应用深度增强型成像技术研究早期年龄相关性黄斑变性患者黄斑区脉络膜厚度的变化

doi:10.3877/cma.j.issn.2095-2007.2019.06.007

目的

应用深度增强型相干光断层扫描(EDI-OCT)技术研究早期年龄相关性黄斑变性(AMD)患者黄斑区脉络膜厚度的变化及其与AMD发病的关系。

方法

收集2015年3月至2017年3月于中国康复研究中心北京博爱医院眼科就诊的早期AMD患者90例(90只眼)和眼底正常者60例(60只眼)的临床资料。早期AMD患者为患者组，眼底正常者为正常组。患者组中男性51例(51只眼)，女性39例(39只眼)；年龄63~85岁，平均年龄(74.3±10.9)岁。正常组中男性24例(24只眼)，女性36例(36只眼)；年龄58~78岁，平均年龄(68.6±10.8)岁。采用EDI-OCT测量两组受试者黄斑中心凹处及由中心凹向鼻侧、颞侧各500 μm、1000 μm处的脉络膜厚度，共测量5个点位。数据以均数±标准差(±s)表示。两组间脉络膜厚度的比较采用t检验，多组间比较采用单因素方差分析，组间两两比较采用Tukey检验。

结果

患者组黄斑区脉络膜的平均厚度为(254.84±51.46)μm；正常组黄斑区脉络膜的平均厚度为(271.46±43.36)μm。患者组黄斑区脉络膜的厚度较正常组低，且两组间差异有统计学意义(t＝-2.061，P<0.05)。所有受试者的年龄与脉络膜的厚度呈负相关，且差异有统计学意义(r＝-0.23，P<0.05)。

结论

早期AMD患者的脉络膜厚度较眼底正常者偏薄，且早期AMD患者脉络膜厚度的改变可作为黄斑变性发展的预警因素，能为早期的临床干预提供参考。

关键词: 年龄相关性黄斑变性, 脉络膜, 厚度, 相干光断层扫描

Objective

The aim of this study was to investigate the relationship between macular choroidal thickness changes and the development of age-related macular degeneration (AMD) in patients with early AMD using depth-enhanced imaging technique (EDI-OCT).

Methods

From March 2015 to March 2017, 90 patients (90 eyes) with early AMD and 60 patients with normal fundus (60 eyes) from the Department of Ophthalmology, China Rehabilitation Research Center Beijing Bo Ai Hospital were selected. Those with early AMD was as patient group, and patients with normal fundus as normal group. In patient group, there were 51 male (51 eyes) and 39 female (39 eyes), and the age range was 63 to 85, and the average age was (74.3±10.9) years-old. In normal group, there were 60 male (60 eyes) and 24 female (24 eyes), and the age range was 63 to 85, the average age was (68.6±10.8) years-old. All patients was to measure the choroidal thickness of the fovea and the choroidal thickness from the fovea to the nasal and temporal sides at 500 μm and 1000 μm using EDI-OCT, respectively. There were 5 measuring sites in this study. The data were represented as mean±standard deviation (±s). The t test was used to compare the differences in choroidal thickness. One-way analysis of variance was used for comparison between groups. The Tukey test was used for comparison between groups. The correlation between choroidal thickness and age was analyzed by linear correlation.

Results

The choroidal thickness of the fovea in the early AMD patients was lower than that of the normal group, whose difference between them was statistically significant(t=-2.061, P<0.05). In the early AMD patients, the average foveal thickness of the fovea was (254.84±51.46) μm. The average thickness of the foveal choroid in the normal group was (271.46±43.36)μm, That shown a negative correlation between the age and choroidal thickness (r=-0.23, P<0.05).

Conclusions

The choroidal thickness of the eyes of patients with early AMD was significantly thinner than that of the normal group. The change of choroidal thickness in early AMD patients could be used as a warning factor for the further development of macular degeneration, which could provide a basis for early intervention.

Key words: Age-related macular degeneration, Choroidal, Thickness, Optical coherence tomography

图1 脉络膜厚度测量的5处点位示意图　黄斑中心凹及以中心凹为中心，颞侧各500 μm、1000 μm至鼻侧各500 μm、1000 μm

图2 黄斑中心凹脉络膜厚度与年龄相关的线性图

图3 患者组与正常组受检眼黄斑中心凹处脉络膜厚度的比较　3A示两组受检眼黄斑中心凹处脉络膜厚度的箱式图；3B示两组受检眼黄斑中心凹处脉络膜厚度的柱状图

表1 患者组与正常组脉络膜厚度的比较(±s，μm)

组别	眼数	颞侧1000 μm	颞侧500 μm	中心凹	鼻侧500 μm	鼻侧1000 μm
患者组	90	251.94±47.56	252.01±50.83	254.84±51.46	251.44±54.29	248.44±55.06
正常组	60	271.50±44.21	270.92±40.00	271.46±43.36	267.52±41.84	264.58±40.13
t值		-2.537	-2.423	-2.061	-2.042	-2.074
P值		<0.05	<0.05	<0.05	<0.05	<0.05

表1 患者组与正常组脉络膜厚度的比较(±s，μm)

组别	眼数	颞侧1000 μm	颞侧500 μm	中心凹	鼻侧500 μm	鼻侧1000 μm
患者组	90	251.94±47.56	252.01±50.83	254.84±51.46	251.44±54.29	248.44±55.06
正常组	60	271.50±44.21	270.92±40.00	271.46±43.36	267.52±41.84	264.58±40.13
t值		-2.537	-2.423	-2.061	-2.042	-2.074
P值		<0.05	<0.05	<0.05	<0.05	<0.05

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The choroidal thickness in the macular area of patients with early age-related macular degeneration using depth-enhanced imaging

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The choroidal thickness in the macular area of patients with early age-related macular degeneration using depth-enhanced imaging