Retinal Oximetry
Retinal Oximetry
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DOI：
10.1111/aos.12086
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发表时间：
2013-03-01
影响因子：
3.4
通讯作者：
Hardarson，Sveinn Hakon
中科院分区：
文献类型：
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作者：
Hardarson，Sveinn Hakon
摘要目的视网膜血流或氧合功能障碍被认为与多种疾病有关。其中包括视网膜血管阻塞、糖尿病视网膜病变和青光眼。可靠的、非侵入性的视网膜氧气测量技术一直很少，有关视网膜氧合的大部分知识都来自动物研究。本论文描述了利用新的视网膜血氧仪技术进行的人体视网膜血氧饱和度测量。本文描述了(1)健康志愿者的明暗视网膜血管血氧饱和度的研究，(2)视网膜中央静脉阻塞，(3)视网膜分支静脉阻塞，(4)视网膜中央动脉阻塞，(5)糖尿病视网膜病变，(6)青光眼手术患者和(7)青光眼药物治疗患者。一个附加的图像分离器允许同时捕获眼底相同区域的四个图像。两幅图像被用来进一步分析，一幅是用586nm光获取的，另一幅是用605 nm光获取的。视网膜血管的光吸光度对605 nm的氧饱和度敏感，而对586 nm的氧饱和度不敏感。测量这些波长的反射光可以估计主要视网膜血管的氧饱和度。结果暗30 后，健康志愿者视网膜小动脉血氧饱和度为92 ± 4%( ± SD，n= 15)。在80 Cd/m2光照射5 后，动脉血氧饱和度为89 ± 5%。下降具有统计学意义(p = 0.008)。视网膜小静脉在黑暗中的对应值为60 ± 5%，在光照下为55 ± 10%(p = 0.020)。在交替5 分钟的黑暗和光照后，也发现了类似的结果。在第二个实验中(n= 19)，与黑暗相比，100 Cd/m2光下视网膜血管血氧饱和度显著降低，但1和10 Cd/m2光对视网膜血管血氧饱和度无明显影响。视网膜中央静脉阻塞在视网膜中央静脉阻塞患者中，视网膜小静脉平均饱和度为49 ± 12%，对侧眼平均为65 ± 6%(平均 ± SD，p = 0.003，n= 8)。患眼视网膜小动脉饱和度(99 ± 3%)与健眼(99 ± 6%)相同。视网膜分支静脉阻塞患眼平均血氧饱和度为59%(12~93%，n= 22)，健眼为63%(23~80%)，对侧眼为55%(39~80%)。差异无统计学意义(p >； )。患眼微动脉(中位数101%；范围89~115%)与非患眼微动脉(95%、85%~104%)之间差异有统计学意义(p <； 0.05，n= 18)。视网膜中央动脉阻塞：1例有颞动脉炎视网膜中央动脉阻塞病史的患者，小静脉平均动脉饱和度为71 ± 9%和63 ± 9%。1个月后，经强的松龙治疗后，平均动脉饱和度为10 0 ± 4%，静脉饱和度为54 ± 5%。糖尿病视网膜病变与健康志愿者(n= 31)相比，所有类型的糖尿病视网膜病变患者的视网膜小动脉饱和度平均增加7-10个百分点(p <；所有类型的 0.0 5，每类n= 6-8)。在小静脉中，饱和度高8-12个百分点(p <； 所有类别均为0.05)。青光眼手术视网膜中的氧饱和度…
AbstractPurposeMalfunction of retinal blood flow or oxygenation is believed to be involved in various diseases. Among them are retinal vessel occlusions, diabetic retinopathy and glaucoma. Reliable, non‐invasive technology for retinal oxygen measurements has been scarce and most of the knowledge on retinal oxygenation comes from animal studies. This thesis describes human retinal oximetry, performed with novel retinal oximetry technology. The thesis describes studies on retinal vessel oxygen saturation in (1) light and dark in healthy volunteers, (2) central retinal vein occlusion, (3) branch retinal vein occlusion, (4) central retinal artery occlusion, (5) diabetic retinopathy, (6) patients undergoing glaucoma surgery and (7) patients taking glaucoma medication.MethodsThe retinal oximeter (Oxymap ehf., Reykjavik, Iceland) is based on a fundus camera. An attached image splitter allows the simultaneous capture of four images of the same area of the fundus. Two images are used for further analysis, one acquired with 586 nm light and one with 605 nm light. Light absorbance of retinal vessels is sensitive to oxygen saturation at 605 nm but not at 586 nm. Measurement of reflected light at these wavelengths allows estimation of oxygen saturation in the main retinal vessels. This is performed with custom‐made analysis software.ResultsLight and darkAfter 30 min in the dark, oxygen saturation in retinal arterioles of healthy volunteers was 92 ± 4% (mean ± SD,n= 15). After 5 min in 80 cd/m2light, the arteriolar saturation was 89 ± 5%. The decrease was statistically significant (p = 0.008). The corresponding values for retinal venules were 60 ± 5% in the dark and 55 ± 10% in the light (p = 0.020). Similar results were found after alternating 5 min periods of darkness and light. In a second experiment (n= 19), a significant decrease in retinal vessel oxygen saturation was found in 100 cd/m2light compared with darkness but 1 and 10 cd/m2light had no significant effect.Central retinal vein occlusionIn patients with central retinal vein occlusion, the mean saturation in affected retinal venules was 49 ± 12%, while the mean value for venules in the fellow eye was 65 ± 6% (mean ± SD, p = 0.003,n= 8). The retinal arteriolar saturation was the same in affected (99 ± 3%) and the unaffected (99 ± 6%) eyes. The venous oxygen saturation showed much variation between affected eyes.Branch retinal vein occlusionMedian oxygen saturation in venules affected by branch retinal vein occlusion was 59% (range, 12–93%,n= 22), while it was 63% (23–80%) in unaffected venules in the affected eye and 55% (39–80%) in venules in the fellow eye. The difference was not statistically significant (p > 0.05). There was a significant difference between affected arterioles (median 101%; range, 89–115%) and unaffected arterioles (95%, 85–104%) in the affected eye (p < 0.05,n= 18).Central retinal artery occlusionIn a patient with a day’s history of central retinal artery occlusion due to temporal arteritis, the mean arteriolar saturation was 71 ± 9% and 63 ± 9% in the venules. One month later, after treatment with prednisolone, the mean arteriolar saturation was 100 ± 4% and the venous saturation 54 ± 5%.Diabetic retinopathyWhen compared with healthy volunteers (n= 31), patients with all categories of diabetic retinopathy had on average 7–10 percentage points higher saturation in retinal arterioles (p < 0.05 for all categories,n= 6–8 in each category). In venules, the saturation was 8–12 percentage points higher (p < 0.05 for all categories).Glaucoma surgeryOxygen saturation in retinal …