光学相干断层扫描血管成像在全身疾病中的临床应用研究进展

Advances in clinical applications of optical coherence tomography angiography in systemic diseases

摘要

全身性疾病是指对全身多个器官影响的系统性疾病，许多全身性疾病对眼部有不同程度的损害，深入研究眼科与全身疾病的关系能提升眼科与全身疾病的综合诊疗水平。光学相干断层扫描血管成像 (optical coherence tomography angiography，OCTA) 能够以无创的方式提供高分辨率的三维图像，对结膜、虹膜、视网膜和脉络膜血管进行详细观察，已在眼科临床工作中得到广泛应用，对于眼底疾病 (如黄斑水肿、脉络膜新生血管、糖尿病性视网膜病变、视网膜分支静脉阻塞等) 的诊断和随访具有重要意义。近年来研究发现 OCTA 不仅能早期筛查和诊断神经退行性疾病，而且可以评估危重症和颈动脉狭窄患者严重程度及其治疗效果。此外 OCTA 还被应用于系统性红斑狼疮的活动度评估，并在构建疾病风险预测模型方面展现出重要价值。本文综述了 OCTA 在多种全身性疾病中的最新应用进展，讨论了其潜在的临床价值，为 OCTA 在全身性疾病中的进一步应用提供思路。

Abstract

Systemic diseases refer to conditions that affect multiple organs throughout the body. Many systemic diseases have different degrees of damage to the eye. An in-depth study of the relationship between ophthalmology and systemic diseases can enhance the comprehensive diagnostic and therapeutic level in both fields. Optical coherence tomography angiography (OCTA) provides non-invasive, high-resolution three-dimensional images allowing for detailed observation of the conjunctival, iris, retinal, and choroidal blood vessels. OCTA has been widely used in ophthalmology, which is of great significance in the observation and follow-up of fundus diseases, such as macular edema, choroidal neovascularization, diabetic retinopathy, and retinal branch vein occlusion. Recent studies have shown that OCTA can not only be used for the early screening and diagnosis of neurodegenerative diseases, but also for assessing the severity of critical illnesses and carotid artery stenosis, as well as evaluating the effects of treatment. Furthermore, OCTA has been applied in assessing disease activity in systemic lupus erythematosus and has demonstrated significant value in constructing disease risk prediction models. In this article, we review the latest advances in the application of OCTA in various systemic diseases, discusses its potential clinical value, and provides insights for further application of OCTA in the field of systemic diseases.

关键词

光学相干断层扫描血管成像 / 全身性疾病 / 微血管改变 / 临床应用 / 研究进展

Key words

Optical coherence tomography angiography (OCTA) / Systemic diseases / Microvascular changes / Clinical application / Recent advances

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基金资助

国家自然科学基金(81700831)

山东省自然科学基金(ZR2023MH139)