光学相干断层扫描血管成像技术对中青年近视患者视盘区血管密度的观察

Optical coherence tomography angiography in detection of vascular density in optic disc in young-middle aged patients with myopia

目的:采用光学相干断层扫描血管成像技术(OCTA)研究中青年近视患者视盘区血管密度与视网膜神经纤维层(RNFL)厚度变化及眼轴的关系。方法:收集中青年近视患者53例(89只眼),正视眼和低度近视眼组(+0.5~-3.0D)17例(30只眼),中度近视眼组(-3.0D~-6.0D)18例(28只眼),高度近视组(>-6.0D)18例(31只眼)。所有患者均行眼科常规检查,包括裂隙灯、眼底检查、眼压测定、眼轴测定(IOL-master)。采用OCTA检查设备收集视盘区微血管密度和RNFL厚度,自动进行计算,并通过单因素方差分析、LSD法进行比较,相关性分析视盘区域血管密度与RNFL厚度和眼轴之间的关系。结果:中度近视组与高度近视组视盘内血管密度均高于正视眼和低度近视组(P<0.05);正视眼和低度近视组与中度近视组视盘周围血管密度均高于高度近视组(P<0.05)。视盘鼻侧(N)象限中正视眼和低度近视组与中度近视组血管密度均高于高度近视组(P<0.05),而在其他象限中差异无统计学意义(P>0.05)。视盘周围血管密度与RNFL厚度分别在4个象限均呈正相关(r=0.544、0.449、0.518、0.536,均P<0.001)。视盘内血管密度与眼轴呈正相关(r=0.463,P<0.001);视盘周围血管密度与眼轴呈负相关(r=-0.281,P=0.008)。结论:在中青年近视患者中,随着眼轴增加,高度近视患者视盘内血管密度增加,而视盘周围血管密度降低,且鼻侧下降明显。

Objective:To study the relationship between the vascular density in the optic disc and the thickness of retinal nerve fiber layer(RNFL)and axial length by optical coherence tomography angiography(OCTA)in young-middle aged patients with myopia.Methods:Fifty-three young-middle aged patients with myopia(a total of 89 eyes),including 17 patients(30 eyes)in the emmetropia and low myopia,18(28 eyes)in the moderate myopia and 18(31 eyes)in the high myopia,were recruited,and undergone conventional ophthalmic examination,including slit lamp,fundus examination,intraocular pressure measurement and axial length measurement by IOL master.OCTA instrument was used to determine the micro-vessel density and RNFL thickness in the optic disc area via automatic calculation.The relationship between vascular density in optic disc and the thickness of RNFL and the axial length comparison was observed by one-way ANOVA and Fisher′s least significant difference(LSD)method.Results:The vascular density in optic disc in moderate myopia group and high myopia group was higher than that of emmetropia group and low myopia group(P<0.05).The vascular density in peripapillary area of emmetropia,low myopia group and moderate myopia group was higher than that in high myopia group(P<0.05).In the nasal(N)quadrant of optic disc,the vascular density of emmetropia and low-moderate myopia group was higher than that of high myopia group(P<0.05),yet there was no statistically significant difference in other quadrants(P>0.05).Peripapillary vascular density was positively correlated with RNFL thickness in the four quadrants(r=0.544,0.449,0.518,0.536,respectively,all P<0.001).The vascular density inside disc was in positive relation with the axial length(r=0.463,P<0.001),yet the vascular density in peripapillary area was negatively correlated with the axial length(r=-0.281,P=0.008).Conclusion:In young-middle aged patients of myopia,the vascular density inside disc of high myopia patients increases with added axial length,while the vascular density in peripapillary area tends to decrease,and the decrease appears evident at the nasal side.