超广角OCTA对视网膜静脉阻塞眼视网膜无灌注区的检出效果分析

目的 分析超广角光学相干断层扫描血管成像(OCTA)对视网膜静脉阻塞(RVO)眼视网膜无灌注区的检出效果。方法 选取2021年11月至2022年4月就诊于四川省人民医院眼科的RVO患者48例(48眼)作为研究对象,其中,视网膜中央静脉阻塞(CRVO)19例19眼,视网膜分支静脉阻塞(BRVO)29例29眼。所有患者均行检眼镜、荧光素眼底血管造影(FFA)和超广角OCTA检查。超广角OCTA检查选择24 mm×20 mm扫描模式。以FFA的检查结果为金标淮,计算超广角OCTA对RVO眼视网膜无灌注区的检出率,并应用受试者工作特征曲线(ROC曲线)分析其检测性能。结果 本研究共28眼(58.3%)被FFA检出视网膜无灌注区,超广角OCTA检出其中27眼,检出率96.4%,遗漏的一只患眼是由于超广角OCTA检测范围受限所致。在余下的20只患眼中,超广角OCTA更灵敏地检出1只患眼黄斑上方存在视网膜无灌注区,而在FFA图像中这个区域被视网膜出血引起的低荧光所掩盖。ROC分析结果显示：超广角OCTA检测RVO眼视网膜无灌注区的灵敏度、特异度分别为83.3%、100.0%,AUC为0.957。结论...

Detection performance of ultra-wide field optical coherence tomography angiography on the retinal non-perfusion areas in eyes with retinal vein obstruction

Objective　To analyze the detection rate of retinal non-perfusion areas in eyes with retinal vein obstruction (RVO) by ultra-wide field optical coherence tomography angiography (OCTA).
Methods　A total of 48 RVO patients (48 eyes) visited the Department of Ophthalmology, Sichuan Provincial People’s Hospital from November 2021 to April 2022 were included, comprising 19 patients (19 eyes) with central retinal vein occlusion and 29 patients (29 eyes) with branch retinal vein occlusion. All patients underwent the ophthalmoscopy, fundus fluorescein angiography (FFA) and ultra-wide field OCTA examination. The 24 mm×20 mm scanning mode was chosen for OCTA. Based on the results of FFA, the detection rate of ultra-wide field OCTA on retinal non-perfusion areas in RVO eyes was calculated, and the detection performance was analyzed by the receiver operating characteristic (ROC) curve.
Results　In this study, 28 eyes (58.3%) were detected with non-perfusion areas using FFA, in which 27 eyes (96.4%) were detected by ultra-wide field OCTA. The non-perfusion area not detected by ultra-wide field OCTA was located beyond the inspection range of ultra-wide field OCTA. In the remaining 20 eyes, ultra-wide field OCTA detected the retinal non-perfusion area over the macula lutea in 1 eye. It was masked by low fluorescence caused by hemorrhage in FFA. ROC analysis showed that the sensitivity and specificity of ultra-wide field OCTA in detecting non-perfusion areas in eyes with RVO were 83.3%and 100%, respectively, and the area under curve was 0.957.
Conclusion　Ultra-wide field OCTA shows a high detection rate, high efficiency and good accuracy in the non-perfusion area in RVO eyes, and it can find the non-perfusion area missed by FFA.