目的：观察常见鞍区肿瘤患者视网膜微血管密度的变化，及与视野损伤的相关性，探索其在评估鞍区肿瘤患者视神经损伤中的应用价值。方法：横断面研究，选取2018-10/2022-05在首都医科大学附属北京天坛医院神经外科和眼科就诊的常见鞍区肿瘤患者157例292眼(垂体腺瘤82例152眼、颅咽管瘤75例140眼)，收集同期就诊于首都医科大学附属北京天坛医院眼科患者的家属、本院学生及工作人员90例180眼作为对照组。所有受检者均进行OCTA检查。比较两组受检者视网膜微血管密度变化，及其与视野参数的相关性。结果：鞍区肿瘤组患者视乳头放射状毛细血管网(RPC)和黄斑区浅层毛细血管丛(SRCP)密度均较对照组降低[50.81%(46.49%，53.49%)vs 52.78%(50.73%，54.51%)和 50.57%(48.13%，52.73%)vs 51.63%(49.78%，53.02%)，均P<0.05]。颅咽管瘤组患者RPC密度较垂体腺瘤组患者更低[49.71%(44.33%，53.14%)vs 51.37%(47.42%，53.95%)，P<0.05]。鞍区肿瘤组患者视野MD值为-4.33(-12.22，-1.85)dB，PSD值为3.37(1.91，8.82)dB，VFI为 92%(65%，97%)。鞍区肿瘤患者各象限RPC密度与MD、VFI正相关，与PSD负相关，各象限SRCP密度与MD正相关，除Para-T外其余各象限与VFI正相关，与PSD负相关(均P<0.05)。结论：鞍区肿瘤患者的视网膜微血管密度降低，血管密度越低，视野损害越严重。在临床工作中，将OCTA检查与视野检查结合起来，更有助于发现患者的视神经损害。

AIM: To evaluate the changes of retinal microvascular density in patients with sellar region tumor, and its correlation with the damage to visual field, and to explore its application value in evaluating optic nerve injury of those patients.METHODS: Cross-sectional study. A total of 157 patients(292 eyes)with sellar region tumor, including 82 cases(152 eyes)of pituitary adenoma and 75 cases(140 eyes)of craniopharyngioma, were selected from neurosurgery department and ophthalmology department of Beijing Tiantan Hospital, Capital Medical University between October 2018 and May 2022. A total of 90 people(180 eyes)during the same period, including the family members of patients, students and staff in Beijing Tiantan Hospital, Capital Medical University were collected as control group. All participants underwent optical coherence tomography angiography(OCTA)examination. The changes of retinal microvascular density and its correlation with visual field parameters were compared between the two groups.RESULTS: In patients with sellar region tumor, the radial peripapillary capillary(RPC)and superficial retinal capillary plexus(SRCP)density were significantly lower than that in the control group [50.81%(46.49%, 53.49%)vs. 52.78%(50.73%, 54.51%)and 50.57%(48.13%, 52.73%)vs. 51.63%(49.78%, 53.02%), all P<0.05]. The RPC density in the craniopharyngioma group was lower than that in the pituitary adenoma group [49.71%(44.33%, 53.14%)vs. 51.37%(47.42%, 53.95%), P<0.05]. The MD, PSD and VFI of the sellar region tumor group were -4.33(-12.22, -1.85)dB, 3.37(1.91, 8.82)dB and 92%(65%, 97%)respectively. RPC density of patients with sellar region tumor was positively correlated with MD and VFI, and was negatively correlated with PSD. The SRCP density of each quadrant was positively correlated with MD, and was positively correlated with VFI except Para-T and it was negatively correlated with PSD(all P<0.05).CONCLUSION: Retinal microvascular changes were present in patients with sellar region tumor. Lower vessel density indicates more severe damage to visual field. In the clinic, visual field examinations combined with OCTA were helpful to find the optic nerve injury of patients.

国家自然科学基金资助项目(No.82071996)