光學(xué)相干斷層掃描血管造影在眼底微血管定量分析中的研究進(jìn)展

姜利剛 童毓華

[摘要] 光學(xué)相干斷層掃描血管造影通過連續(xù)探測同一位置的血管內(nèi)紅細(xì)胞運動，生成三維血流信息，獲取高分辨率的眼底血管圖像。分頻幅去相關(guān)血流成像演算技術(shù)，減少了因眼球軸向運動和組織運動產(chǎn)生的噪點及偽影，優(yōu)化了信噪比，使得對毛細(xì)血管網(wǎng)的檢測更具有連貫性。光學(xué)相干斷層掃描血管造影目前已應(yīng)用于糖尿病性視網(wǎng)膜病變、年齡相關(guān)性黃斑變性、視網(wǎng)膜血管阻塞、青光眼、中心性漿液性脈絡(luò)膜病變等疾病的診療中，具有廣闊的臨床應(yīng)用及科研前景。本文就光學(xué)相干斷層掃描血管造影在眼底微血管定量分析中的應(yīng)用作綜合性論述。

[關(guān)鍵詞] 光學(xué)相干斷層掃描血管造影;糖尿病性視網(wǎng)膜病變;年齡相關(guān)性黃斑變性;視網(wǎng)膜血管阻塞;青光眼;中心性漿液性脈絡(luò)膜病變

[中圖分類號] R774.1 ? ? ? ? ?[文獻(xiàn)標(biāo)識碼] A ? ? ? ? ?[文章編號] 1673-9701（2020）12-0184-09

[Abstract] Optical coherence tomography angiography generates three-dimensional blood flow information by continuously detecting the movement of red blood cells in the same location， and obtains high-resolution images of fundus vessels. The split-spectrum amplitude decorrelation angiography（SSADA） reduces the noise and artifacts caused by the axial movement of the eyeball and tissue movement， optimizes the signal-to-noise ratio， and makes the detection of the capillary network more consistent. Optical coherence tomography angiography has been applied to the diagnosis and treatment of diseases such as diabetic retinopathy， age-related macular degeneration， retinal vascular obstruction， glaucoma， and central serous choroidal disease. It has broad clinical application and scientific research prospects. This article makes a comprehensive discussion on the application of optical coherence tomography angiography in the quantitative analysis of fundus microvasculature.

[Key words] Optical coherence tomography angiography; Diabetic retinopathy; Age-related macular degeneration; Retinal vascular obstruction; Glaucoma; Central serous choroidal disease

光學(xué)相干斷層掃描（optical coherence tomography，OCT）是一種非侵入性的成像方式，可以對視網(wǎng)膜進(jìn)行詳細(xì)地結(jié)構(gòu)視覺化，最早的報道見于1991年Huang D博士[1]發(fā)表在Science的關(guān)于OCT的論文，其敘述了OCT的基本原理，與B型超聲波很相似，區(qū)別在于它是探測光的反射而不是探測聲的反射。OCT 有助于臨床醫(yī)生發(fā)現(xiàn)和監(jiān)測視網(wǎng)膜血管疾病中液體的滲出，但無法直接發(fā)現(xiàn)毛細(xì)血管無灌注區(qū)和新生血管，臨床上常用熒光素眼底血管造影（fundus fluorescein angiography，F(xiàn)FA）或吲哚箐綠血管造影檢查（Indocyanine green angiography，ICGA）來檢測這些變化，而這兩項屬于侵入性檢查方式，需要注射造影劑，對身體造成不可避免的損傷。……