高度近视黄斑血流及睫状视网膜动脉OCTA检测分析

Analysis of macular blood flow and ciliary retinal artery OCTA in high myopia

目的利用相干光层析血管成像术(OCTA)评估黄斑血流及睫状视网膜动脉对高度近视患者的影响。方法回顾性系列病例研究。选择2021年6月至2022年6月在我院就诊的高度近视患者100例,根据OCTA结果将患者分为睫状视网膜动脉(PCA)组(48例)和无睫状视网膜动脉组(52例)。采用OCTA评估视网膜血管长度密度(VLD)和血管灌注密度(VPD),并量化分析黄斑中心凹无血管区(FAZ),并分析与眼轴长度(AL)和等效球镜屈光度(SE)的Spearman相关性。结果OCTA结果表明,两组患者整体VLD、内层VLD、整体V PD相比,差异均有统计学意义(均P<0.05),PCA组整体VLD、内层VLD、整体VPD高于无PCA组。PCA组整体VLD、内层VLD分别为18.39±1.08、17.28±2.14、整体VPD为0.481±0.027,两组患者整体VLD、内层VLD、整体VPD相比,差异均有统计学意义(均P<0.05),且PCA组整体VLD、内层VLD、整体VPD高于无PCA组。PCA组、黄斑中心凹无灌注区面积(FAZ⁃A)为(0.29±0.12)mm 2、FZA充实度(FAZ⁃CI)为0.78±0.11,与无PCA组相比,FAZ⁃A和FAZ⁃CI差异均有统计学意义(均P<0.05),且PCA组FAZ⁃A和FAZ⁃CI值高于非PCA组,其他指标相比,差异均不显著,无统计学意义(均P>0.05)。Spearman相关性分析结果表明,PCA高度近视患者SE与FAZ⁃A,FAZ周长(per⁃imeter,FAZ⁃P),FAZ⁃CI均呈负相关,且差异有统计学意义(均P<0.05);AL与FAZ⁃A、FAZ⁃P、FAZ⁃CI均呈负相关,差异有统计学意义(均P<0.05)。结论睫状视网膜动脉的存在可能会补偿高度近视眼的黄斑血管系统的损失,对高度近视具有保护作用。

Objective To evaluate the effect of macular blood flow and cilioretinal artery in high myopia by optical coherence tomography angiography(OCTA).Methods A retrospective case series study.A total of 100 patients with high myopia who visited our hospital from June 2021 to June 2022 were selected and divided into posterior ciliary artery(PCA)group(48 cases)and no PCA group(52 cases)according to OCTA results.Retinal vascular length density(VLD)and vascular perfusion density(VPD)were assessed using OCTA,and the foveal avascular zone(FAZ)was quan⁃tified and analyzed,and Spearman correlations with axial length(AL)and spherical equivalent refraction(SE)were ana⁃lyzed.Results The overall VLD,inner VLD,and overall VPD in the PCA group were significantly higher than those in the group without PCA(P<0.05).In PCA group,the overall VLD,inner VLD and overall VPD were(18.39±1.08),(17.28±2.14)and(0.481±0.027),respectively.In the PCA group,FAZ⁃A(0.29±0.12 mm 2)and FAZ⁃CI(0.78±0.11)were significantly higher than those in the without PCA group(P<0.05),and other indicators were not significantly different(P>0.05).The results of Spearman correlation analysis showed that SE was negatively correlated with FAZ⁃A,FAZ⁃P,and FAZ⁃CI in PCA patients with high myopia,and the difference was statistically significant(P<0.05).AL was negatively correlated with FAZ⁃A,FAZ⁃P,and FAZ⁃CI,and the difference was statistically significant(P<0.05).Conclusions The presence of the PCA may compensate for the loss of macular vascular system in high myopia and has a protective effect on high myopia.