埋藏性视盘玻璃疣患者视网膜浅层结构及血管密度临床观察
Observation of microstructure and vessel density changes in the superficial retinal layer in buried optic disc drusen patients
摘要目的:观察埋藏性视盘玻璃疣(ODD)患者视网膜浅层结构及血管密度的改变。方法:回顾性病例对照研究。收集2018年1月至2020年7月于北京协和医院确诊为埋藏性ODD患者的36只眼资料(ODD组)及26只正常眼资料(对照组)。均行最佳矫正视力、眼压、裂隙灯显微镜、眼底、视野、谱域相干光层析成像术(SD-OCT)及相干光层析血管成像术(OCTA)检查,比较视盘鼻侧神经纤维层(RNFL)厚度、神经节细胞复合体(GCC)厚度及黄斑区浅层血管密度。双眼ODD患者选取右眼数据进行分析,统计学方法主要采用独立样本 t检验及Mann Whitney U检验。 结果:ODD组20例,对照组26例,两组均为女性,年龄差异无统计学意义( P>0.05)。ODD组最佳矫正视力及视野检查均未见明显异常,SD-OCT检查显示视盘鼻侧外核层下椭圆形低信号影,或局部堆积样中等信号影,边界清晰,部分可见高信号包膜。ODD组与对照组上方鼻侧区域的RNFL厚度分别为(102.6±19.1)、(119.0±13.8)μm,两组间差异有统计学意义( t=-2.81; P<0.01)。ODD组GCC厚度[ M( Q1, Q3)]为97.0(89.3,99.8)μm,对照组为101.0(100.0,102.0)μm,两组间差异有统计学意义( U=48.50; P<0.01)。ODD组OCTA en-face扫描图像可见黄斑区血管网较对照组稀疏。ODD组黄斑区浅层血管密度为48.5%±2.8%,与对照组的51.0%±2.3%比较,差异有统计学意义( t=-2.63; P<0.05)。 结论:埋藏性ODD患者视网膜上方鼻侧RNFL及黄斑区GCC层变薄,黄斑区浅层血管密度减低。
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abstractsObjective:To investigate the changes of the microstructure and vascular density in the superficial retinal layer of buried optic disc drusen (ODD) patients.Methods:Retrospective case-control study. A total of 36 ODD eyes (20 patients) and 26 normal control eyes were recruited in Beijing Union Medical College Hospital from January 2018 to July 2020. Measurement of best corrected visual acuity (BCVA), intraocular pressure, slit lamp, fundus examination and visual field examination were performed. The images and data of spectral domain-optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA) were analyzed and summarized. The differences of nasal retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) thickness and macular superficial vascular density (VD) between ODD patients and normal controls were compared by independent sample t-test or Mann Whitney U test (the right eye was selected in bilateral ODD patients). Results:The 20 ODD patients and 26 normal controls were all female. There was no significant difference in age between the two groups ( P>0.05). The BCVA and visual field examination was normal in all ODD patients. The SD-OCT examination showed an oval low signal shadow under the nasal outer nuclear layer of the optic disc, or local accumulation like a medium signal shadow with a clear boundary, and a high signal capsule in ODD patients. The RNFL in the upper nasal side of the ODD group was significantly different from the normal control group [(102.6±19.1) μm vs. (119.0±13.8) μm; t=-2.81; P<0.01]. Compared with normal control group [101.0 (100.0, 102.0) μm], the average GCC thickness in the ODD group [97.0 (89.3, 99.8) μm] was significantly different ( U=48.50; P<0.01). The OCTA en-face scan showed that the vascular network in the macular area of the affected eyes was sparser than that of the control eyes. There was significant difference in superficial macular VD beteeen the ODD group (48.5%±2.8%) and the control group (51.0%±2.3%) ( t=-2.63; P<0.05). Conclusions:There is thinning in the RNFL upper nasal side and GCC layer of the macular region in buried ODD patients, and the superficial VD of the macular region in buried ODD patients is lower than that in the normal controls.
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