Impact of Pupil Dilation on Optical Coherence Tomography Angiography Retinal Microvasculature in Healthy Eyes.
Impact of Pupil Dilation on Optical Coherence Tomography Angiography Retinal Microvasculature in Healthy Eyes.
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DOI：
10.1097/ijg.0000000000001647
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发表时间：
2020-11
影响因子：
2
通讯作者：
中科院分区：
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目的探讨2.5%苯哌丁胺和0.5%托吡卡胺扩瞳对OCTA定量评价视网膜微血管的影响。在26名健康受试者（平均年龄：40.0岁; 95% CI=33.9，46.1岁）中，以15分钟间隔在扩张前和扩张后获得OptoVue AngioVue高密度（HD）和非HD OCTA黄斑和视神经乳头（ONH）图像。在整个图像（wiVD）和黄斑旁区域（pfVD）中测量黄斑表面血管密度（VD）。在整个图像（wiCD）和视乳头周围区域（cpCD）中测量视神经乳头毛细血管密度。使用线性混合效应模型评估扩张前和扩张后密度之间的差异，以解释患者内的相关性。滴注扩张滴剂导致非HD ONH wiCD的下降幅度较小，但具有统计学显著性，从平均45.2%（95% CI= 41.9%，48.4%）降至44.6%（41.4%，47.8%）（P=0.046）。还观察到非HD ONH cpCD的0.8%的类似降低，从平均49.3%（45.3%，53.3%）降至48.5%（44.5%，52.4%）（P=0.025）。未观察到黄斑血管密度或HD ONH毛细血管密度的扩张后降低。局部使用2.5%苯哌丁胺和0.5%托吡卡胺扩瞳导致健康眼的非HD ONH整体图像和乳头周围毛细血管密度小幅但具有统计学显著性降低。观察到的降低可能不具有临床意义，因为观察到的降低在先前报告的测量变异性范围内。进一步的研究应该考虑调查这些影响在非健康的眼睛青光眼和媒体混浊，以及老年人。在用2.5%苯肾上腺素/0.5%托吡卡胺扩张的健康眼睛中观察到OCTA测量的乳头周围毛细血管密度的小但显著的降低。虽然可能在临床上不显著，但眼科医生在解释散瞳眼的OCTA结果时应考虑这些变化。
To investigate the effect of pupil dilation using 2.5% phenylephrine and 0.5% tropicamide on quantitative assessment of retinal microvasculature using OCTA. OptoVue AngioVue high density (HD) and non-HD OCTA macula and optic nerve head (ONH) images were obtained at 15-minute intervals pre- and post-dilation in 26 healthy participants (mean age: 40.0; 95% CI=33.9, 46.1 years). Superficial macular vessel density (VD) was measured in the whole image (wiVD) and the parafoveal region (pfVD). Optic nerve head capillary density was measured in the whole image (wiCD) and the circumpapillary region (cpCD). Differences between pre- and post-dilation densities were assessed using linear mixed effects models to account for within-patient correlation. Instillation of dilating drops resulted in a small but statistically significant reduction in non-HD ONH wiCD of 0.6%, from a mean of 45.2% (95% CI=41.9%, 48.4%) to 44.6% (41.4%, 47.8%) (P=0.046). A similar reduction in non-HD ONH cpCD of 0.8% also was observed, from a mean of 49.3% (45.3%, 53.3%) to 48.5% (44.5%, 52.4%) (P=0.025). No post-dilation decreases in macular vessel density or HD ONH capillary density were observed. Pupil dilation using topical 2.5% phenylephrine and 0.5% tropicamide results in a small but statistically significant reduction in non-HD ONH whole image and circumpapillary capillary densities in healthy eyes. The observed reduction likely is not clinically significant because the observed reduction was within the previously reported range of measurement variability. Further studies should consider investigating these effects in non-healthy eyes with glaucoma and media opacities, as well as older individuals. Small but significant decreases in OCTA-measured circumpapillary capillary density were observed in healthy eyes dilated with 2.5% phenylephrine/0.5% tropicamide. Though likely clinically insignificant, ophthalmologists should consider these changes when interpreting OCTA results from dilated eyes.