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弱视儿童频域光学相干断层扫描血管造影 Spectral-Domain Optical Coherence Tomographic Angiography in Children With Amblyopia

Lonngi M, Velez FG, Tsui I, Davila JP, Rahimi M, Chan C, Sarraf D, Demer JL, Pineles SL

期刊名称:JAMA Ophthalmology

卷期:2017年第135卷第10期

关键词:
断层 光学 血管

摘要

摘要:重要性:弱视是儿童时期视力损害的最常见原因,美国儿童患病率为1%至4%。迄今为止,还没有关于使用无创光学相干断层扫描血管造影术(OCTA)测量弱视儿童视网膜毛细血管层血流量的研究。目的:旨在使用OCTA评价弱视患儿(<18岁)视网膜和微血管特征。 设计,设置和研究对象:201691日至2017531日,这项观察性病例对照研究开始招募患者,于201691日至2017630日期间在加州大学洛杉矶分校(加州,洛杉矶)进行。研究对象包括在一家儿科眼科诊所接受检查,或由共同调查人员转诊的59名(<18岁)患有弱视和无弱视的儿童。所有患者均接受了全面的眼科检查,包括视力,屈光度和眼球运动试验;前后段检查;和OCTA。结果:63只眼中,弱视眼13只(21%),对照眼50只(79%)。在59例患者中,弱视患者和对照患者的平均年龄分别为8.04.0)岁和10.33.3)岁;33名患者(56%)是女性; ,弱视组13例中有5例(39%),对照组46例中有27例(54%)为白人。在3×3mm6×6mm扫描中,弱视组中的浅表毛细血管丛的黄斑血管密度低于对照组。校正年龄和屈光不正后,6×6mm扫描的浅表毛细血管丛平均(SD)差异有统计学意义(49.3[4.1]51.2[2.9]; P = 0.02)。 6×6-mm扫描的深部毛细血管丛的黄斑血管密度也有显着差异:弱视组深度视网膜毛细血管丛的平均血管密度为54.4%(4.7%),对照组为60.1%( 3.3%),相差5.7%(95CI3.4-8.1; P = 0.002)。结论及意义:研究发现,OCTA可显示弱视患者黄斑视网膜下层浅层和深层毛细血管密度。还需进一步的研究来确定这一发现的临床意义。

Importance:Amblyopia is the most common cause of visual impairment in childhood, with a prevalence of 1% to 4% in children in the United States. To date, no studies using noninvasive optical coherence tomographic angiography (OCTA) have measured blood flow in the retinal capillary layers in children with amblyopia.Objective:To evaluate the retinal and microvascular features using OCTA in children (<18 years) with amblyopia.Design, Setting, and Participants:This observational case-control study enrolled patients from September 1, 2016, through May 31, 2017, and was conducted from September 1, 2016, through June 30, 2017, at the Stein Eye Institute at UCLA (University of California, Los Angeles). Participants included 59 children (<18 years) with amblyopia and without amblyopia examined at a pediatric ophthalmology clinic or referred to the clinic by coinvestigators. All patients underwent comprehensive ophthalmological examination, including visual acuity, refraction, and ocular motility tests; anterior and posterior segment examination; and OCTA.Main Outcomes and Measures:Reduced superficial and deep retinal capillary vessel density on OCTA.Results:Of the 63 eyes evaluated, 13 (21%) were amblyopic and 50 (79%) were control eyes. Of the 59 patients, the mean (SD) age of patients with amblyopia was 8.0 (4.0) years and 10.3 (3.3) years for the controls; 33 patients (56%) were female; and 5 of 13 (39%) and 27 of 46 (54%) patients in the amblyopic and control groups, respectively, were identified as white. The macular vessel density of the superficial capillary plexus was lower in the amblyopic group than in the control group in both 3 × 3-mm and 6 × 6-mm scans. After adjusting for age and refractive error, the mean (SD) difference in the superficial capillary plexus in the 6 × 6-mm scan was statistically significant (49.3% [4.1] vs 51.2% [2.9]; P=.02). Macular vessel density of the deep capillary plexus in the 6 × 6-mm scans was also considerably different between groups: mean (SD) vessel density of the deep retinal capillary plexus was 54.4% (4.7%) in the amblyopia group and 60.1% (3.3%) in the control group, with a difference of 5.7% (95% CI, 3.4%-8.1%; P=.002).Conclusions and Relevance:The study found that OCTA reveals subnormal superficial and deep retinal capillary density in the macula of patients with amblyopia. Further studies are needed to determine the clinical relevance of this finding.


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