侧眼及正常同龄眼。双眼视网膜浅层FAZ面积差值及周长差值越大,弱视眼BCVA越差。

Contrastive analysis of macular vascular density of unilateral congenital cataract caused form-vision deprivation amblyopia eyes,contralateral eyes and normal control eyes

Objective　To compare and investigate macular vascular density of unilateral congenital cataract caused form-vision deprivation amblyopia eyes, contralateral eyes and normal control eyes using optical coherence tomography angiography (OCTA). Methods　Totally 20 patients (20 eyes) with form-vision deprivation amblyopia who underwent unilateral congenital cataract surgery in our hospital from January 2014 to December 2019 were included. All participants of this study were divided into 3 groups, observation group: 20 eyes with unilateral congenital cataract caused form-vision deprivation amblyopia; self-control group: 20 contralateral eyes and the normal control group was 20 normal eyes under-went visual inspection in our hospital. All participants were detected by the optical coherence tomography angiography (OCTA) through Cirrus 5000-HD-OCT, so as to measure the vessel length and density, perfusion density, foveal avascular zone (FAZ) area, FAZ perimeter, morphological index and other parameters in the superficial capillary plexus ocular of the retina. We then compared differences in various parameters among the three groups, analyzed correlations between best corrected visual acuity (BCVA) of the deprivation amblyopic eyes and differences of blood flow parameters between the two eyes. Results　In the observation group, the BCVA were significantly lower than that in the self-control group and the normal control group, and the difference was statistically significant (P<0.001). The vessel length and density and perfusion density in the central region, inner region, outer region, and complete region of the superficial capillary plexus ocular macular fovea in the observation group were significantly lower than those in the self-control group and the normal control group, and the differences were statistically significant (all P<0.05). There were no significant differences in blood flow parameters above between the self-control group and the normal control group (all P＞0.05). The FAZ area and FAZ perimeter of the superficial capillary plexus in the observation group were significantly smaller than those in the self-control group and the normal control group, and the differences were statistically significant (all P＜0.05). There were no significant differences in the FAZ area and perimeter of the superficial capillary plexus between the self-control group and normal control group (both P＞0.05). There was no significant difference in the FAZ morphological index of superficial capillary plexus ocular of the retina among the three groups (P＞0.05). The BCVA of amblyopic eyes was negatively correlated with the differences in the FAZ area and FAZ perimeter of two eyes (r=-0.464, P= 0.045; r=-0.548, P=0.015). Conclusion　In the eyes with unilateral congenital cataract caused deprivation amblyopia, the blood flow density is significantly lower than that in the contralateral eyes or the normal eyes, and the FAZ area and FAZ perimeter are smaller than those in the contralateral eyes or the normal eyes. The differences in FAZ area and perimeter between amblyopic eyes and contralateral eyes increase with the worse BCVA of amblyopia eyes.