近视患者黄斑区微血流密度及神经节细胞复合体厚度的变化

Changes in the macular microvessel density and the thickness of the macular ganglion cell complex in myopic patients

目的探讨近视患者黄斑区微血流密度及黄斑区神经节细胞复合体(mGCC)厚度的变化。方法选取2018年12月至2020年12月就诊于遵义医科大学第二附属医院的近视患者25例(41眼)作为研究对象。按照患者屈光度分为中度近视组(-3.00~-5.75 D)13例(21眼)和高度近视组(-6.00~-9.25 D)12例(20眼)。另选取11人(18眼)健康志愿者作为对照组,屈光度为0~-2.75 D。三组受试者年龄、性别构成差异均无统计学意义(均为P>0.05)。测量各组受试者等效球镜度数,使用IOL Master测量受试者眼轴长度。利用光学相干断层扫描血管成像(OCTA)进行检测,获取受试者黄斑区浅层视网膜毛细血管丛(SCP)血流密度和深层视网膜毛细血管丛(DCP)血流密度。通过ETDRS自动分割OCTA图像,以黄斑为中心进行3 mm×3 mm及6 mm×6 mm区域OCTA图像采集,记录受试者视网膜各象限mGCC厚度。结果对照组受试者颞侧和上方SCP血流密度均较中度近视组患者高,差异均有统计学意义(均为P<0.05);对照组受试者上方SCP血流密度较高度近视组患者高(P<0.05)。对照组受试者鼻上、鼻侧、颞下、鼻下RNFL厚度均较高度近视组患者厚(均为P<0.05);中度近视组患者颞下RNFL厚度较高度近视组厚(P<0.05)。对照组受试者各象限mGCC厚度均较高度近视组患者厚(均为P<0.05);中度近视组患者鼻侧及下方mGCC厚度均较高度近视组患者厚(均为P<0.05)。眼轴长度与RNFL厚度和mGCC厚度均呈负相关(r=-0.607、r=-0.764,均为P<0.001)。屈光度与RNFL厚度和mGCC厚度亦均呈负相关(r=-0.729、r=-0.689,均为P<0.001)。结论随着近视程度的增加,患者黄斑区mGCC厚度逐渐变薄,RNFL亦呈现逐渐变薄趋势,黄斑区SCP、DCP血流密度有先降低后增高的趋势。

Objective To investigate the changes in macular microvessel density and thickness of macular ganglion cell complex(mGCC)in patients with myopia.Methods Totally 41 eyes of 25 patients with myopia treated in the Second Affiliated Hospital of Zunyi Medical University from December 2018 to December 2020 were selected in this study.According to the diopter,13 patients(21 eyes)were classified into the moderate myopia group(-3.00~-5.75 D),and 12 patients(20 eyes)were classified into the high myopia group(-6.00~-9.25 D).Another 11 healthy volunteers(18 eyes)were selected into the control group,with the diopter of 0~-2.75 D.There were no significant differences in age and gender composition among the three groups(all P>0.05).The spherical equivalent was measured,and the axial length was also measured by IOL Master.The vessel density in the superficial retinal capillary plexus(SCP)and deep retinal capillary plexus(DCP)was measured by optical coherence tomography angiography(OCTA).The OCTA images were automatically segmented by ETDRS,and those of 3 mm×3 mm and 6 mm×6 mm area were collected with the macula as the center.The mGCC thickness in each quadrant of the retina was recorded.Results The SCP vessel density in the temporal and superior sides in the control group was higher than that in the moderate myopia group,and the difference was statistically significant(both P<0.05).The SCP vessel density in the superior side in the control group was higher than that in the high myopia group(P<0.05).The retinal nerve fiber layer(RNFL)in the superior,nasal,temporal,and inferior sides in the control group was thicker than that in the high myopia group(all P<0.05).The temporal RNFL in the moderate myopia group was thicker than that in the high myopia group(P<0.05).The mGCC in each quadrant in the control group was thicker than that in the high myopia group(all P<0.05).The nasal and inferior mGCC in the moderate myopia group was thicker than that in the high myopia group(all P<0.05).The axial length was negatively correlated with RNFL thickness and mGCC thickness(r=-0.607,r=-0.764,all P<0.001).Diopter was also negatively correlated with RNFL thickness and mGCC thickness(r=-0.729,r=-0.689,all P<0.001).Conclusion With the increase of myopia,the retinal mGCC and RNFL gradually become thinner,while the vessel density in the macular SCP and DCP tends to increase after decreasing.