山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (1): 89-92.doi: 10.6040/j.issn.1673-3770.0.2019.280

• 论著 • 上一篇    

眼压波动对人工晶体植入术患者眼底黄斑及视盘血流密度的影响分析

李锐,李勇,谢洪涛,岳章显,刘钊臣,袁慧敏   

  1. 武汉科技大学附属孝感医院 眼科, 湖北 孝感 432000
  • 发布日期:2020-03-06
  • 通讯作者: 袁慧敏. E-mail:xgyhm@sina.com

Effects of intraocular lens implantation and postoperative intraocular pressure fluctuations on the fundus macular and optic disc vascular density

LI Rui, LI Yong, XIE Hongtao, YUE ZhangXian, LIU Zhaochen, YUAN huimin   

  1. Department of Ophthalmology, Xiaogan Hospital, Wuhan University of Science and Technology, Xiaogan 432000, Hubei, China
  • Published:2020-03-06

摘要: 目的 检测眼压变化对白内障手术视盘、黄斑的灌注密度、血管密度的影响。 方法 选取2016年1月至2019年1月进行白内障超声乳化吸除结合人工晶状体植入患者100例(100眼),依据患者不同水平将患者分成4组,其中眼压<21 mmHg 38例、21~30 mmHg 15例、31~40 mmHg 19例、>40 mmHg 28例,观察患者手术前、术后即刻,术后1 h、8 h、24 h患者眼压、黄斑与视盘血管密度、灌注密度情况。 结果 术后即刻、术后1 h患者黄斑、视盘灌注密度较术前降低;眼压>40 mmHg组患者术后8 h黄斑与视盘血管密度较术前降低,>40 mmHg组患者术后24 h黄斑与视盘血管密度、视盘灌注密度较术前降低;31~40 mmHg、>40 mmHg组患者术后24 h黄斑灌注密度较术前降低。 结论 白内障手术患者术中灌注压会造成视盘与黄斑灌注密度、血管密度下降,在术后60 min其血管密度可恢复至正常水平,同时患者术后眼底血流密度会受到眼压波动的影响。

关键词: 白内障, 眼底血流密度, 光学相干断层扫描血管造影, 眼压

Abstract: Objective To analyze the effect of intraocular pressure fluctuations on vascular density in patients who undergo cataract surgery. Methods One hundred patients(100 eyes)who underwent phacoemulsification and intraocular lens implantation at our hospital between January 2016 and January 2019 were enrolled. The patients were divided into 4 groups according to their intraocular pressure levels as follows: 38 patients were in the <21 mmHg group, 15 patients the 21-30 mmHg group, 19 patients in the 31-40 mmHg group, and 28 patients were in the >40 mmHg group. The patients underwent an intraocular pressure and macular spot test before and after surgery, as well as 60 minutes, 8 hours, and 24 hours after the operation. Optic disc vascular density and perfusion density were also determined. Results Immediately after the surgery and 1-hour following, the macular and optic disc perfusion density were lower than before the operation. In the >40 mmHg group, the intraocular pressure was lower than the preoperative blood density 8 hours after surgery. The macular density and optic disc perfusion density were lower than before the operation after 24 hours in the >40 mmHg group. The macular perfusion density of patients in the 31-40 mmHg and >40 mmHg groups was lower than before the operation. Conclusion Intraoperative perfusion pressure in cataract surgery can cause optic disc macular perfusion density and vascular density to decrease. Vascular density can be restored to a normal level 60 minutes after the operation. The fundus blood flow density will be affected by intraocular pressure fluctuations.

Key words: Cataract, Fundus blood flow density, Optical coherence tomography angiography, Intraocular pressure

中图分类号: 

  • R776.1
[1] 刘玉青, 张海燕, 王静娴. 年龄相关性黄斑变性的白内障患者人工晶状体植入术后疗效观察[J]. 现代仪器与医疗, 2017, 23(2): 81-83. doi:10.11876/mimt201704033. LIU Yuqing, ZHANG Haiyan, WANG Jingxian. Effect of intraocular lens implantation in cataract patients with age-related macular degeneration[J]. Modern Instruments Mediccal Treatment, 2017, 23(2): 81-83. doi:10.11876/mimt201704033.
[2] Alnawaiseh M, Müller V, Lahme L, et al. Changes in flow density measured using optical coherence tomography angiography after iStent insertion in combination with phacoemulsification in patients with open-angle glaucoma[J]. J Ophthalmol, 2018, 2018: 1-5. doi:10.1155/2018/2890357.
[3] 杨杰, 高玲. 31例脉络膜皱褶光学相干断层扫描表现及其影响因素分析[J]. 中国医师杂志, 2017, 19(11): 1736-1737. doi:10.3760/cma.j.issn.1008-1372.2017.11.040.
[4] 焦芮, 韩克阳, 王淑雅, 等. 光学相干断层扫描技术在非动脉炎性前部缺血性视神经病变中的诊断现状[J]. 山东大学耳鼻喉眼学报, 2017, 31(1):119-122. doi:10.6040/j.issn.1673-3770.0.2016.451. JIAO Rui, HAN Keyang, WANG Shuya, et al. The situation of optical coherence tomography in the diagnosis of non-arteritic anterior ischemic optic neuropathy[J]. Journal Otolaryngology and Ophthalmology of Shandong University, 2017, 31(1):119-122. doi:10.6040/j.issn.1673-3770.0.2016.451.
[5] Grudzińska E, Modrzejewska M. Modern diagnostic techniques for the assessment of ocular blood flow in myopia: current state of knowledge[J]. J Ophthalmol, 2018, 2018: 4694789. doi:10.1155/2018/4694789.
[6] Zong Y, Xu H, Yu J, et al. Retinal vascular autoregulation during phase IV of the Valsalva maneuver: an optical coherence tomography angiography study in healthy Chinese adults[J]. Front Physiol, 2017, 8: 553. doi:10.3389/fphys.2017.00553.
[7] 陈娜, 闫焱, 李祯, 等. 葡萄膜炎患者的荧光素眼底血管造影及光学相干断层扫描的特点分析[J]. 上海交通大学学报(医学版), 2017, 37(12): 1653-1657. doi:10.3969/j.issn.1674-8115.2017.12.013. CHEN Na, YAN Yan, LI Zhen, et al. Characteristic analysis of fundus fluorescein angiography and optical coherence tomography findings in uveitis[J]. Journal of Shanghai Jiao Tong University(Medical Science), 2017, 37(12): 1653-1657. doi:10.3969/j.issn.1674-8115.2017.12.013.
[8] Zhu L, Zong Y, Yu J, et al. Reduced retinal vessel density in primary angle closure glaucoma: a quantitative study using optical coherence tomography angiography[J]. J Glaucoma, 2018, 27(4):322-327. doi:10.1097/IJG.0000000000000900.
[9] Moussa M, Leila M, Khalid H. Imaging choroidal neovascular membrane using en face swept-source optical coherence tomography angiography[J]. Clin Ophthalmol, 2017, 11: 1859-1869. doi:10.2147/OPTH.S143018.
[10] 刘青, 艾明. 光学相干断层扫描血管成像(OCTA)和荧光素血管造影(FFA)对比观察增生型糖尿病视网膜病变(PDR)[J]. 眼科新进展, 2017, 37(1): 52-55. doi:10.13389/j.cnki.rao.2017.0014. LIU Qing, AI Ming. Characteristics of proliferative diabetic retinopathy observed by optical coherence tomography angiography and fundus fluorescein angiography[J]. Recent Advances in Ophthalmology, 2017, 37(1): 52-55. doi:10.13389/j.cnki.rao.2017.0014.
[11] 赵丰平, 杜持新, 蔡思捷. 结膜良性增生性疾病的光学相干断层扫描特征[J]. 中华眼视光学与视觉科学杂志, 2018, 20(9): 556-560. doi:10.3760/cma.j.issn.1674-845X.2018.09.009. ZHAO Fengping, DU Chixin, CAI Sijie. Structural imaging of benign conjunctival proliferative diseases using optical coherence tomography[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2018, 20(9): 556-560. doi:10.3760/cma.j.issn.1674-845X.2018.09.009.
[12] Augustin M, Fialová S, Fischak C, et al. Ocular fundus pulsations within the posterior rat eye: Chorioscleral motion and response to elevated intraocular pressure[J]. Sci Rep, 2017, 7(1): 8780. doi:10.1038/s41598-017-09310-1.
[13] 梁倩倩, 杨庭骅, 赵博军. 光学相干层析血管扫描在视网膜静脉阻塞中的应用[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 139-142. doi:10.6040/j.issn.1673-3770.0.2018.364. LIANG Qianqian, YANG Tinghua, ZHAO Bojun. Application of optical coherence tomography angiography in retinal vein occlusion[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 139-142. doi:10.6040/j.issn.1673-3770.0.2018.364.
[14] Kang AS, Welch RJ, Sioufi K, et al. Optical coherence tomography angiography of iris microhemangiomatosis[J]. Am J Ophthalmol Case Rep, 2017, 6(3):24-26. doi:10.1016/j.ajoc.2017.02.003
[15] Glacet-Bernard A, Sellam A, Coscas F, et al. Optical coherence tomography angiography in retinal vein occlusion treated with dexamethasone implant: a new test for follow-up evaluation[J]. Eur J Ophthalmol, 2016, 26(5): 460-468. doi:10.5301/ejo.5000829.
[16] Susanna BN, Ogata NG, Jammal AA, et al. Corneal biomechanics and visual field progression in eyes with seemingly well-controlled intraocular pressure[J]. Ophthalmology, 2019, 126(12): 1640-1646. doi:10.1016/j.ophtha.2019.07.023.
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