基于OCTA的高度近视患眼黄斑区视网膜血管密度分析

Analysis of retinal vascular density in macular area of eyes with high myopia by OCTA

目的应用光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)对高度近视患眼黄斑不同区域视网膜血管密度(vascular density,VD)进行观察及测量,探讨其与年龄、眼轴长度、屈光度之间的相关性。方法收集2019年1月至5月在临沂市人民医院眼科就诊的单纯高度近视患者34例61眼,应用OCTA对受检眼黄斑不同区域,包括距黄斑中心凹直径为1 mm的中心区、>1~3 mm的内层、>3~6 mm的外层的浅层视网膜血管长度密度(vascular length density,VLD)、血管灌注密度(vascular perfusion density,VPD)进行检测,并量化黄斑中心凹无血管区(foveal avascular zone,FAZ),比较各区域的VD差异,并分析年龄、眼轴长度、屈光度与VD、FAZ参数之间的相关性。结果OCTA检查结果显示,中心区、内层、外层VLD分别为(8.09±3.88)mm·mm-2、(16.51±3.30)mm·mm-2、(17.55±2.21)mm·mm-2,PD分别为0.176±0.087、0.393±0.080、0.428±0.057。三个区域间VLD、VPD两两相比,差异均有统计学意义(均为P<0.05)。年龄与各区域VLD、VPD均呈负相关(均为P<0.05);眼轴长度与黄斑区整体及内层、外层的VLD、VPD均呈负相关(均为P<0.05),与中心区VLD、VPD均不相关(均为P>0.05);屈光度与黄斑区各区域的VLD、VPD均不相关(均为P>0.05)。年龄与FAZ面积、周长均不相关(均为P>0.05),与FAZ充实度轻度负相关(r=-0.270,P=0.035);眼轴长度、屈光度与FAZ各参数均不相关(均为P>0.05)。结论高度近视患眼黄斑各区浅层视网膜VD随年龄、眼轴长度的增加而下降,而FAZ各参数均保持稳定。

Objective To measure the vascular density(VD)in different macular regions by optical coherence tomography angiography(OCTA),and explore its correlation with age,axial length and diopter.Methods The study collected a total of 34 patients(61 eyes)with high myopia who received treatment at Ophthalmology Department in Linyi People’s Hospital from January to May 2019.The OCTA was used to detect the vascular length density(VLD)and vascular perfusion density(VPD)at different regions of macular shallow layer,including the central region with a diameter of 1 mm from the macular fovea,an inner layer with a diameter of 1-3 mm,and an outer layer with a diameter of 3-6 mm,as well as the foveal avascular zone(FAZ)parameters.VD differences in different macular regions were compared,and the correlation of age,axial length and diopter with VD and FAZ parameters were analyzed.Results OCTA examination showed that VLD at the central region,inner layer and outer layer were(8.09±3.88)mm·mm-2,(16.51±3.30)mm·mm-2 and(17.55±2.21)mm·mm-2,respectively,and the VPD were 0.176±0.087,0.393±0.080 and 0.428±0.057,respectively.Statistical differences were found in VLD and VPD by two-two comparisons among three regions(all P<0.05).Age was negatively correlated with VLD and VPD in each region(all P<0.05).Axial length was negatively correlated with VD and VPD in the whole macular area,inner layer and outer layer(all P<0.05),but had no relation with VLD or VPD in central region(both P>0.05).Diopter was not correlated with VLD or VPD at each macular region(all P>0.05).Age was not related to FAZ area or perimeter(all P>0.05),but slightly negative related to FAZ circularity(r=-0.270,P=0.035).Axial length and diopter were not correlated with FAZ parameters(all P>0.05).Conclusion VD at superficial retina of each macular region in patients with high myopia decreases with age and axial length,but all FAZ parameters remain stable.