青年近视人群视网膜血管几何结构的改变

Changes in retinal vascular geometry in young myopic subjects

目的观察青年近视人群视网膜血管几何结构的变化。方法去回顾性临床研究。2018年6~12月于华东疗养院行常规体检的青年人235名235只眼纳入研究。其中,男性94名,女性141名;年龄(34.89±6.15)岁;等效球镜度(SE)(-3.78±3.25)D。根据SE将受检者分为高度近视组(SE≤-6.0D)、中低度近视组(-0.5D>SE>-6.0D)、正视组(0.5D≥SE≥0.5D),分别为59(25.11%,59/235)、131(55.74%,131/235)、45(19.15%,45/235)名。应用计算机程序提取和分析视网膜血管几何参数,包括视网膜中央动脉管径当量(CRAE)、视网膜中央静脉管径当量(CRVE)、动脉分形维数(FDa)、静脉分形维数(FDv)、动脉曲率纤曲度(CTORTa)、静脉曲率纤曲度、动脉分支角(BAa)、静脉分支角、动脉分支系数、静脉分支系数。单因素方差分析和协方差分析比较高度近视组、中低度近视组、正视组测量结果;线性回归分析SE与视网膜血管几何参数间的关系。结果校正年龄、糖化血红蛋白、平均动脉压、体重指数、眼压后,高度近视组、中低度近视组、正视组受检眼CRAE(F=65.11)、CRVE(F=61.52)、FDa(F=14.26)、FDv(F=8.31)、CTORTa(F=5.07)、BAa(F=6.51)比较,差异均有统计学意义(P<0.05)。线性回归分析结果显示,CRAE、CRVE与SE呈线性相关(P<0.05);高度近视组受检眼FDa、FDv、CTORTa、BAa随近视加深而减小(P<0.05)。结论近视人群视网膜血管几何学结构发生改变,随近视屈光度加深,视网膜血管改变逐步加剧。

Objective To investigate the effect of myopia on retinal vascular geometry in young subjects.MethodsA retrospective cross-sectional study.From June 2018 to December 2018,235 participants(235 eyes)who took part in routine physical examination in Huadong Sanatorium were included.There were 94 males and 141 females;age was(34.89±6.15)years old;equivalent spherical refraction(SE)was(-3.78±3.25)D.59(25.11%,59/235)were divided into high myopia group(SE≤-6.0 D),along with 131(55.74%,131/235)low to moderate myopia group(-0.5 D>SE>-6.0 D),and 45(19.15%,45/235)emmetropia group(0.5 D≥SE≥-0.5 D).Retinal vascular geometric measurements,including central retinal arteriolar equivalent(CRAE),central retinal venular equivalent(CRVE),fractal dimension arteriole(FDa),fractal dimension venule(FDv),curvature tortuosity arteriole(CTORTa),curvature tortuosity venule,branch angle arteriole(BAa),branch angle venule,branch coefficient arteriole and branching coefficient venule,were extracted by using a validated computer program.One-way analysis of variance and analysis of covariance were performed to compare the measurements across the high myopia,low to moderate myopia,and emmetropia groups.Linear regression analysis was used to explore the relationship between SE and retinal vascular geometric parameters.Results The differences in CRAE(F=65.11),CRVE(F=61.52),FDa(F=14.26),FDv(F=8.31),CTORTa(F=5.07)and BAa(F=6.51)among eys of high myopia group,low to moderate myopia group and emmetropia group remained significant(P<0.05)after adjusting for age,glycosylated hemoglobin,mean arterial pressure,body mass index,and intraocular pressure.CRAE and CRVE were linearly correlated with the SE(P<0.05).FDa,FDv,cTORTa and BAa decreased with the decrease of SE in high myopia(P<0.05).Conclusions Myopia is associated with the change of the retinal vascular geometric characteristics.With the deepening of myopia,the change of retinal vascular geometric characteristics gradually worsens.