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光相干断层扫描血管成像技术在青光眼损害评价中的作用
张阳
李元媛
原慧萍 [综述]
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20191210-00537
Optical coherence tomography angiography in the evaluation of glaucomatous damage
Zhang Yang
Li Yuanyuan
Yuan Huiping
Authors Info & Affiliations
Zhang Yang
The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Li Yuanyuan
The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Yuan Huiping
The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
·
DOI： 10.3760/cma.j.cn115989-20191210-00537
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摘要

青光眼是一种神经退行性疾病，其特征性改变为视盘的凹陷性萎缩和视野的特征性缺损。目前青光眼的诊断和评价主要应用眼底照相、光相干断层扫描和视野检查。血流动力学改变在青光眼视神经损害的病理生理学机制中占有重要作用。以往对视盘的血流评估都是针对大血管，而对于微血管的血流定量评估一直缺少很好的评估设备。光相干断层扫描血管成像技术(OCTA)可实现对视网膜及脉络膜血流的量化，为青光眼视神经损害的评价提供了新的手段和指标。本文对应用OCTA技术测量视盘和黄斑区的血管密度在青光眼诊断和进展评估中的研究及血流参数与视神经纤维层和筛板等结构参数和视野参数的一致性等方面的研究进展进行综述，评价血流参数在青光眼损害评估中的作用。

光相干断层扫描血管成像技术;青光眼;评估指标
ABSTRACT

Glaucoma is a neurodegenerative disease, which is characterized by a concave atrophy of the optic disc and a characteristic defect of the visual field.The current diagnosis and evaluation of glaucoma are mainly based on fundus photography, optical coherence tomography and visual field examination.Hemodynamic changes play an important role in the pathophysiology of glaucomatous optic nerve damage, however, blood flow evaluation of the optic disc has been directed to large vessels in the past, and there has been no good evaluation equipment for quantitative evaluation of blood flow in microvessels.Optical coherence tomography angiography quantifies blood flow in the retina and choroid, which provides a new method and index for the evaluation of glaucomatous optic nerve damage.In this paper, the application of optical coherence tomography angiography in the measurement of blood vessel density in the optic disc and macular region in the diagnosis and progress assessment of glaucoma, and the consistency of blood flow parameters with structural parameters such as the optic nerve fiber layer and sieve plate and visual field parameters, etc.were reviewed to evaluate the value of blood flow parameters in predicting and assessing glaucomatous damage.

Optical coherence tomography angiography;Glaucoma;Evaluation indexes
Yuan Huiping, Email: mocdef.6ab213102phnauy
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引用本文

张阳,李元媛,原慧萍. 光相干断层扫描血管成像技术在青光眼损害评价中的作用[J]. 中华实验眼科杂志,2021,39(04)：365-368.

DOI:10.3760/cma.j.cn115989-20191210-00537

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青光眼是一种以视神经凹陷性萎缩和视野缺损为共同特征的疾病，病理性眼压增高是其主要危险因素。青光眼性视神经损伤在早期阶段难以发现，传统血管检测方式主要有2种，彩色多普勒超声成像无法检测血液流动，荧光素血管造影术为有创方式、有致敏危险且对深层毛细血管检测率极低。其他青光眼检查设备，如眼底照相、光相干断层扫描(optical coherence tomography，OCT)等难以评估视网膜和视神经的微血管异常。光相干断层扫描血管成像技术(optical coherence tomography angiography，OCTA)是一种无创的三维视网膜和脉络膜血流成像技术，通过算法生成视网膜结构和视网膜脉络膜毛细血管高分辨率图像，可对视网膜和脉络膜血管密度和血流进行量化，并能分层观察视网膜脉络膜血流改变，算法的改进提高了深度分辨率 [ 1 , 2 ]。OCTA在青光眼视神经损害评估中的应用主要集中在视盘结构、视盘周围血管密度(circumpapillary vessel density，cpVD)、黄斑全层厚度、黄斑区视网膜神经节细胞复合体(macular ganglion cell complex，mGCC)厚度等方面，还可以与眼底照相、视野以及OCT测量的视网膜神经纤维层(retinal nerve fiber layer，RNFL)厚度对比分析，为青光眼诊断提供临床依据。本文对应用OCTA技术测量视盘和黄斑区的血管密度在青光眼诊断和进展评估中的研究及血流参数与视神经纤维层和筛板等结构参数和视野参数一致性等研究进展进行综述，评价血流参数在青光眼损害评估中的作用。
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原慧萍，Email： mocdef.6ab213102phnauy
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