近视患者近距离用眼后黄斑血流的变化  

Changes of Macular Microcirculation After Near Work in Myopic Patients

作　　者：张汝婷 滕月 李君慧 廉丽华[2] ZHANG Ru-ting;TENG Yue;LI Jun-hui;LIAN Li-hua(Ophthalmology Research Institute,Aier School of Ophthalmology,Central South University,Changsha 410000;The First Affiliated Hospital ofGuangzhou University of Traditional Chinese Medicine,Guangzhou 510000)

机构地区：[1]中南大学爱尔眼科学院爱尔眼科研究所,湖南长沙410000 [2]广州中医药大学第一附属医院,广东广州510000

出　　处：《中山大学学报（医学科学版）》2023年第4期684-690,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家中医药管理局中医药循证能力建设项目(2019XZZX-YK003);广东省中医药管理局科研项目(20201106)。

摘　　要：【目的】比较近距离用眼前后黄斑区浅层视网膜微循环指标的变化,探讨近距离用眼影响近视的可能原因。【方法】采用近距离观看手机视频1 h作为近距离用眼的方式,通过光学相干断层扫描血管成像(OCTA)技术测量用眼前、后黄斑区6 mm×6 mm范围内的浅层视网膜微循环指标,包括浅层(神经纤维层至外丛状层内界)视网膜血管长度密度(VLD)、血管灌注密度(VPD)以及黄斑中心凹无灌注区(FAZ)的面积(FAZ-A)、周长(FAZ-P)、形态指数(FAZ-CI),按区域划分为中心、内层、外层及整体,得出11项微循环指标,对比用眼前及用眼后各项指标的差异。【结果】近距离用眼后的黄斑区浅层视网膜微循环指标普遍较用眼前低,除了FAZ-A及FAZ-P以外(P=0.148、P=0.975),差异均具有统计学意义,VLD中以中心VLD(差异1.00)及内层VLD(差异0.80)的差异最大(P=0.001、P=0.008),VPD中以中心VPD(差异0.02)及内层VPD(差异0.02)最大(P=0.001、P=0.008),不同屈光度及眼轴的青年变化程度无差异。【结论】近距离用眼可能通过影响黄斑区浅层视网膜微循环的改变,导致局部缺血缺氧,影响近视的发生及发展。【Objective】To compare the changes of retinal microcirculation indexes in the anterior and posterior macu⁃lar areas of the eyes used at close range and to explore the possible causes of myopia affected by near work.【Methods】Watching mobile phone video for 1 hour at close range was used as the method of defining near work.The OCTA technology was used to measure the superficial retinal microcirculation indexes within 6 by 6 mm macular area before and after near work,including the superficial retinal VLD from the nerve fiber layer to the inner boundary of the outer plexiform layer,the VPD,nonperfusion area of FAZ,FAZ-P and FAZ circulation,.The FAZ was divided int center,inner layer,outer lay⁃er and overall according to the region,and 11 microcirculation indexes were obtained to compare the differences between before and after near work.【Results】The indexes of superficial retinal microcirculation in the macular area generally de⁃creased after near work,except for FAZ-A and FAZ-P(P=0.148,0.975).The largest differences among both VLD and VPD occurred between the central and inner layer(Difference=1.00,0.80,0.02,0.02,P=0.001,0.008,0.001,0.008).No differences in microcirculation indexs were observed in the macular area after near work with different diopters and axial lengths.【Conclusion】Near work may affect the occurrence and development of myopia by affecting the changes of retinal microcirculation in the superficial layer of macula,leading to ischemia and hypoxia.

关 键 词：近距离用眼 黄斑区浅层视网膜微循环 近视 

分 类 号：R771[医药卫生—眼科]