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中华眼科医学杂志(电子版) ›› 2020, Vol. 10 ›› Issue (01) : 27 -32. doi: 10.3877/cma.j.issn.2095-2007.2020.01.005

论著

运用深度增强成像光学相干断层扫描技术监测女性妊娠晚期脉络膜厚度的变化
王惠云1, 张骏2, 陆勤康1, 邓国华2,()   
  1. 1. 315000 宁波大学医学院附属鄞州医院 宁波市鄞州人民医院眼科中心
    2. 213000 常州市第三人民医院眼科
  • 收稿日期:2019-08-11 出版日期:2020-02-28
  • 通信作者: 邓国华
  • 基金资助:
    浙江省医药卫生科技项目(2018KY162); 宁波市科技项目(2019C50053); 常州市自然科学基金(CE20175039)

Changes of choroidal thickness in late trimester of pregnant women with enhanced depth imaging optical coherence tomography

Huiyun Wang1, Jun Zhang2, Qinkang Lu1, Guohua Deng2,()   

  1. 1. Department of Ophthalmology, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo 315000, China
    2. Department of Ophthalmology, No.3 Hospital of Changzhou, Changzhou 21300, China
  • Received:2019-08-11 Published:2020-02-28
  • Corresponding author: Guohua Deng
引用本文:

王惠云, 张骏, 陆勤康, 邓国华. 运用深度增强成像光学相干断层扫描技术监测女性妊娠晚期脉络膜厚度的变化[J/OL]. 中华眼科医学杂志(电子版), 2020, 10(01): 27-32.

Huiyun Wang, Jun Zhang, Qinkang Lu, Guohua Deng. Changes of choroidal thickness in late trimester of pregnant women with enhanced depth imaging optical coherence tomography[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2020, 10(01): 27-32.

目的

利用深度增强成像光学相干断层扫描(EDI-OCT)技术监测妊娠晚期女性脉络膜厚度的变化。

方法

采用数字表法随机选择2018年8月至2019年1月于宁波大学医学院附属鄞州医院建卡的30位(30只眼)妊娠32周女性和30位(30只眼)健康未孕女性。妊娠32周女性为妊娠组,年龄22~30岁,平均年龄(28.0±2.5)岁;健康的未孕女性为未孕组,年龄25~30岁,平均年龄(27.2±1.5)岁。全部受试者均检测血压、最佳矫正视力、屈光度、眼压及眼轴长度;采用EDI-OCT检测以黄斑中心凹为圆心,3000 μm为半径的5处脉络膜测量点的厚度。其中,妊娠组分别检测妊娠36周及产后3个月的脉络膜厚度。数据采用均数±标准差(±s)表示。妊娠组与未孕组女性脉络膜厚度的比较采用独立样本t检验,妊娠组产前与产后3个月脉络膜厚度的比较采用配对样本t检验。

结果

妊娠组与未孕组女性的年龄、眼压、眼轴长度、屈光度、收缩压及舒张压间差异无统计学意义(t=1.52,0.22,0.18,-1.29,1.29,1.16;P>0.05)。妊娠组女性黄斑中心凹、上方、下方、鼻侧及颞侧脉络膜的厚度值分别为(243.80±76.20)μm、(259.33±58.56)μm、(254.03±71.08)μm、(160.50±60.62)μm及(249.50±61.86)μm;未孕组女性5处脉络膜测量点的厚度值分别为(210.23±43.37)μm、(231.97±35.00)μm、(222.77±44.32)μm、(154.90±57.46)μm及(220.07±50.78)μm。妊娠组女性5处脉络膜测量点的厚度值均低于未孕组。其中,两组女性黄斑中心凹、上方、下方及颞侧脉络膜的厚度比较差异有统计学意义(t=2.10,2.20,2.04,2.01;P<0.05);两组女性鼻侧脉络膜的厚度比较差异无统计学意义(t=0.37,P>0.05)。妊娠组产前妊娠晚期女性黄斑中心凹、上方、下方、鼻侧及颞侧的脉络膜厚度大于产后3个月,且差异有统计学意义(t=3.68,2.49,5.21,3.34,2.51;P<0.05)。

结论

妊娠组女性5处脉络膜测量点的厚度值均低于未孕组,妊娠晚期女性的脉络膜增厚,且其增厚在产后3个月有所恢复。

Objective

The aim of this study was to monitor the choroidal thickness of pregnant women in the third trimester with enhanced depth imaging optical coherence tomography (EDI-OCT).

Methods

30 age-matched healthy women (30 eyes) in their third trimester and 30 healthy pregnant women (30 eyes) were selected according to the random number table who were checked in the Yinzhou Hospital Affiliated to Medical School of Ningbo University from August 2018 to January 2019. In pregnant women group, they were 22 to 30 years-old with the average age of (28.0±2.5) years-old; in non-pregnant women group, they were 25 to 30 years-old with the average age of (27.2±1.5) years-old. Age, intraocular pressure, axial length, diopter, systolic blood pressure and diastolic blood pressure were measured. Choroid thickness was measured at 5 points (3000 μm with a radius of fovea, fovea, up and down to the fovea, nasal, temporal) by EDI-OCT. And the pregnant women group was measured in the 36th week during gestation and 3 months after delivery, respectively. Data was expressed by mean±standard deviation(±s). The choroidal thickness between pregnant women group and non-pregnant women group was compared by independent sample t test, and that of pregnant women before and after delivery was compared by paired sample t test.

Results

The basic feature between two groups including age, intraocular pressure, axial length, diopter, systolic blood pressure, diastolic blood pressure was showed no statistical difference (t=1.52, 0.22, 0.18, -1.29, 1.29, 1.16; P>0.05). The choroidal thicknesses of the healthy women at 5 points were (210.23±43.37)μm, (231.97±35.00)μm, (222.77±44.32)μm, (154.90±57.46)μm, (220.07±50.78)μm, respectively. The choroidal thicknesses of the pregnant group at 5 points were (243.80±76.20)μm, (259.33±58.56)μm, (254.03±71.08)μm, (160.50±60.62)μm and (249.50±61.86)μm. The choroidal thicknesses of the healthy women were less than the pregnant group at 5 points. Among of them, fovea, up, down and temporal were statistically significant (t=2.10, 2.20, 2.04, 2.01; P<0.05); nasal was non-statistically significant (t=0.37, P>0.05). The choroid of the pregnant women were thicker in the 36th week during gestation than 3 months after delivery, and 5 points were statistically significant (t=3.68, 2.49, 5.21, 3.34, 2.51; P<0.05).

Conclusions

The choroidal thicknesses of the healthy women were less than the pregnant group at 5 points. Choroidal thickness had thickened during pregnancy, which could be recovered after delivery for 3 months.

表1 妊娠组与未孕组女性基本特征的比较(±s)
图2 妊娠组妊娠晚期与产后3个月女性各测量点脉络膜厚度的比较柱状图  *P<0.05,**P<0.01,***P<0.001
表2 妊娠组与未孕组女性各测量点脉络膜厚度的比较(±s,μm)
表3 妊娠晚期与产后3个月女性各测量点脉络膜厚度的比较(±s,μm)
[1]
Zhang J, Wang H, Yu Q, et al. Enhanced depth imaging optical coherence tomography: A new way measuring choroidal thickness in pregnant women [J]. J Ophthalmol, 2017, 2017(8): 1-9.
[2]
Kim JW, Park MH, Kim YJ, et al. Comparison of subfoveal choroidal thickness in healthy pregnancy and pre-eclampsia [J]. Eye, 2014, 30(3): 349-354.
[3]
Ataş M, Açmaz G, Aksoy H, et al. Evaluation of the macula, retinal nerve fiber layer and choroid in preeclampsia, healthy pregnant and healthy non-pregnant women using spectral-domain optical coherence tomography [J]. Hypertens Pregnancy, 2014, 33(3): 299-310.
[4]
Necip K, Nihat S, Dilara P, et al. Evaluation of subfoveal choroidal thickness in pregnant women using enhanced depth imaging optical coherence tomography [J]. Cur Eye Res, 2014, 39(6): 642-647.
[5]
Zeynep D, Husnu A, Nursen OA, et al. Changes in choroidal thickness during pregnancy detected by enhanced depth imaging optical coherence tomography [J]. Br J Ophthalmol, 2015, 99(9): 1255-1259.
[6]
Chen W, Li L, Zhang H, et al. Macular choroidal thickness in highly myopic women during pregnancy and postpartum: a longitudinal study [J]. BMC Pregnancy Childb, 2018, 18(1): 220.
[7]
Chapman AB, Abraham WT, Zamudio S, et al. Temporal relationships between hormonal and hemodynamic changes in early human pregnancy [J]. Kidney Int, 1998, 54(6): 2056-2063.
[8]
August P, Lenz T, Ales KL, et al. Longitudinal study of the renin-angiotensin-aldosterone system in hypertensive pregnant women: deviations related to the development of superimposed preeclampsia [J]. Am J Obstet Gynecol, 1990, 163(5): 1612-1621.
[9]
Akar Y, Yucel I, Akar ME, et al. Long-term fluctuation of retinal sensitivity during pregnancy[J]. Can J Ophthalmol, 2005, 40(4): 487-491.
[10]
Kump LI, Cervantes-Castaneda RA, Androudi SN, et al. Patterns of exacerbations of chronic non-infectious uveitis in pregnancy and puerperium [J]. Am J Ophthalmol, 2006, 142(6): 1097-1097.
[11]
Weinreb RN, Lu A, Beeson C. Maternal corneal thickness during pregnancy [J]. Am J Ophthalmol, 1988, 105(3): 258-260.
[12]
Sanke RF. Blepharoptosis as a complication of pregnancy [J]. Annals Ophthalmol, 1984, 16(8): 720-722.
[13]
Park SB, Lindahl KJ, Temnycky GO, et al. The effect of pregnancy on corneal curvature [J]. Clao J, 1992, 18(4): 256-259.
[14]
Kadziauskiene A, Kuoliene K, Asoklis R, et al. Changes in choroidal thickness after intraocular pressure reduction following trabeculectomy [J]. Acta Ophthalmol, 2016, 94(6): 586-591.
[15]
Fernándezmontero A, Besrastrollo M, Morenomontaňés J, et al. Effect of pregnancy in myopia progression: the sun cohort [J]. Eye, 2017, 31(7): 1085-1092.
[16]
Errera MH, Kohly RP, Cruz LD. Pregnancy-associated retinal diseases and their management [J]. Surv Ophthalmol, 2013, 58(2): 127-142.
[17]
Alm A, Bill A. Ocular and optic nerve blood flow at normal and increased intraocular pressures in monkeys (macaca irus): a study with radioactively labelled microspheres including flow determinations in brain and some other tissues [J]. Exp Eye Res, 1973, 15(1): 15-29.
[18]
Parver LM. Temperature modulating action of choroidal blood flow [J]. Eye, 1991, 5(2): 181-185.
[19]
Mrejen S, Spaide RF. Optical coherence tomography: imaging of the choroid and beyond [J]. Surv Ophthalmol, 2013, 58(5): 387-429.
[20]
Cao J, Mcleod S, Merges CA, et al. Choriocapillaris degeneration and related pathologic changes in human diabetic eyes [J]. Arch Ophthalmol, 1998, 116(5): 589-597.
[21]
Eiko T, Kiyoshi S, Ryotaro U, et al. Enhanced depth imaging optical coherence tomography of the choroid in central retinal vein occlusion [J]. Am J Ophthalmol, 2013, 156(3): 543-547.
[22]
Imamura Y, Fujiwara T, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy [J]. Am J Ophthalmol, 2009, 29(3): 445-450.
[23]
Qi S, Wang C, Song D, et al. Intraperitoneal injection of (â)-epigallocatechin-3-gallate protects against light-induced photoreceptor degeneration in the mouse retina [J]. Mol Vision, 2017, 23(1): 171-178.
[24]
Knott EJ, Sheets KG, Zhou YD, et al. Spatial correlation of mouse photoreceptor-RPE thickness between SD-OCT and histology [J]. Exp Eye Res, 2011, 92(2): 155-160.
[25]
Dell′Omo R, Costagliola C, Salvatore FD, et al. Enhanced depth imaging spectral-domain optical coherence tomography [J]. Am J Ophthalmol, 2012, 146(4): 496-500.
[26]
Giuseppe Q, Rosangela L, Lea Q, et al. Enhanced depth imaging optical coherence tomography in type 2 diabetes [J]. Invest Ophth Vis Sci, 2012, 53(10): 6017-6024.
[27]
Weiner CP, Lizasoain I, Baylis SA, et al. Induction of calcium-dependent nitric oxide synthases by sex hormones [J]. PNAS, 1994, 91(11): 5212-5216.
[28]
August P, Lenz T, Ales KL, et al. Longitudinal study of the renin-angiotensin-aldosterone system in hypertensive pregnant women: deviations related to the development of superimposed preeclampsia [J]. Am J Obstetri Gynecol, 1990, 163(5): 1612-1621.
[29]
Thornburg KL, Jacobson SL, Giraud GD, et al. Hemodynamic changes in pregnancy [J]. Semin Perinatol, 2000, 24(1): 11-14.
[30]
Sertan G, Ahmet B, Yasar S, et al. Measurement of choroid thickness in pregnant women using enhanced depth imaging optical coherence tomography [J]. Arquivos brasileiros de oftalmologia, 2015, 77(3): 148-151.
[31]
Ulusoy DM, Duru N, Atas M, et al. Measurement of choroidal thickness and macular thickness during and after pregnancy [J]. Int J Ophthalmol, 2015, 8(2): 321-325.
[32]
Nihat S, Necip K, Dilara P, et al. Subfoveal choroidal thickness in preeclampsia: comparison with normal pregnant and non-pregnant women [J]. Semin Ophthalmol, 2014, 29(1): 11-17.
[33]
Acmaz G, Atas M, Gulhan A, et al. Assessment of macular peripapillary nerve fiber layer and choroidal thickness changes in pregnant women with gestational diabetes mellitus, healthy pregnant women, and healthy non-pregnant women [J]. Med Sci Monitor, 2015, 21(3): 1759-1764.
[34]
Duru N, Ulusoy DM, Özköse A, et al. Choroidal changes in pre-eclampsia during pregnancy and the postpartum period: Comparison with healthy pregnancy [J]. Arquivos brasileiros de oftalmologia, 2016, 79(3): 143-146.
[35]
Saidahmed K, Moustafa G, Fawzy M. Incidence and natural course of symptomatic central serous chorioretinopathy in pregnant women in a maternity hospital in kuwait [J]. Middle East Afr J Ophthalmol, 2012, 19(3): 273-276.
[36]
Gass JDM, Little H. Bilateral bullous exudative retinal detachment complicating idiopathic central serous chorioretino-pathy during systemic corticosteroid therapy [J]. Ophthalmology, 1995, 102(5): 737-747.
[37]
Ranjay C, Read SA, Collins MJ. Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics [J]. Invest Ophthalmol Vis Sci, 2011, 52(8): 5121-5129.
[38]
Tan CS, Yanling O, Humberto R, et al. Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography [J]. Invest Ophth Vis Sci, 2012, 53(1): 261-266.
[39]
Noriko T, Hideya K, Atsuko F, et al. Difference in morning and evening choroidal thickness in Japanese subjects with no chorioretinal disease [J]. Ophthal Surg Las IM, 2012, 43(2): 109-114.
[40]
Linsell CR, Lightman SL, Mullen PE, et al. Circadian rhythms of epinephrine and norepinephrine in man [J]. J Clin Endocr Metab, 1985, 60(6): 1210-1215.
[41]
Spaide RF. Age-related choroidal atrophy [J]. Am J Ophthalmol, 2009, 147(5): 801-810.
[42]
Fujiwara T, Imamura Y, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes [J]. Am J Ophthalmol, 2009, 148(3): 445-450.
[43]
Zengin MO, Karahan E, Yilmaz S, et al. Association of choroidal thickness with eye growth: A cross-sectional study of individuals between 4 and 23 years [J]. Eye, 2014, 28(12): 1482-1487.
[44]
Noori J, Esfahani MR, Hajizadeh F, et al. Choroidal mapping: a novel approach for evaluating choroidal thickness and volume [J]. J Ophthal Vis Res, 2012, 7(2): 180-185.
[45]
Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes [J]. Am J Ophthalmol, 2009, 147(5): 811-815.
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