OCTA检测青少年不同程度近视患者视网膜神经纤维层厚度和视乳头周围脉络膜毛细血管的微观结构改变  

Microvascular alterations of peripapillary choriocapillaris and retinal nerve fiber layer thickness in adolescents with different degrees of myopia detected by optical coherence tomography angiography

作　　者：王继文 邓锐东[2] 陈子林 WANG Ji-wen;DENG Rui-dong;CHEN Zi-lin(Department of Ophthalmology,First Clinical College of Guangdong Medical University,Zhanjiang Guangdong 524000,China;Department of Ophthalmology,Huizhou Central People's Hospital,Guangdong Medical University,Huizhou Guangdong 516001,China)

机构地区：[1]广东医科大学第一临床医学院眼科,广东湛江524000 [2]惠州市中心人民医院眼科,广东惠州516001

出　　处：《临床和实验医学杂志》2024年第3期321-325,共5页Journal of Clinical and Experimental Medicine

基　　金：广东省科技计划项目(编号:2020G00194)。

摘　　要：目的利用光学相干断层扫描血管造影术(OCTA)测定青少年不同程度近视眼视网膜神经纤维厚度(RNFL)及视乳头周围脉络膜毛细血管的微结构改变。方法回顾性将2022年1月至2023年1月的惠州市中心人民医院收治的90例5~15岁青少年(共计180只眼睛)作为研究对象,按等效球镜度数(SE)分为正视组(n=30),轻度近视组(n=44),中度近视组(n=56),高度近视组(n=50)。用OCTA测定各组的RNFL、视盘旁萎缩弧β区(PPA-β)及视盘旁萎缩弧α区(PPA-α)面积、PPA-β及PPA-α区微血管丢失(MVD)面积、PPA-β及PPA-α区血流密度值,同时收集各组的SE和眼轴长度(AL)进行比较,用Spearman相关性分析PPA-β区MVD面积与SE、AL、RNFL及PPA-β区面积的相关性。结果4组的SD、AL值比较,差异均有统计学意义(P<0.05),且随着近视程度越重SD、AL值越高。4组的上方、下方、鼻侧及颞侧RNFLT、平均RNFLT比较,差异均有统计学意义(P<0.05);轻度近视组与正视组的上方、下方、鼻侧及颞侧RNFLT、平均RNFLT差异均无统计学意义(P>0.05);高度近视组的上方、下方、颞侧和平均RNFLT均显著低于中度近视组和轻度近视组,差异均有统计学意义(P<0.05)。150只近视眼中有141只(94.00%)的PPA-β区存在MvD。高度近视组PPA-β区的MvD面积、PPA-β面积分别为(0.239±0.106)、(1.104±0.270)mm^(2),均显著高于中度近视组[(0.095±0.041)、(0.612±0.264)mm^(2)]和轻度近视组[(0.071±0.030)、(0.507±0.241)mm^(2)],而PPA-β区血流密度为198.24±95.89,低于中度近视组(349.07±126.32)和轻度近视组(402.63±132.09),差异均有统计学意义(P<0.05)。高度近视组PPA-α区存在MvD占比为56.00%,显著高于中度近视组(26.79%)和轻度近视组(15.91%),差异有统计学意义(P<0.05),3组PPA-α区的MvD面积、PPA-α面积及PPA-α区血流密度差异均无统计学意义(P>0.05)。Spearman相关性分析显示,PPA-β区MvD面积与与SE、RNFLT呈负相关(r=-0.492、-0.574,P<0.05),与AL、PPA-�Objective To investigate microvascular alterations of peripapillary choriocapillaris and retinal nerve fiber layer thickness(RNFL) in adolescents with different degrees of myopia detected by optical coherence tomography angiography(OCTA).Methods A total of 90 adolescents with a total of 180 eyes aged 5-15 years old admitted to Huizhou Central People's Hospital from January 2022 to January 2023 were divided into emmetropia group(n=30),mild myopia group(n=44),moderate myopia group(n=56),and high myopia group(n=50) based on spherical equivalent(SE).RNFL,PPA-β area,PPA-α area,microvascular loss(MVD) and blood flow density values in PPA-β and PPA-α zone were determinred by OCTA,and SE and axial length(AL) of each group were also collected.Spearman correlation analysis was used to analyze the correlation of MVD area in PPA-β zone with SE,AL,RNFL,and PPA-β area.Results There were significant differences on SE and AL among the four groups(P<0.05),and the higher the degree of myopia,the higher the SD and AL values.There were significant differences on RNFLT the upper,lower,nasal,and temporal sides and average RNFLT among the four groups(P<0.05);there were no statistically significant differences on the upper,lower,nasal,and temporal RNFLT and average RNFLT between the mild myopia group and the emmetropia group(P>0.05);the upper,lower,temporal,and average RNFLT of the high myopia group were significantly lower than those of the moderate myopia group and mild myopia group,and the differences were statistically significant(P<0.05).A total of 141 out of 150(94.00%) nearsighted eyes were found in PPA-β zone.The MvD area and PPA-β area of PPA-β zone in high myopia group were(0.239±0.106) and(1.104±0.270) mm^(2),which were significantly higher than those in moderate myopia group[(0.095±0.041) and(0.612±0.264) mm^(2)] and the mild myopia group[(0.071±0.030) and(0.507±0.241) mm^(2)],while blood flow density in PPA-β zone was 198.24±95.89,which was lower than that in the moderate myopia group(349.07±126.32) and th

关 键 词：青少年 近视 光学相干断层扫描血管造影术 视网膜神经纤维厚度 视乳头周围脉络膜毛细血管 

分 类 号：R778.11[医药卫生—眼科]