正常儿童脉络膜血管指数分布特征及影响因素分析  

Analysis of choroidal vascularity index distribution and influencing factors in normal children

作　　者：马娜娜 符爱存[1] 于世傲 黄聪聪 尚丽丽 常铭航 金学民[1] 雷博 高莎莎[1] Ma Nana;Fu Aicun;Yu Shiao;Huang Congcong;Shang Lili;Chang Minghang;Jin Xuemin;Lei Bo;Gao Shasha(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Henan Eye Institute,Henan Eye Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学第一附属医院眼科,郑州450000 [2]河南省眼科研究所河南省立眼科医院河南省人民医院,郑州450003

出　　处：《中华实验眼科杂志》2023年第6期568-575,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：河南省高等学校重点科研项目(22A320024)。

摘　　要：目的应用扫频源光学相干断层扫描(SS-OCT)评估正常儿童黄斑区脉络膜血管指数(CVI)的分布特征,并探讨其影响因素。方法采用横断面研究,连续纳入2021年5—11月于郑州大学第一附属医院眼科就诊的6~12岁正常儿童63人,测量其等效球镜度数、眼轴长度及其他眼部生物学参数。并以黄斑为中心,采用SS-OCT血管成像测量黄斑区CVI及脉络膜厚度(ChT),根据ETDRS分区将图像划分为黄斑中心凹区(直径0~1 mm)、内环区(直径1~3 mm)和外环区(直径3~6 mm)。均选取右眼数据纳入统计分析,比较3个环区和内、外环区上方、颞侧、下方和鼻侧4个区域的CVI。采用单因素线性回归分析和多元线性回归分析3个环区的CVI与性别、眼轴长度、前房深度、ChT和瞳孔直径等参数的关系。结果黄斑中心凹区、内环区和外环区3个环区的CVI平均值分别为0.35±0.12、0.32±0.10和0.27±0.08,总体比较差异有统计学意义(F=10.96,P<0.001),其中3个环区的CVI两两比较差异均有统计学意义(均P<0.05)。内环区和外环区上方、颞侧、下方、鼻侧不同区域CVI比较,差异均有统计学意义(F环区=11.60,P=0.001;F部位=12.02,P<0.05),其中内环区上方和鼻侧CVI值低于颞侧,外环区上方、颞侧和下方CVI值高于鼻侧,外环区上方CVI低于内环区,差异均有统计学意义(均P<0.001)。经单因素线性回归分析,黄斑中心凹区、内环区和外环区ChT均是对应3个环区CVI的影响因素(均β=0.001,P<0.001)。瞳孔直径(β=0.034,P=0.038;β=0.040,P=0.003;β=0.024,P=0.011)和前房深度(β=0.097,P=0.034;β=0.097,P=0.013;β=0.061,P=0.032)均是黄斑中心凹区、内环区、外环区CVI的影响因素。经多重线性回归分析,建立的回归方程分别为:黄斑中心凹区CVI=0.001×黄斑中心凹区ChT+0.001×内环区ChT+0.001×外环区ChT-0.301(R 2=0.514,F=6.875,P<0.001);内环区CVI=0.001×黄斑中心凹区ChT+0.001×内环区ChT+0.001×外环区ChT+0.088×前房深度-0.30Objective To evaluate the distribution characteristics of choroidal vascularity index(CVI)in macula among normal children using swept-source optical coherence tomography(SS-OCT),and to investigate the influencing factors.Methods A cross-sectional study was conducted.Sixty-three children aged 6 to 12 years were enrolled in The First Affiliated Hospital of Zhengzhou University from May 2021 to November 2021.Spherical equivalent refraction,axial length(AL)and other ocular biological parameters were measured.Macula-centered CVI and choroidal thickness(ChT)were measured by SS-OCT angiography.According to the ETDRS partition,the obtained image was divided into macular central fovea(0-1 mm diameter),inner ring(1-3 mm diameter)and outer ring(3-6 mm diameter)zones.Data from the right eye were selected for statistical analysis.CVI in the three rings and four zones(superior,temporal,inferior and nasal zones)of the inner and outer rings were compared.Univariate and multiple linear regression analyses were used to analyze the correlation between CVI and sex,AL,anterior chamber depth(ACD),ChT and pupil diameter.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of The First Affiliated Hospital of Zhengzhou University(No.2021-KY-0399-003).Written informed consent was obtained from each guardian.Results The average CVI in the macular central fovea,inner ring and outer ring were 0.35±0.12,0.32±0.10 and 0.27±0.08,respectively,with a significant difference(F=10.96,P<0.001),and significant differences in CVI were found in pairwise comparisons of the three ring zones(all at P<0.05).Significant differences in CVI were found among superior,temporal,inferior and nasal zones in inner and outer rings(F ring=11.60,P=0.001;F zone=12.02,P<0.05).The CVI was smaller in superior and nasal zones in inner ring than in temporal zone,greater in superior,temporal and inferior zones in outer ring than in nasal zone,smaller in superior zone of outer ring than that of the inner ring,and the diff

关 键 词：脉络膜 儿童 参考值 脉络膜血管指数 扫频源光学相干断层扫描成像 相关因素 近视 脉络膜疾病 

分 类 号：R773.4[医药卫生—眼科]