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

doi:10.3877/cma.j.issn.2095-2007.2020.01.005

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。

关键词: 妊娠, 脉络膜, 光学相干断层扫描

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 36^th 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 36^th 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.

Key words: Pregnancy, Choroid, Optical coherence tomography

表1 妊娠组与未孕组女性基本特征的比较(±s)

组别	例数	年龄(岁)	眼压(mmHg)	眼轴(mm)	屈光度(D)	收缩压(mmHg)	舒张压(mmHg)
妊娠组	30	28.0±2.5	16.53±2.83	24.32±1.22	-3.03±2.04	116.43±12.20	70.67±8.51
未孕组	30	27.2±1.5	16.18±3.72	24.27±0.76	-2.40±1.71	113.23±6.02	68.23±7.75
t值		1.52	0.22	0.18	-1.29	1.29	1.16
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

表1 妊娠组与未孕组女性基本特征的比较(±s)

组别	例数	年龄(岁)	眼压(mmHg)	眼轴(mm)	屈光度(D)	收缩压(mmHg)	舒张压(mmHg)
妊娠组	30	28.0±2.5	16.53±2.83	24.32±1.22	-3.03±2.04	116.43±12.20	70.67±8.51
未孕组	30	27.2±1.5	16.18±3.72	24.27±0.76	-2.40±1.71	113.23±6.02	68.23±7.75
t值		1.52	0.22	0.18	-1.29	1.29	1.16
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

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　 ^*示P<0.05，^**示P<0.01，^***示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)

组别	例数	中心凹	上方	下方	鼻侧	颞侧
妊娠组	30	243.80±76.20	259.33±58.56	254.03±71.08	160.50±60.62	249.50±61.86
未孕组	30	210.23±43.37	231.97±35.00	222.77±44.32	154.90±57.46	220.07±50.78
t值		2.10	2.20	2.04	0.37	2.01
P值		<0.05	<0.05	<0.05	>0.05	<0.05

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)

组别	例数	中心凹	上方	下方	鼻侧	颞侧
妊娠组	30	243.80±76.20	259.33±58.56	254.03±71.08	160.50±60.62	249.50±61.86
未孕组	30	210.23±43.37	231.97±35.00	222.77±44.32	154.90±57.46	220.07±50.78
t值		2.10	2.20	2.04	0.37	2.01
P值		<0.05	<0.05	<0.05	>0.05	<0.05

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)

组别	例数	中心凹	上方	下方	鼻侧	颞侧
妊娠晚期	23	234.91±77.69	257.87±62.51	248.96±68.91	156.96±57.80	251.13±63.39
产后3个月	23	229.74±78.11	246.52±58.10	240.04±64.81	150.74±58.04	246.61±63.06
t值		3.68	2.49	5.21	3.34	2.51
P值		<0.05	<0.05	<0.05	<0.05	<0.05

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)

组别	例数	中心凹	上方	下方	鼻侧	颞侧
妊娠晚期	23	234.91±77.69	257.87±62.51	248.96±68.91	156.96±57.80	251.13±63.39
产后3个月	23	229.74±78.11	246.52±58.10	240.04±64.81	150.74±58.04	246.61±63.06
t值		3.68	2.49	5.21	3.34	2.51
P值		<0.05	<0.05	<0.05	<0.05	<0.05

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

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