不同分级的视网膜中央动脉阻塞患者视网膜厚度变化及相关性分析

万宇薇; 陈婷; 李莹; 李雪杰; 杨安怀; 肖璇

doi:10.14188/j.1671-8852.2024.0091

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不同分级的视网膜中央动脉阻塞患者视网膜厚度变化及相关性分析

基础及临床医学研究 | 更新时间：2026-11-05

- 不同分级的视网膜中央动脉阻塞患者视网膜厚度变化及相关性分析
- Retinal changes in different grades of central retinal artery occlusion and correlation analysis
- 武汉大学学报（医学版） 2025年46卷第4期页码：487-492
- 作者机构：
  
  武汉大学人民医院眼科中心湖北武汉 430060
- 作者简介：
  
  万宇薇，女，1998—，医学硕士生，主要从事视网膜血管阻塞性疾病及眼心脑泛血管事件的临床诊治、致病机理、应用转化研究。E⁃mail：wyw1213ninetyeight@163.com
  陈婷，女，1987—，医学博士，副主任医师，主要从事视网膜血管阻塞性疾病及眼心脑泛血管事件的临床诊治、致病机理、应用转化研究，E⁃mail：ct19870629@hotmail.com
  杨安怀，男，1965—，医学博士，主任医师，博士生导师，主要从事玻璃体与视网膜、眼外伤疾病研究，E⁃mail:yah0525@126.com
  肖璇，女，1979—，医学博士，主任医师，博士生导师，主要从事视网膜血管阻塞性疾病及眼心脑泛血管事件的临床诊治、致病机理、应用转化研究，E⁃mail:xiaoxuan1111@163.com。万宇薇、陈婷为本文共同第一作者
- 基金信息：
  
  湖北省重点研发计划项目(2022BCA009)
- DOI：10.14188/j.1671-8852.2024.0091
  中图分类号： R774
- 收稿：2024-02-01，
  
  纸质出版：2025-04-25
- 稿件说明：
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万宇薇,陈婷,李莹等.不同分级的视网膜中央动脉阻塞患者视网膜厚度变化及相关性分析[J].武汉大学学报（医学版）,2025,46(04):487-492.

WAN Yuwei,CHEN Ting,LI Ying,et al.Retinal changes in different grades of central retinal artery occlusion and correlation analysis[J].Medical Journal of Wuhan University,2025,46(04):487-492.
万宇薇,陈婷,李莹等.不同分级的视网膜中央动脉阻塞患者视网膜厚度变化及相关性分析[J].武汉大学学报（医学版）,2025,46(04):487-492. DOI： 10.14188/j.1671-8852.2024.0091.

WAN Yuwei,CHEN Ting,LI Ying,et al.Retinal changes in different grades of central retinal artery occlusion and correlation analysis[J].Medical Journal of Wuhan University,2025,46(04):487-492. DOI： 10.14188/j.1671-8852.2024.0091.

摘要

目的

研究光谱域光学相干断层扫描（SD⁃OCT)下视网膜中央动脉阻塞患者（CRAO）特定视网膜厚度变化及其与临床特征的相关性。

方法

回顾性收集91例CRAO患者临床资料。根据SD⁃OCT检查将CRAO分为3个等级（不完全、次全、完全），测量并比较各组患者及对照组特定视网膜厚度

分析其与入院视力、出院视力的相关性。

结果

CRAO各组黄斑中心凹厚度（CFT)、视网膜最内层（IMRL)、视网膜中层（MRL)以及视网膜外层（ORL)厚度均显著高于同组CRAO患者对侧健眼（

0.001）。CRAO阻塞程度增加，CFT、IMRL、MRL、ORL厚度明显增加（

0.001）。CRAO患者入院视力logMAR与分级、CFT、IMRL、MRL厚度呈正相关（

分级

=0.336，

分级

=0.001；

CFT

=0.352，

CFT

=0.001；

IMRL

=0.280，

IMRL

=0.007；

MRL

=0.348，

MRL

=0.001）；CRAO患者出院视力logMAR与分级、入院视力logMAR、CFT厚度呈正相关（

分级

=0.245，

入院视力

=0.019；

入院视力

=0.804，

入院视力

0.001；

CFT

=0.278，

IMRL

=0.008），与接受溶栓治疗呈负相关（

接受溶栓治疗

=-0.311，

接受溶栓治疗

=0.003）。

结论

SD⁃OCT可显示CRAO患者视网膜特征性病理变化。CFT越厚，CRAO阻塞严重，患者视力预后越差。

Abstract

Objective

To investigate selected retinal layers in patients with acute central retinal artery occlusion (CRAO) under spectral⁃domain optical coherence tomography (SD⁃OCT) examination

and further analyze the correlation between retinal thickness and clinical characteristics in CRAO patients.

Methods

Clinical data from 91 patients with acute CRAO were retrospectively collected. Based on the SD⁃OCT image

CRAO was categorized into three grades (incomplete

subtotal

and total occlusion). The thickness of selected retinal layers was measured and compared across the three grades and against the contralateral eyes (controls). The relationship between selected retinal thickness and clinical characteristics was analyzed.

Results

The thickness of central foveal thickness (CFT)

the innermost retinal layer (I

MRL)

the middle retinal layer (MRL)

and the outer retinal layer (ORL) in CRAO patients significantly differed from that of the contralateral eye (

0.001). As the severity of CRAO increased

the thickness of CFT

IMRL

MRL

and ORL increased significantly

with a significant difference (

0.001). The baseline visual acuity (logMAR) was positively correlated with CRAO grading

as well as the thickness of CFT

IMRL

and MRL in CRAO patients (

grading

=0.336

grading

=0.001;

CFT

=0.352

CFT

=0.001;

IMRL

=0.280

IMRL

=0.007;

MRL

=0.348

MRL

=0.001). The discharge visual acuity (logMAR) was positively correlated with CRAO grading

baseline visual acuity (logMAR)

and CFT thickness in CRAO patients

and negatively correlated with thrombolytic therapy (

=-0.311

=0.003).

Conclusion

SD⁃OCT can reveal the characteristic pathological retinal changes in CRAO patients. CFT thickness is positively associated with baseline visual acuity and discharge visual acuity.

关键词

Keywords

references

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