光学相干断层扫描血管成像技术评估青少年近视眼黄斑区视网膜血管密度及厚度变化

Evaluation of the changes of retinal vascular density and thickness in macular region of juvenile myopia with optical coherence tomography angiography

目的 采用光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)技术检测不同近视程度青少年黄斑区视网膜血管密度、厚度变化,并分析其相关性。方法 选取2019年6月至2022年6月温州医科大学附属眼视光医院诊治的青少年近视眼患者196例(392眼)。根据等效球镜度(spherical degree,SE)分为轻度近视组43例、中度近视组55例、高度近视组51例、超高度近视组47例。采用OCTA技术测量四组患者的黄斑区视网膜浅层血管密度、厚度水平;采用Pearson相关分析黄斑区视网膜血管密度与厚度的相关性;采用线性回归分析黄斑区视网膜血管密度的相关影响因素。结果 四组SE、眼轴长度比较,差异有统计学意义(P <0.05),随近视程度增加,SE逐渐降低,眼轴长度逐渐增加(P <0.05)。四组黄斑区不同部位(中心凹、中心凹旁、上侧、鼻侧、下侧、颞侧)视网膜血管密度比较,差异有统计学意义(P <0.05),随近视程度增加,黄斑区不同部位视网膜血管密度均降低(P <0.05)。四组黄斑区不同部位(中心凹、中心凹旁、上侧、鼻侧、下侧、颞侧)视网膜厚度比较,差异有统计学意义(P <0.05),随近视程度增加,黄斑区不同部位视网膜厚度均降低(P<0.05)。Pearson相关性分析显示,黄斑区中心凹、中心凹旁视网膜血管密度与中心凹(r=0.464、0.515)、中心凹旁(r=0.312、0.330)、上侧(r=0.398、0.422)、鼻侧(r=0.391、0.326)、下侧(r=0.324、0.273)、颞侧(r=0.353、0.428)厚度均呈正相关(P <0.05)。线性回归分析显示,眼轴长度、SE均负向影响黄斑区中心凹、中心凹旁视网膜血管密度(P <0.05)。结论 随着青少年近视程度增加,其黄斑区视网膜血管密度、厚度均降低,且黄斑区视网膜血管密度与厚度呈正相关,与眼轴长度呈负相关。

Objective Using the optical coherence tomography angiography(OCTA)technology to detect the macular retinal blood vessel density and thickness levels and to analyze their correlation in myopic adolescents with different myopia degree.Methods A total of 196 adolescent myopia patients(392 eyes)diagnosed and treated in Eye Hospital,Wenzhou Medical University from June 2019 to June 2022 were selected.According to the equivalent spherical degree(SE),they were divided into mild myopia group(43 cases),moderate myopia group(55 cases),high myopia group(51 cases),and super high myopia group(47 cases).OCTA technology was used to quantitatively measure the retinal blood vessel density and thickness in the macular area of the four groups of patients;Pearson analysis was used to analyze the correlation between retinal vascular density and thickness in the macular area;linear regression analysis was used to investigate the relevant influencing factors of retinal vascular density in the macular area.Results There was a statistically significant difference in SE and axial length among the four groups(P<0.05).As the degree of myopia increased,SE gradually decreased and the length of the eye axis gradually increased(P<0.05).Comparison of the retinal blood vessel density in different parts of the macular area(fovea,parafovea,upper side,nasal side,inferior side,and temporal side)among the four groups,the difference was statistically significant(P<0.05).As the degree of myopia increased,and the retinal blood vessel density in different parts of the macular area decreased(P<0.05).Comparison of retinal thickness in different parts of the macular area(fovea,parafovea,upper side,nasal side,inferior side,and temporal side)among the four groups,the difference was statistically significant(P<0.05).As the degree of myopia increased,and the thickness of the retina in different parts of the macular area decreased(P<0.05).Pearson correlation analysis showed that the macular fovea,the retinal blood vessel density and the fovea adjacent to the fovea(r=0.464,0.515),adjacent to the fovea(r=0.312,0.330),upper side(r=0.398,0.422),nasal side(r=0.391,0.326),inferior side(r=0.324,0.273),and temporal side(r=0.353,0.428)were positively correlated(P<0.05).Linear regression analysis showed the axial length and SE had negative impact on retinal vascular density in the fovea and parafovea of the macular area(P<0.05).Conclusion As the degree of myopia in adolescents increased,the density and thickness of retinal blood vessels in the macular area decreased,and there was a positive correlation between the density and thickness of retinal blood vessels in the macular area,and negative correlation with axial length.