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早产儿脉络膜与视网膜血管相对位置的变化

Kim, S.J., Campbell, J.P., Ostmo, S., Jonas, K.E., RVP, C., Chiang, M.F.

期刊名称:Investigative Ophthalmology & Visual Science

卷期:2017年第58卷第14期

摘要

摘要:目的:本研究旨在描述一项新发现的特征,即脉络膜和视网膜血管的相对位置在早产儿中随时间变化,并通过定量分析确定与这一发现相关的因素。方法:通过早产儿视网膜病(ROP)队列研究前瞻性获取眼底图像数据。如果无法确定脉络膜血管,则排除。测量相隔57周的两个时间点相对于视网膜血管的特征性脉络膜标志的相对位置变化。进行单因素和多因素回归分析,以确定相关因素与变化量。结果:发现和复制队列分别包括45例和58例患者。其中92例(89%)是非西班牙裔白人。在发现和复制队列的所有眼中检测到脉络膜和视网膜血管相对位置变化(平均量分别为0.42±0.120.35±0.12mm)。对两组患者进行联合多元回归分析,1ROP,第一个时间点射血后时间较高,以及视盘与脉络膜边界的距离较短明显与相对位置变化较小相关。结论:脉络膜血管向前生长到早产儿后极视网膜血管,提示脉络膜外周生长较视网膜血管相对较快。严重ROP眼的生长差异较小,这可能代表由于晚期ROP引起的脉络膜发育改变。这些发现可能有助于更好地了解脉络膜发育的生理学和ROP参与。

Purpose:The purpose of this study was to characterize a novel finding that relative positions of choroidal and retinal vessels change over time in preterm infants and to identify factors associated with this finding using quantitative analysis.Methods:Fundus images were obtained prospectively through a retinopathy of prematurity (ROP) cohort study. Images were excluded if choroidal vessels could not be identified. Changes in relative position of characteristic choroidal landmarks with respect to retinal vessels between two time points 5 to 7 weeks apart were measured. Univariate and multivariate regression analyses were performed to identify associated factors with the amount of change.Results:The discovery and replication cohorts included 45 and 58 patients, respectively. Ninety-two of them (89%) were non-Hispanic Caucasians. Changes in relative position of choroidal versus retinal vessels were detected in all eyes of the discovery and replication cohorts (mean amount = 0.42 ± 0.12 and 0.35 ± 0.12 mm, respectively). On combined multiple regression analysis of the two cohorts, type 1 ROP, higher postmenstral age at the first time point, and shorter distance from optic disc to choroidal landmark were significantly associated with less change in relative position.Conclusions:Choroidal vessels grow anteriorly with respect to retinal vessels at posterior pole in preterm infants, suggesting relatively faster peripheral growth of choroidal versus retinal vessels. Eyes with severe ROP showed less difference in growth, which might represent alterations in choroidal development due to advanced ROP. These findings may contribute to better understanding about the physiology of choroidal development and involvement in ROP.


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