血病真的会导致微血管变化,我们没有注意到吗? 一个光学连贯性断层扫描血管学研究的孩子们与β-thalassemia
Umay Güvenç1, Nurten Ünlü2, Hüsniye Neşe Yaralı3
1Ankara Training and Research Hospital Ophthalmology Department, Ankara, Turkey. umay.guvenc@gmail.com.
International ophthalmology
|June 30, 2023
概括
儿科β-thalassemia患者显示改变了视网膜微血管结构. 输血依赖性沙拉西米亚 (TDT) 患者的输血导致视网膜神经纤维厚度和输液减少,突出显示了贫血和铁过载的影响.
科学领域:
- 眼科医生 眼科 眼科
- 血液学 血液学 血液学
- 医疗成像医学成像
背景情况:
- β-thalassemia是一种遗传性血液疾病,导致慢性贫血和铁过载.
- 微血管并发症,特别是视网膜,在β-thalassemia中越来越多地被识别出来.
- 光学连贯断层扫描血管学 (OCTA) 提供了一种非侵入性方法来评估视网膜微血管.
研究的目的:
- 为了评估使用OCTA的儿科β-thalassemia患者的视网状微血管变化.
- 为了研究输血对视网膜输液在输血依赖性血病 (TDT) 患者的影响.
- 为了将微血管变化与血液学参数和铁积累相关联.
主要方法:
- 一项多中心,前性,横截面研究,涉及56名TDT,14名非TDT (NTDT) 和63名健康儿童.
- OCTA用于测量表面和深层毛细血管,辐射周毛细血管,胆管毛细血管和状血管区域 (FAZ) 的血管密度 (VD).
- 对TDT患者输血前和输血后的OCTA参数进行了比较,并与血液值和铁含量相关联.
主要成果:
- 与对照组相比,TDT患者表现出较薄的/准区域和更大的FAZ区域.
- 非TDT患者在表面毛细管 (SCP) 中显示了最小的黄斑VD.
- 在TDT患者中,输血后发现视网膜神经纤维厚度降低和深毛细管VD (ppVD). 在血红蛋白/血红素和ppVD之间发现了负相关性.
结论:
- 在儿科β-thalassemia中,OCTA对于检测视网膜和choriocapillaris血管功能障碍非常有价值.
- 微血管变化与不同β-thalassemia表型中的组织缺氧和氧化应激有关.
- 输血管理可能会影响TDT患者的视网膜 perfusion 参数.
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