高度近视及合并青光眼患者视网膜结构参数的差异  

Differences in retinal structural parameters in patients with high myopia and glaucoma

作　　者：赵云徽 高雨婷 王心琛 王静[1] 张康玉 刘贺婷[1] Zhao Yunhui;Gao Yuting;Wang Xinchen;Wang Jing;Zhang Kangyu;Liu Heting(Department of Ophthalmology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Aier Eye Hospital affiliated to Anhui Medical University,Hefei 230031,China)

机构地区：[1]安徽医科大学第二附属医院眼科,合肥230601 [2]安徽医科大学附属爱尔眼科医院,合肥230031

出　　处：《临床眼科杂志》2024年第4期338-342,共5页Journal of Clinical Ophthalmology

基　　金：2023年度安徽省转化医学研究院科研基金项目(2023zhyxC72);2022年安徽医科大学校科研基金项目(2022xkj261)。

摘　　要：目的探讨高度近视(HM)和高度近视合并青光眼(HMG)患者视网膜结构参数的差异。方法回顾性临床研究。临床研究对象包括HM患者20例(36只眼)和HMG患者21例(35只眼)。分别记录两组患者的年龄、视力、眼压、视野(VF)等人口学及临床特征,使用相干光层析成像术(OCT)扫描视网膜神经纤维层(RNFL)厚度和黄斑厚度,使用相干光层析血管成像术(OCTA)扫描黄斑、视盘为中心的浅层毛细血管丛、深层毛细血管丛和脉络膜毛细血管丛三个层面的血流密度(VD),再分别测算上下两个半区的VD血流密度比值(VDR),最后进行统计分析。结果RNFL在上侧、下侧、颞侧、中央厚度参数上,HM组均高于HMG组,具有明显统计学意义(均P<0.001)。HM组9个分区的黄斑厚度均大于HMG组,但存在统计差异的区域只有内层下侧、颞侧和外层下侧(均P<0.05)。无论黄斑还是视盘,HMG组VD均低于HM组(均P<0.05),其中SCP下侧区域血流密度的降低最为明显,只有SCPVDR存在统计学差异(均P<0.05)。结论视乳头周围RNFL厚度、黄斑厚度、视盘和黄斑血流密度等结构参数有助于HMG的临床诊断,其中SCPVDR的降低可能可以进一步提高诊断效能。Objective To investigate the differences in retinal structural parameters in patients with high myopia(HM)and high myopia combined with open-angle glaucoma(HMG).Methods The clinical study subjects included 20 patients with 36 eyes and 21 patients with HMG patients with 35 eyes.The demographic and clinical characteristics of the two groups of patients such as age,visual acuity,intraocular pressure,and visual field were recorded,and the thickness of the retinal nerve fiber layer(RNFL)and the macular thickness were scanned by optical coherence tomography(OCT),and optical coherence tomography was used to scan the angiographic imaging technology angiography,(OCTA)scans the vessel density(VD)at the three levels of macula,superficial capillary plexus centered on the optic disc,deep capillary plexus and choroidal capillary plexus,and then calculates the VD vessel density ratio(VDR)in the upper and lower halves respectively,and finally performs statistical analysis.Results The HM group was higher than the HMG group in the upper,lower,temporal and central thickness parameters of RNFL,which had significant statistical significance(all P<0.001).The macular thickness of all 9 partitions in the HM group was greater than that in the HMG group,but the only areas with statistical differences were the inferior inner layer,temporal side and inferior outer layer(all P<0.05).The VD in both the macula and optic disc was lower than that in the HMG group(all P<0.05),and the reduction of blood flow density in the lower area of SCP was the most obvious,and only the VDR of SCP was statistically different(all P<0.05).Conclusions Structural parameters such as peripapillary RNFL thickness,macular thickness,optic disc and macular blood flow density are helpful for the clinical diagnosis of HMG,and the reduction of SCP VDR may further improve the diagnostic efficacy.

关 键 词：青光眼 高度近视 相干光层析成像术 相干光层析血管成像术 

分 类 号：R778.11[医药卫生—眼科] R775.2[医药卫生—临床医学]