运用光学相干断层扫描血管成像技术分析不同程度近视眼眼底微循环变化

The analysis of retinal microvascular alteration of myopic eyes with optical coherence tomography angiography

目的通过光学相干断层扫描血管成像技术(OCTA)分析不同程度近视眼黄斑区及视盘周围微循环改变及其与眼轴的关系。方法共纳入患者66例(共106眼),其中低度近视(-0.5^-3.0 D) 16例(28眼)、中度近视(-3.0^-6.0 D)组23例(36眼)、高度近视(>-6.0 D)组27例(42眼)。所有患者均行完整的眼科检查,包括等效球镜度验光、裂隙灯及眼底检查,然后行OCTA检查,使用最新版分析软件,获取受检者的图像质量、中心凹旁300μm血流密度(FD-300)、非圆指数(AI)、黄斑区旁中心凹处浅层视网膜微血管(SCP)血流密度、深层视网膜微血管(DCP)血流密度以及视盘周围微血管血流密度,视网膜神经纤维层(RNFL)厚度等一系列参数。结果三组间AI、SCP血流密度比较,差异无统计学意义(P> 0.05)。3组间DCP血流密度和视盘周围微血管密度,RNFL厚度差异有统计学意义(P<0.05)。高度近视组及中度近视组DCP血流密度较低度近视低,差异有统计学意义(P <0.05),而中度近视组DCP血流密度与高度近视组之间差异无统计学意义(P> 0.05)。高度近视组视盘周围血流密度较中度近视组与低度近视组低,差异有统计学意义(P <0.05),而低度近视组视盘周围血流密度与中度近视组之间差异无统计学意义(P> 0.05)。视盘周围血流密度与RNFL厚度呈正相关性。DCP血流密度、视盘周围微血管密度、FD-300均与眼轴呈负相关性。结论通过OCTA分析,随着眼轴的增加,DCP血流密度、FD-300、视盘区微血管密度均随之降低。高度近视眼视盘周围血流密度及RNFL厚度降低。

Objective To investigate the microcirculation alteration in macular area and peripapillary region of myopic eyes and their relationship with axial length(AL) by optical coherence tomography angiography(OCTA). Methods A total of 66 patients(106 eyes) were selected, including 16 patients(28 eyes) in the low myopia group(control group), 23 patients(36 eyes) in the moderate myopia group and 27 patients(42 eyes) in the high myopia group. All patients were performed a complete ophthalmic examination, including spherical equivalent, slit lamp and fundus examination before OCTA inspection, then a series of parameters, including image quality, feveal density 300 μm(FD-300), A-circularity index(AI), parafoveal region superficial capillary plexus(SCP) blood flow density, deep capillary plexus(DCP) blood flow density, peripapillary blood flow density, retinal nerve fiber layer(RNFL) thickness were obtained by using OCTA and the latest version of analysis software. Results There was no significant difference in AI and SCP blood flow density among the three groups(P>0.05). There were statistically significant differences in DCP blood flow density, peripapillary microvascular density and RNFL thickness among the three groups(P<0.05). In the high myopia group and the moderate myopia group, the DCP blood flow density was lower than that of the low myopia group(all P<0.05), while the DCP blood flow density of the moderate myopia group and the high myopia group showed no statistically significant difference(P>0.05). The peripapillary microvascular density of the high myopia group was lower than that of the moderate myopia group and the low myopia group(P<0.05), while there was no statistically significant difference between the peripapillary blood flow density of the low myopia group and the moderate myopia group(P>0.05). Peripapillary blood flow density was positively correlated with RNFL thickness. The blood flow density of DCP, peripapillary vascular density, and FD-300 were all negatively correlated with the axis length. Conclusion Through analysis of OCTA, FD-300,DCP blood flow density and peripapillary microvascular density decrease accordingly with the increase of axis length. Peripapillary microvascular density and RNFL thickness decrease in high myopia.