应用光学相干断层扫描血管成像技术分析近视眼黄斑区微血管变化

The analysis of macular microvasculature alteration of myopic eyes with optical coherence tomography angiography

目的:应用光学相干断层扫描血管成像技术(OCTA)研究近视眼黄斑区视网膜微血管的变化及其与视网膜厚度的相关性。方法:2015年6月至2016年5月在温州医科大学附属眼视光医院就诊的患者45例(90眼)纳入研究,其中低度近视及正视眼组15例(30眼)作为对照组,中度近视组15例(30眼)、高度近视组15例(30眼)。采集黄斑区微血管密度及视网膜厚度,通过自动分层获得视网膜表层和深层血管图。选取以黄斑中心凹(fovea)为中心直径1 mm圆和3 mm旁中心(parafovea)圆环内血管密度进行分析。结果:Fovea处表层微血管密度和深层微血管密度均与眼轴呈正相关(r=0.51、0.52,P<0.05)。Parafovea处表层微血管密度与眼轴呈负相关(r=-0.34,P=0.01),其深层微血管密度与眼轴无相关性(r=-0.03,P=0.79)。Fovea处表层微血管密度和深层微血管密度均与fovea处视网膜内五层厚度呈显著正相关(r=0.85、0.82,P<0.05)。Parafovea处表层微血管密度和深层微血管密度均与parafovea处视网膜内五层厚度无相关性(r=0.16、0.07,P>0.05)。结论:随着眼轴的增加和视网膜厚度的增加,fovea处视网膜微血管密度会随之增加,而在parafovea区域,表层视网膜微血管密度会随着眼轴的增加而减少,但与视网膜厚度的变化并无相关性。临床上在应用血管成像技术时应考虑近视眼本身对黄斑区微血管的影响。

Objective： To explore the alterations of myopic macular retinal capillaries and its correlation with retinal thickness using optical coherence tomography angiography （OCTA）. Methods： Ninety eyes of 45 people were included in this study, divided into low myopia and emmetropia group 30 eyes of 15 people （control group）, moderate myopia group 30 eyes of 15 people, high myopia group 30 eyes of 15 people. Acquisition of macular micro-vascular density and retinal thickness, then obtained the superficial and deep vascular graph by automatic stratification. The densities of 1 mm circle （fovea） and 3 mm circle ring （parafovea） in the center of macular fovea were analyzed using the built-in software. Results： There was a significant positive correlation between foveal superficial/deep density and the axial length （r=0.51, 0.52, P〈0.05）. There was a significant negative correlation between parafoveal superficial density and axial length （r=-0.34, P=0.01）, but no significant correlation between parafoveal deep density and axial length （r=-0.03, P=-0.79）. There was a significant positive correlation between foveal superficial/deep density and the inner five-layer thickness of fovea （r=0.85, 0.82, P〈0.05）. There was no significant correlation between parafoveal superficial/deep density and the inner five-layer thickness of parafovea （r=0.16, 0.07, P〉0.05）. Conclusion： The density of retinal blood vessels in macular fovea will increase with increasing axial length and retinal thickness, while the density of retinal blood vessels will decrease with increasing of axial length but not directly related with the change of retina thickness in retinal parafoyea. Clinical application of blood flow imaging technology should be taken account into myopia on the macular micro vascular impact.