病理性近视黄斑和视盘血流密度变化及其与眼轴长度的相关性研究  

Changes in the vessel densities of macular and optic nerve head and their relationships with axial length in pathological myopia

作　　者：万婷 李涛 佘曼 石文卿 李炳[2] 周晓东 Wan Ting;Li Tao;She Man;Shi Wenqing;Li Bing;Zhou Xiaodong(Department of Ophthalmology,Jinshan Hospital of Fudan University,Shanghai 201508,China;Research Center for Clinical Medicine,Jinshan Hospital of Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属金山医院眼科,上海201508 [2]复旦大学附属金山医院临床医学研究中心,上海201508

出　　处：《中华眼底病杂志》2022年第6期440-446,共7页Chinese Journal of Ocular Fundus Diseases

基　　金：上海申康医院发展中心促进市级医院临床技能与临床创新能力三年行动计划项目(SHDC2020CR1043B-004)。

摘　　要：目的观察病理性近视(PM)黄斑和视盘区血流密度(VD)变化及其与眼轴长度(AL)的相关性。方法回顾性临床研究。2019年6〜12月于复旦大学附属金山医院眼科就诊的近视患者171例171只眼纳入研究。其中,男性72例,女性99例;年龄(35.0±10.8)岁。将患者分为PM组、高度近视(HM)组、非HM组,分别为51例51只眼、70例70只眼、50例50只眼。采用光相干断层扫描血管成像对患眼黄斑和视盘区6mm×6m m范围进行扫描。根据糖尿病视网膜病变治疗研究分区将黄斑、视盘区中心6 mm范围内视网膜划分为以黄斑、视盘中心为中心的2个同心圆,分别是直径为1 mm的中心区,1〜3 mm的旁中心区;旁中心区分别有2条放射线将其分为上方、下方、鼻侧、颞侧4个区。测量患眼黄斑和视盘的中心区、上方、下方、鼻侧、颞侧视网膜浅层毛细血管层(SCP)、深层毛细血管层(DCP)、外层视网膜、脉络膜毛细血管层的VD_(0)对比观察PM组、HM组、非HM组患眼VD情况。三组患眼之间VD比较采用方差分析;VD与AL的相关性采用Pearson相关性分析。结果PM组患眼黄斑旁中心区SCP、外层视网膜和脉络膜毛细血管层的VD均低于HM组、非HM组,差异有统计学意义(P<0.05)。PM组患眼黄斑中心区DCP的VD高于HM组,差异有统计学意义(P=0.020)。视盘区,除DCP上方、下方、颞侧和外层视网膜中心区外,PM组患眼其他区VD均低于非HM组,差异均有统计学意义(P<0.05)。相关性分析结果显示,DCP的黄斑中心区、视盘区上方和脉络膜毛细血管层视盘中心区的VD与AL不相关(P=0.647、0.688、0.146),其他区域的VD均与AL呈负相关(P<0.05)。结论与HM、非HM患眼比较,PM患眼黄斑及视盘区多数区域的VD降低。Objective To observe the changes of vessel densities(VD)in the macula and optic disc and its correlation with axial length(AL)in pathological myopia(PM).Methods A retrospective clinical study.A total of 171 eyes from 171 patients admitted to Department of Ophthalmology of Jinshan Hospital of Fudan University from June 2019 to December 2019 were included in this study.Among them,there were 72 males and 99 females;age was 35.0±10.8 years old.The patients were divided into PM group,high myopia(HM)group and non-HM group,51 cases with 51 eyes,70 cases with 70 eyes,and 50 cases with 50 eyes,respectively.Optical coherence tomography angiography was used to scan the macular and optic disc areas of all the examined eyes in the range of 6 mm×6 mm.According to the early treatment of diabetic retinopathy study,the 6 mm macular and optic disc scan range was centered on the macular fovea and optic disc,respectively,then divided into two concentric circles with diameters of 1 mm of central area,an annulus between 1-3 mm circles of paracentral area.The paracentral area was divided into superior,inferior,nasal,temporal four quadrants by 2 radiation lines.The VD of superficial capillary plexus(SCP),deep capillary plexus(DCP),outer retina,and choriocapillaris layer were calculated in the central,superior,inferior,nasal,and temporal areas,respectively.The VD of PM,HM and non-HM groups were compared.The variance analysis was used to compare the VD among the three groups;Pearson's correlation was used to assess the correlation between VD and AL.Results The perifoveal VD of the SCP,outer retina and choriocapillaris layers were all lower in the PM than those of HM and non-HM group,and the differences were statistically significant(P<0.05).The VD of DCP macular central was higher in the PM than in the HM group,and the difference was statistically significant(P=0.020).In the optic disc,the VD were lower in the PM group than in the non-HM group except for the area of DCP superior,inferior,temporal,outer retinal center,and the differences

关 键 词：近视 退行性 局部血流 体层摄影术 光学相干 

分 类 号：R778.11[医药卫生—眼科]