综述
ENGLISH ABSTRACT
视网膜静脉阻塞的光学相干断层扫描血管成像应用
孙佳
杨冬妮 [综述]
作者及单位信息
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DOI: 10.3760/cma.j.cn115989-20200918-00655
Application of optical coherence tomography angiography in retinal vein occlusion
Sun Jia
Yang Dongni
Authors Info & Affiliations
Sun Jia
Chengde Medical College, Chengde 067000, China
Yang Dongni
Department of Ophthalmology, the First Hospital of Qinhuangdao, Qinhuangdao 066000, China
·
DOI: 10.3760/cma.j.cn115989-20200918-00655
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摘要

视网膜静脉阻塞(RVO)是临床上常见的引起无痛性视力下降的视网膜血管性疾病,目前荧光素眼底血管造影(FFA)是其诊断的金标准。但FFA为有创检查,可重复性差,不具备分辨和描绘深层毛细血管的能力。光学相干断层扫描血管成像(OCTA)具有无创、安全、简便、高效及较高轴向分辨率等特点,成为目前RVO诊断及疗效评价的有力工具。OCTA还可以快速分层分析RVO患者微血管图像,定性定量评估双眼黄斑及视盘区各层毛细血管的形态结构及灌注状态。本文对OCTA在RVO患者中的应用做一全面综述,包括检测患眼和对侧健眼的黄斑及视盘区视网膜结构及血流变化、评估视力预后和抗血管内皮生长因子治疗效果、探究黄斑水肿复发机制、局限性以及发展前景,有助于医生更加全面地了解RVO疾病特征,为准确有效地指导疾病治疗、预测患者预后视力奠定重要基础。

视网膜静脉阻塞;光学相干断层扫描血管成像;图像特征;综述
ABSTRACT

Retinal vein occlusion (RVO) is a common retinal vascular disease that causes painless visual impairment in clinical practice.Currently, fluorescein fundus angiography (FFA) is the gold standard for its diagnosis.However, FFA is an invasive examination, which has poor reproducibility and lacks the ability to distinguish and depict deep capillaries.Optical coherence tomography angiography (OCTA) has the characteristics of the non-invasive, safe, simple, efficient, and high axial resolution, making it a powerful tool for the diagnosis and efficacy evaluation of RVO.OCTA not only rapidly analyzes microvascular images of RVO patients, but also evaluates the morphologic structure and perfusion status of capillaries qualitatively and quantitatively in each layer in the macular and optic disc area of both eyes.The article comprehensively reviewed the application of OCTA in RVO patients, including the detection of changes in retinal structure and blood flow in the macula and optic disc area of the affected eye and healthy contralateral eye, the evaluation of visual prognosis and the effect of anti-vascular endothelial growth factor treatment, the investigation of the recurrence mechanism of macular edema, and the limitations and development prospects.The article aimed to help ophthalmologists have a more comprehensive understanding of the characteristics of RVO disease and lay an important foundation for accurately and effectively guiding disease treatment and predicting patients' prognosis vision.

Retinal vein occlusion;Optical coherence tomography angiography;Image features;Review
Yang Dongni, Email: mocdef.aabnisdhqingnodgnay
引用本文

孙佳,杨冬妮. 视网膜静脉阻塞的光学相干断层扫描血管成像应用[J]. 中华实验眼科杂志,2023,41(07):697-701.

DOI:10.3760/cma.j.cn115989-20200918-00655

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视网膜静脉阻塞(retinal vein occlusion,RVO)是一种常见的视网膜血管性疾病,表现为视网膜静脉迂曲怒张、火焰状出血、黄斑水肿、硬性渗出等。荧光素眼底血管造影(fluorescein fundus angiography,FFA)是目前诊断RVO的金标准,在检测RVO分型、视网膜灌注及血管渗漏等方面具有不可替代的重要作用。但FFA为有创检查,可重复性差,不具备分辨和描绘深层毛细血管的能力,且部分患者在注射造影剂后可能发生恶心、呕吐、荨麻疹等症状 [ 1 ],甚至可能发生严重的过敏反应,导致FFA的临床应用受到了一定的限制。而光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)操作简便、可重复性强,无需注射任何染料便可观察评估各层微血管的形态结构及灌注状态,成为目前RVO诊断及疗效评价的有力工具。深入分析RVO患者不同类型、不同部位、不同阶段的OCTA图像特征,可为患者预后视力预测、抗血管内皮生长因子(vascular endothelial growth factor,VEGF)治疗效果及黄斑水肿复发情况探究发挥重要作用。随着与人工智能的紧密结合,OCTA的应用范围越来越广泛,为临床中RVO疾病诊断及治疗效果评估带来方便。本文就RVO患者的OCTA图像特征进行综述。
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