系统性红斑狼疮患者黄斑区视网膜微血管变化特征

doi:10.3760/cma.j.issn.1674-845X.2020.01.008

科研成果详情

题名	系统性红斑狼疮患者黄斑区视网膜微血管变化特征
其他题名	Characteristics of Macular Microvascular Changes in Patients with Systemic Lupus Erythematosus
作者	包露露 ; 王红 ; 吴宇霏 ; 周容 ; 沈梅晓 ; 陈绮
发表日期	2020-01-25
发表期刊	中华眼视光学与视觉科学杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	系统性红斑狼疮视网膜毛细血管密度狼疮性视网膜病系统性红斑狼疮疾病活动度评分
其他关键词	systemic lupus erythematosus ; retinal capillary density ; lupus retinopathy ; score of systemic lupus erythematosus disease activity index
摘要	目的：利用高分辨率光学相干断层扫描血管成像技术(OCTA)探究系统性红斑狼疮(SLE)患者黄斑区视网膜微血管形态的早期变化特征。方法：系列病例研究。收集2018年5─11月在温州医科大学附属第二医院风湿免疫科门诊就诊的SLE患者31例(62眼),分为狼疮性视网膜病(LR)组10例(17眼)和非狼疮性视网膜病(NLR)组24例(45眼)。同时招募与疾病组年龄、性别匹配的正常成年人35例(35眼)作为正常对照组。应用OCTA对所有受检者黄斑区视网膜行3 mm×3 mm模式扫描,获得黄斑区浅层及深层视网膜微血管图像,并用本实验室自行编写的分析程序将视网膜血流灌注图进行骨架化分析,获得去除中央无血管区(FAZ,0.6 mm)的总环区域(TAZ)以及进一步4分区(S、T、I、N)的浅层及深层视网膜骨架化毛细血管密度(RCD)。此外,以系统性红斑狼疮疾病活动度评分(SLEDAI)对疾病组进行评分。采用独立样本t检验和方差分析等进行数据分析。结果：在浅层视网膜TAZ区域以及S、T、I、N各分区,NLR组和LR组的RCD值均低于正常对照组,且LR组相较于NLR组更低,这些差异均有统计学意义(P<0.05)。在深层视网膜,3组之间的差异不如浅层明显,仅发现LR组在N区域的RCD值较NLR组明显下降(P=0.022),且LR组在除T外其他3个分区的RCD值均较正常对照组明显下降(P<0.05)。此外,LR组的SLEDAI评分显著高于NLR组(P=0.006),且LR组的SLE并发症,如狼疮性肾炎和神经精神性狼疮的发生率均更高(分别为50%vs. 25%,10%vs. 4%)。结论： OCTA能有效检测SLE患者黄斑区视网膜微血管形态的早期改变。SLE患者无明显眼底及视力损伤时,浅层视网膜RCD即发生显著性改变,推测其可能可以作为监测SLE视网膜损害的早期生物学特征。
其他摘要	Objective: To observe the characteristics of early macular microvascular changes in patients with systemic lupus erythematosus using optical coherence tomography angiography (OCTA). Methods: This was a retrospective series of case study. Thirty-one patients (62 eyes) who were diagnosed with SLE by the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from May to November 2018, were divided into a lupus retinopathy (LR) group of 10 patients (17 eyes) and a non-lupus retinopathy group of 24 patients (45 eyes). At the same time, 35 healthy subjects (35 eyes) who were matched by age and sex with the disease groups were recruited as a control group. All subjects had a 3 mm×3 mm area of the macula scanned by OCTA to obtain superficial and deep retinal microvascular images of the macular area, and retinal blood flow density maps were skeletonized and analyzed by a custom automated algorithm. The total annular zone (TAZ), with a diameter of 2.5 mm, was obtained after excluding the foveal avascular zone (FAZ, 0.6 mm), and the superficial and deep retinal skeletonized capillary densities (RCD) of the TAZ were further divided into 4 regions (S, T, I, N). In addition, disease activity of the patients was assessed using the SLE disease activity index (SLEDAI). Data analysis was performed using a t test and analysis of variance. Results: The RCD of the superficial retinal capillary plexus (SRCP) were found to be significantly lower in the NLR and LR groups than in the control group, and the LR group was even lower than the NLR group and the difference was significant (P<0.05). In the deep retinal capillary plexus (DRCP), the difference between the three groups was not as obvious as that in the superficial layer. Only the RCD of the LR group in the N region was significantly lower than that in the NLR group (P=0.022), which were also lower than those in the control group (P<0.05) except for the T region. In addition, the score of SLEDAI in the LR group was significantly higher than in the NLR group (P=0.006), and the incidence of SLE complications such as lupus nephritis and neuropsychiatric SLE were higher in the LR group (50% vs. 25%, 10% vs. 4% respectively). Conclusions: OCTA can effectively detect early changes in macular microvascular morphology in the patients with SLE. In patients with SLE without significant fundus and visual impairment, the RCD of SRCP is significantly altered, suggesting that it may be used as an early biomarker for monitoring SLE retinal damage.
ISSN	1674-845X
卷号	22 期号:01 页码:44-50
DOI	10.3760/cma.j.issn.1674-845X.2020.01.008
页数	7
收录类别	CNKI ; CSCD ; 万方 ; 维普 ; ISTIC
学科领域	医药、卫生
URL	查看原文
CSCD记录号	CSCD:6664420
维普分类号	R59
CN号	11-5909/R
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/55298
专题	眼视光学院（生物医学工程学院）、附属眼视光医院附属第二医院
作者单位	1.温州医科大学附属眼视光医院; 2.温州医科大学附属第二医院风湿免疫科; 3.温州医科大学附属眼视光医院; 4.温州医科大学附属眼视光医院; 5.温州医科大学附属眼视光医院; 6.温州医科大学附属眼视光医院
推荐引用方式 GB/T 7714	包露露,王红,吴宇霏,等. 系统性红斑狼疮患者黄斑区视网膜微血管变化特征[J]. 中华眼视光学与视觉科学杂志,2020,22(01):44-50.
APA	包露露, 王红, 吴宇霏, 周容, 沈梅晓, & 陈绮. (2020). 系统性红斑狼疮患者黄斑区视网膜微血管变化特征. 中华眼视光学与视觉科学杂志, 22(01), 44-50.
MLA	包露露,et al."系统性红斑狼疮患者黄斑区视网膜微血管变化特征".中华眼视光学与视觉科学杂志 22.01(2020):44-50.