综述
ENGLISH ABSTRACT
光学相干断层扫描血管成像在特发性黄斑前膜中的应用研究进展
徐钊楷
毛剑波 [综述]
沈丽君 [综述]
作者及单位信息
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DOI: 10.3760/cma.j.cn115989-20200713-00493
Advances of optical coherence tomography angiography in idiopathic macular epiretinal membrane
Xu Zhaokai
Mao Jianbo
Shen Lijun
Authors Info & Affiliations
Xu Zhaokai
School of Ophthalmology and Biomedical Engineering, Wenzhou Medical University, Wenzhou 325000, China
Mao Jianbo
Ophthalmic Center, Zhejiang Provincial People Hospital (People Hospital of Hangzhou Medical College), Hangzhou 310000, China
Shen Lijun
School of Ophthalmology and Biomedical Engineering, Wenzhou Medical University, Wenzhou 325000, China
Ophthalmic Center, Zhejiang Provincial People Hospital (People Hospital of Hangzhou Medical College), Hangzhou 310000, China
·
DOI: 10.3760/cma.j.cn115989-20200713-00493
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摘要

特发性黄斑前膜(iERM)是一种因黄斑区及周边视网膜形成非血管性纤维膜,继而因纤维膜的牵拉导致黄斑的变形、皱褶等导致患眼视力下降及视物变形的眼底疾病。光学相干断层扫描血管成像(OCTA)凭借无创、分辨率高、可分层显示视网膜血管、量化视网膜血管密度和无灌注血管区大小等优势,已被广泛应用于包括iERM在内的黄斑疾病的诊断中。OCTA除了可以提供视网膜微血管结构、血流灌注的数字化信息,揭示iERM对微血管结构的牵拉作用,还可以在疾病的随访中用于监测血流灌注的改变。虽然目前OCTA尚不能完全替代眼底血管造影检查,但其已经为进一步了解iERM的发病机制、疾病进程及预后因素带来了更加丰富的信息。本文就OCTA在iERM中的应用研究进展作一综述,以期为OCTA在iERM中的应用提供更多启示。

特发性黄斑前膜;体层摄影术,光学相干;综述
ABSTRACT

Idiopathic macular epiretinal membrane (iERM) is a kind of fundus disease caused by fibrocellular proliferation over the internal limiting membrane (ILM) followed by deformation and wrinkling of the macula due to traction of the fibrous membranes, leading to vision loss and visual distortion in the affected eye.Optical coherence tomography angiography (OCTA) has been widely used in the diagnosis of macular diseases including iERM by virtue of non-invasive, high resolution and stratified display of superficial and deep retinal vessels and quantification of retinal vessel density and non-perfusion area.OCTA can provide information of retinal microvascular structure and blood perfusion under disease conditions, revealing the pulling effect of iERM on the microvascular structure, and it can also be used to evaluate changes in blood flow during the course of disease follow-up.After surgery, OCTA can also be used for follow-up monitoring of microvascular structure and blood flow to further predict vision.Although OCTA cannot completely replace fundus angiography, it has provided richer information about the pathogenesis, disease progression and prognostic factors of iERM.This article reviews the progress of research on the application of OCTA in iERM to provide more insight into the application of OCTA in iERM.

Idiopathic macular epiretinal membrane;Tomography, optical coherence;Review
Shen Lijun, Email: nc.defcaab.eye.liamjls
引用本文

徐钊楷,毛剑波,沈丽君. 光学相干断层扫描血管成像在特发性黄斑前膜中的应用研究进展[J]. 中华实验眼科杂志,2024,42(05):483-486.

DOI:10.3760/cma.j.cn115989-20200713-00493

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黄斑前膜(macular epiretinal membrane,ERM)是一种常见的黄斑疾病,可在黄斑区及周边视网膜形成非血管性纤维膜 [ 1 ]。ERM病变早期可仅有轻度的视物变形症状,随着病情的进展,纤维膜的牵拉可导致黄斑的变形、皱褶,甚至黄斑水肿,从而导致患眼的视力下降及视物变形症状加重 [ 2 ]。目前,玻璃体手术被认为是治疗ERM的主要手段。根据发病原因,ERM可分为特发性黄斑前膜(idiopathic macular epiretinal membrane,iERM)和继发性ERM。继发性ERM常继发于玻璃体视网膜疾病,如视网膜脱离、视网膜血管病变等玻璃体视网膜疾病 [ 3 ]。而iERM则指发生于正常且无已知玻璃体视网膜病变的黄斑中心凹区域视网膜前膜。
ERM向心性收缩会导致视网膜和视网膜血管发生牵拉性改变,进而导致黄斑区局部血流及视网膜微结构发生变化。光学相干断层扫描(optical coherence tomography,OCT)、眼底照相、荧光素眼底血管造影(fundus fluorescein angiography,FFA)常用于ERM的检查及诊断。其中OCT及眼底彩色照相主要用于评价视网膜结构变化,FFA可观察患者黄斑区血管的改变。然而,FFA需注射造影剂,存在变态反应的风险,且不适用肝肾功能异常或妊娠的患者 [ 4 ];FFA不能显示视网膜不同分层的血流变化,也无法量化相关的视网膜血流数据。
光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)作为一种无创、分辨率高的新兴眼科检查技术,可测量浅层、深层视网膜血管密度、无灌注血管区面积,越来越多地应用于视网膜和脉络膜血管性疾病的诊断、随访及临床研究 [ 5 ]。由于iERM会对黄斑中心凹及周边区域产生牵拉作用,引起微血管扭曲、变形,近年来许多研究利用OCTA对iERM患者的视网膜微血管结构进行分析。随着OCTA设备的发展,它可以分析视网膜不同层间的血流变化,已用于分析iERM的视网膜微血管形态结构的变化,并探究不同层次血流情况及其与视力预后之间的关系。为探究iERM的发病机制和预后预测提供了新的检测手段。
目前,ERM的OCTA研究主要集中于黄斑中心凹无血管区。本文就OCTA在iERM中的应用研究进展作一综述,以期为OCTA在iERM中的应用研究提供更多启示。
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参考文献
[1]
Wang N Peng A Li S et al. Clinic study on macular epiretinal membrane in patients under the age of 40 years[J/OL]. BMC Ophthalmol 202323(1)∶79[2024-04-08]. http://www.ncbi.nlm.nih.gov/pubmed/36841759. DOI: 10.1186/s12886-023-02813-8 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Flaxel CJ Adelman RA Bailey ST et al. Idiopathic Epiretinal Membrane and Vitreomacular Traction Preferred Practice Pattern ® [J]. Ophthalmology 2020127(2)∶P145P183. DOI: 10.1016/j.ophtha.2019.09.022 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Fung AT Galvin J Tran T . Epiretinal membrane:a review[J]. Clin Exp Ophthalmol 202149(3)∶289308. DOI: 10.1111/ceo.13914 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Meira J Marques ML Falcão-Reis F et al. Immediate reactions to fluorescein and indocyanine green in retinal angiography:review of literature and proposal for patient ' s evaluation [J]. Clin Ophthalmol 202014171178. DOI: 10.2147/OPTH.S234858 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
王倩魏文斌分频幅去相干血管成像[J]. 国际眼科纵览 201640(2)∶112116. DOI: 10.3760/cma.j.issn.1673-5803.2016.02.009 .
返回引文位置Google Scholar
百度学术
万方数据
Wang Q Wei WB . Optical coherence tomography angiography with split-spectrum amplitude decorrelation angiography[J]. Int Rev Ophthalmol 201640(2)∶112116. DOI: 10.3760/cma.j.issn.1673-5803.2016.02.009 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[6]
Nelis P Alten F Clemens CR et al. Quantification of changes in foveal capillary architecture caused by idiopathic epiretinal membrane using OCT angiography[J]. Graefes Arch Clin Exp Ophthalmol 2017255(7)∶13191324. DOI: 10.1007/s00417-017-3640-y .
返回引文位置Google Scholar
百度学术
万方数据
[7]
毛剑波劳吉梦俞雪婷特发性黄斑前膜OCTA检查结果的改变及其与视力的关系[J]. 中华眼科杂志 201955(10)∶757762. DOI: 10.3760/cma.j.issn.0412-4081.2019.10.006 .
返回引文位置Google Scholar
百度学术
万方数据
Mao JB Lao JM Yu XT et al. Correlation of capillary plexus with visual acuity in idiopathic macular epiretinal membrane eyes using optical coherence tomography angiography[J]. Chin J Ophthalmol 201955(10)∶757762. DOI: 10.3760/cma.j.issn.0412-4081.2019.10.006 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[8]
Chen H Chi W Cai X et al. Macular microvasculature features before and after vitrectomy in idiopathic macular epiretinal membrane:an OCT angiography analysis[J]. Eye (Lond) 201933(4)∶619628. DOI: 10.1038/s41433-018-0272-3 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
曾苗陈晓洪玲特发性黄斑前膜患者中心凹无血管区面积与中心凹形态相关性研究[J]. 中华眼底病杂志 201935(1)∶1519. DOI: 10.3760/cma.j.issn.1005-1015.2019.01.004 .
返回引文位置Google Scholar
百度学术
万方数据
Zeng M Chen X Hong L et al. Correlation between foveal avascular zone size and foveal morphology in patients with idiopathic macular epiretinal membrane[J]. Chin J Ocul Fundus Dis 201935(1)∶1519. DOI: 10.3760/cma.j.issn.1005-1015.2019.01.004 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[10]
Mastropasqua R <x>D</x> <x>'</x> <x>Aloisio</x> R Viggiano P et al. Early retinal flow changes after vitreoretinal surgery in idiopathic epiretinal membrane using swept source optical coherence tomography angiography[J/OL]. J Clin Med 20198(12)∶2067[2023-06-12]. http://www.ncbi.nlm.nih.gov/pubmed/31771299. DOI: 10.3390/jcm8122067 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Kitagawa Y Shimada H Shinojima A et al. Foveal avascular zone area analysis using optical coherence tomography angiography before and after idiopathic epiretinal membrane surgery[J]. Retina 201939(2)∶339346. DOI: 10.1097/IAE.0000000000001972 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Coppe AM Lapucci G Ripandelli G et al. Inner macular changes in fellow eye of patients with unilateral idiopathic epiretinal membrane[J/OL]. Invest Ophthalmol Vis Sci 202162(10)∶29[2023-06-12]. http://www.ncbi.nlm.nih.gov/pubmed/34427622. DOI: 10.1167/iovs.62.10.29 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Kim YJ Kim S Lee JY et al. Macular capillary plexuses after epiretinal membrane surgery:an optical coherence tomography angiography study[J]. Br J Ophthalmol 2018102(8)∶10861091. DOI: 10.1136/bjophthalmol-2017-311188 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Savastano MC Lumbroso B Rispoli M In vivo characterization of retinal vascularization morphology using optical coherence tomography angiography [J]. Retina 201535(11)∶21962203. DOI: 10.1097/IAE.0000000000000635 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Yu Y Teng Y Gao M et al. Quantitative choriocapillaris perfusion before and after vitrectomy in idiopathic epiretinal membrane by optical coherence tomography angiography[J]. Ophthalmic Surg Lasers Imaging Retina 201748(11)∶906915. DOI: 10.3928/23258160-20171030-06 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Rommel F Siegfried F Sochurek J et al. Mapping diurnal variations in choroidal sublayer perfusion in patients with idiopathic epiretinal membrane:an optical coherence tomography angiography study[J]. Int J Retina Vitreous 2019512[2023-06-18]. DOI: 10.1186/s40942-019-0162-2 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Inoue M Kadonosono K Macular diseases:epiretinal membrane[J]. Dev Ophthalmol 201454159163. DOI: 10.1159/000360462 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Malyshev AV Karapetov GY . Effect of surgery on quality of life in patients with epiretinal membrane[J]. Vestn Oftalmol 2015131(1)∶3035. DOI: 10.17116/oftalma2015131130-35 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Shimada H Nakashizuka H Mori R et al. 25-gauge scleral tunnel transconjunctival vitrectomy[J]. Am J Ophthalmol 2006142(5)∶871873. DOI: 10.1016/j.ajo.2006.05.057 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Tranos P Koukoula S Charteris DG et al. The role of internal limiting membrane peeling in epiretinal membrane surgery:a randomised controlled trial [J]. Br J Ophthalmol 2017101(6)∶719724. DOI: 10.1136/bjophthalmol-2016-309308 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Fang XL Tong Y Zhou YL et al. Internal limiting membrane peeling or not:a systematic review and meta-analysis of idiopathic macular pucker surgery[J]. Br J Ophthalmol 2017101(11)∶15351541. DOI: 10.1136/bjophthalmol-2016-309768 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
曾苗陈晓蔡春艳特发性黄斑前膜患眼手术后中心凹无血管区面积变化及其与视物变形的相关性研究[J]. 中华眼底病杂志 202036(3)∶205210. DOI: 10.3760/cma.j.cn511434-20181213-00426 .
返回引文位置Google Scholar
百度学术
万方数据
Zeng M Chen X Cai CY et al. Changes of foveal avascular zone size and correlation between foveal avascular zone size and metamorphopsia before and after idiopathic macular epiretinal membrane surgery[J]. Chin J Ocul Fundus Dis 202036(3)∶205210. DOI: 10.3760/cma.j.cn511434-20181213-00426 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[23]
Baba T Kakisu M Nizawa T et al. Study of foveal avascular zone by OCTA before and after idiopathic epiretinal membrane removal[J]. Spektrum der Augenheilkunde 201732(1)∶3138. DOI: 10.1007/s00717-017-0375-4
返回引文位置Google Scholar
百度学术
万方数据
[24]
Cheng CY Hsiao CC Hsieh YT . Image processing and quantification analysis for optical coherence tomography angiography in epiretinal membrane[J/OL]. Photodiagnosis Photodyn Ther 202342103534[2024-04-08]. http://www.ncbi.nlm.nih.gov/pubmed/36965759. DOI: 10.1016/j.pdpdt.2023.103534 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Shen Y Ye X Tao J et al. Quantitative assessment of retinal microvascular remodeling in eyes that underwent idiopathic epiretinal membrane surgery[J/OL]. Front Cell Dev Biol 2023111164529[2024-06-26]. http://www.ncbi.nlm.nih.gov/pubmed/37152290. DOI: 10.3389/fcell.2023.1164529 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Al-Sheikh M Phasukkijwatana N Dolz-Marco R et al. Quantitative OCT angiography of the retinal microvasculature and the choriocapillaris in myopic eyes[J]. Invest Ophthalmol Vis Sci 201758(4)∶20632069. DOI: 10.1167/iovs.16-21289 .
返回引文位置Google Scholar
百度学术
万方数据
[27]
Okawa Y Maruko I Kawai M et al. Foveal structure and vasculature in eyes with idiopathic epiretinal membrane[J/OL]. PLoS One 201914(4)∶e0214881[2023-06-22]. http://www.ncbi.nlm.nih.gov/pubmed/30939161. DOI: 10.1371/journal.pone.0214881 .
返回引文位置Google Scholar
百度学术
万方数据
[28]
Ulfik-Dembska K Teper S Dembski M et al. Idiopathic epiretinal membrane:microvasculature analysis with optical coherence tomography and optical coherence tomography angiography[J]. Tomography 20228(1)∶189199. DOI: 10.3390/tomography8010016 .
返回引文位置Google Scholar
百度学术
万方数据
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沈丽君,Email: nc.defcaab.eye.liamjls
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