高度近视眼黄斑区脉络膜血循环的研究

Study of choroidal circulation in macular area in high myopia

目的 观察高度近视眼黄斑区脉络膜血循环特征。方法 利用TOPCON 5 0IA眼底荧光照相系统分别对 2 5例44只高度近视眼、16例 2 0只中低度近视眼和 19例 2 4只眼正常组进行眼底荧光血管造影 (fundusfluoresceinangiography ,FFA)和吲哚青绿血管造影 (indocyaninegreenangiography ,ICGA)检查。将各组主照眼早期脉络膜荧光充盈时间、脉络膜血管荧光充盈情况进行比较 ,以及对高度近视组脉络膜异常荧光形态和黄斑区脉络膜毛细血管灌注与矫正视力的关系进行分析。结果 高度近视眼脉络膜早期荧光充盈时间和黄斑区脉络膜荧光充盈情况与对照组比较有显著性差异 (P <0 0 5 ) ,44只高度近视眼中有 3 2眼黄斑区局限性和广泛性脉络膜充盈不良 ,黄斑区脉络膜毛细血管荧光充盈程度与矫正视力比较有显著性差异 (P <0 0 1)。结论 ICGA可清楚显示高度近视眼的脉络膜血流灌注 。

Objective To observe the characteristics of the choroidal circulation in the macular area in patients with high myopia. Methods Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 25 cases (44 eyes) with high myopia, 16 cases (20 eyes) of low to moderate myopia, and 19 cases (24 eyes) of normal eyes using TOPCON50IA fundus fluorescein photographic system. The filling time of fluorescence in the choroid at the earlier stage and the filling time of fluorescence in the choroidal vessels in each group were compared. The relationship of the abnormal fluorescence configuration and the blood perfusion in the choroidal capillary vessels with the corrected visual acuity was analyzed. Results The filling time of fluorescence in the choroid at the earlier stage in eyes with high myopia and the filling time of fluorescence in the choroid in the macular area were significantly different from those of the control ( P <0.05). Local or extensive choroidal filling insufficiency was found in 32 eyes out of the 44 eyes with high myopia. A significant difference was found between the degrees of fluorescence filling of the choroidal capillary vessels in the macular area and the corrected visual acuity ( P <0.01). Conclusion ICGA can display clearly the choroidal circulation, which is helpful for the studies of pathological damages of eyes with high myopia in vivo .