OCT和OCTA检测视网膜血流及厚度的应用

【摘要】 目的 应用光学相干断层扫描（OCT）及光学相干断层扫描血管成像（OCTA）技术，比较不同年龄段健康成人视网膜血流及厚度变化。方法 选取2023年5月至2024年5月在我院眼科中心行眼部检查的健康成人240例（240眼）作为研究对象，按年龄分为3组：青年组（30～44岁组，80眼）、中年组（45～59岁组，80眼），老年组（60～75岁，80眼）。应用OCT及OCTA进行扫描分析并记录收据，比较各组间以下参数差异：黄斑区视网膜神经上皮层（ILM-RPE）厚度、黄斑区神经节细胞层（GCL）厚度、视盘周围视网膜神经纤维层（RNFL）厚度、黄斑中心凹无血管区（FAZ）面积，以及黄斑区（中心凹、内环、外环、整体）和视盘区（整体、内环、外环）的血流密度（VD）与灌注密度（PD）。结果 不同年龄组间黄斑区ILM-RPE厚度、黄斑区GCL各分区厚度及视盘周围RNFL厚度差异均有统计学意义（P<0.05），且随年龄增长呈逐渐变薄趋势。黄斑区GCL各分区厚度中，鼻上方最厚，下方最薄。不同年龄组间黄斑区FAZ面积、中心凹/内环/外环/整体VD及PD差异均有统计学意义（P<0.05）。随年龄增长，FAZ面积逐渐增大，而各层VD、PD呈递减趋势。不同年龄组间视盘中心VD差异无统计学意义（P>0.05），但视盘内环、外环、整体VD及各层PD差异均有统计学意义（P<0.05），且均随年龄增长呈递减趋势。结论 OCT及OCTA技术可定量评估视网膜结构厚度及微循环血流变化。健康成人黄斑区ILM-RPE及GCL厚度在年龄组间无明显差异，但视盘周围RNFL厚度以及视盘区、黄斑区的血流密度（VD）和灌注密度（PD）随年龄增长呈现显著下降趋势。更多还原

【Abstract】 Objective To compare changes in retinal blood flow and thickness among healthy adults of different age groups using Optical Coherence Tomography(OCT)and Optical Coherence Tomography Angiography(OCTA).Methods A total of 240 healthy adults(240 eyes) who underwent ocular examinations at our ophthalmology center between May 2023 and May 2024 were enrolled as subjects. Participants were divided into three age groups: the Young group(30～44 years, 80 eyes), the Middle-aged group(45～59 years, 80 eyes), and the Elderly group(60～75 years, 80 eyes). OCT and OCTA scans were performed,and data were collected.Differences between groups were compared for the following parameters:macular inner limiting membrane to retinal pigment epithelium(ILM-RPE)thickness,macular ganglion cell layer(GCL)thickness,peripapillary retinal nerve fiber layer(RNFL)thickness,macular foveal avascular zone(FAZ)area,as well as vessel density(VD)and perfusion density(PD)in the macular region(fovea,inner ring,outer ring,overall)and optic disc region(overall,inner ring,outer ring).Results Significant differences(P<0.05)were found in macular ILM-RPE thickness,macular GCL thickness in all sectors,and peripapillary RNFL thickness among the age groups,with a progressive thinning trend observed with increasing age.Within macular GCL sectors,the superonasal sector was the thickest,while the inferior sector was the thinnest.Significant differences(P<0.05)were found in macular FAZ area,as well as foveal,inner ring,outer ring,and overall macular VD and PD among the age groups.FAZ area progressively enlarged with age,while VD and PD in all macular layers showed a decreasing trend.No significant difference(P>0.05)was found in foveal VD of the optic disc among age groups.However,significant differences(P<0.05)were observed in inner ring,outer ring,and overall optic disc VD,as well as PD in all optic disc layers,all showing a decreasing trend with increasing age.Conclusion OCT and OCTA techniques enable the quantitative assessment of changes in retinal structural thickness and microvascular blood flow. While macular ILM-RPE and GCL thickness show no significant differences between age groups in healthy adults, peripapillary RNFL thickness and VD and PD in both the optic disc and macular regions demonstrate a significant decline with advancing age.更多还原