高度近视人群的黄斑区视网膜血管密度及厚度分析

Macular retinal vascular density and thickness in high myopia patients

目的应用光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA)检测高度近视人群的黄斑区视网膜血管密度(vascular density,VD)及厚度(retinal thickness,RT),并分析其相关性。方法纳入2020年9月至2021年9月于本院眼科门诊就诊的18~40岁近视患者共110例(110眼),根据等效球镜度(spherical equivalent refraction,SER)将其分为高度近视组(SER<-6.00 D)57眼、对照组(-6.00~-0.50 D)53眼。对所有受检者进行OCTA检查,量化黄斑区各部位视网膜厚度及表层微血管密度,比较对照组及高度近视组各部位视网膜微血管密度及视网膜厚度的差异,并进行相关性分析。结果高度近视组黄斑区内环范围内血管长度密度(vascular length density,VLD)、血管灌注密度(vascular perfusion density,VPD)较对照组有所下降(P<0.05),外环VLD、VPD无明显变化;黄斑中心凹无血管区(foveal avascular zone,FAZ)的相关指标包括面积、周长、充实度两组间差异均无统计学意义;与对照组相比,高度近视组黄斑区中心凹及外环上方RT有所减少(P<0.05),内环RT两组间无明显差异。相关性分析表明,黄斑各分区VLD和VPD均呈正相关(P<0.05);黄斑中心凹及外环各象限的VLD、VPD与对应区域RT呈正相关(P<0.05),内环各象限VLD、VPD与RT无明显相关性;内环部分象限及外环整体RT与SER呈正相关(P<0.05),与眼轴(axial length,AL)呈负相关(P<0.05);黄斑区VLD、VPD与SER呈正相关,与AL呈负相关(P<0.05)。结论黄斑各区视网膜厚度及血管密度随近视程度增加而减少,早期应用OCTA检测近视人群视网膜结构和血流循环的变化,有利于评估和监测近视进展。

ObjectiveTo measure the macular vascular density(VD)and retinal thickness(RT)of highly myopic patients by optical coherence tomography angiography(OCTA)and analyze their correlation.MethodsA total of 110 myopia patients(110 eyes)aged 18~40 years who attended the Ophthalmology Clinic of the First Affiliated Hospital of Chongqing Medical University from September 2020 to September 2021 were included.According to spherical equivalent refraction(SER),they were divided into high myopia(HM)group(SER<-6.00 D,57 eyes)and control group(-6.00~-0.50 D,53 eyes).OCTA was performed on all subjects to quantify the retinal thickness and superficial vessel density.The differences in VD and RT were compared between the control group and HM group,and correlation analysis was carried out.ResultsIn general,the vascular length density(VLD)and vascular perfusion density(VPD)in the inner ring were significantly lower in the HM group than the control group(P<0.05).The perifoveal VLD and VPD had no significant changes.There was no statistically significant difference in the characteristics of foveal avascular zone(FAZ)including area,perimeter and circularity between the 2 groups(P<0.05).The RT of the macular fovea and perifoveal’s superior side of the macular area was decreased in the HM group than the control group(P<0.05),and there were no significant differences in the thickness of the parafoveal quadrants between the 2 groups.Correlation analysis showed that the VLD and VPD of each subzone of the macula were positively correlated(P<0.05).The VLD and VPD of the fovea and the perifoveal quadrants were positively correlated with the RT of the corresponding area(P<0.05),while the VLD and VPD of the inner ring had no significant correlation with the RT.RT of partial quadrants of the inner ring and the overall outer ring were positively correlated with SER(P<0.05),and negatively correlated with axial length(AL)(P<0.05).VLD and VPD were roughly positively correlated with SER and negatively correlated with AL(P<0.05).ConclusionRT and VD in macular area are decreased with increased myopia.Early application of OCTA to detect the changes of retinal structure and blood flow circulation in myopic population is helpful for evaluating and monitoring the progress of myopia.