基于超广角SS-OCTA的高度近视患者脉络膜血管改变  

Choroidal vascular changes in high myopic patients using ultra-widefield SS-OCTA

作　　者：涂书 姚昱欧[1] 曾巧珠 赵明威[1] Tu Shu;Yao Yuou;Zeng Qiaozhu;Zhao Mingwei(Department of Ophthalmology,Eye Diseases and Optometry Institute,Peking University People's Hospital,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases,College of Optometry,Peking University Health Science Center,Beijing 100044,China)

机构地区：[1]北京大学人民医院眼科、眼视光中心、视网膜脉络膜疾病诊治研究北京市重点实验室、眼病与视光医学研究所、北京大学医学部眼视光学院,北京100044

出　　处：《中华实验眼科杂志》2024年第11期1020-1027,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：国家重点研发计划(2020YFC2008200)。

摘　　要：目的采用超广角扫频源光学相干断层扫描血管成像(SS-OCTA)评估高度近视患者三维脉络膜血管指数(3D-CVI)与脉络膜毛细血管血流密度(CCD)改变,进而探讨眼轴长度(AL)与高度近视脉络膜血管结构改变的关系。方法采用横断面研究设计,纳入2021年11月至2022年10月于北京大学人民医院行24 mm×20 mm超广角SS-OCTA扫描的正常受试者168例168眼作为对照组及高度近视患者182例182眼作为高度近视组。比较高度近视组与对照组的全域平均及中央区3D-CVI和CCD,对AL与3D-CVI、CCD分别做相关分析及受试者工作特征曲线分析,并得出3D-CVI及CCD降低时的AL界值。结果高度近视组平均3D-CVI和中央区3D-CVI分别为(31.37±7.85)%和(29.63±9.00)%,均显著低于对照组的(32.86±4.25)%和(35.01±3.96)%,差异均有统计学意义(t=2.241、7.337,均P<0.05)。高度近视组平均CCD为(45.59±3.63)%,显著低于对照组的(46.47±1.36)%,差异有统计学意义(t=3.038,P=0.003)。相关分析结果提示高度近视组中平均3D-CVI、平均CCD均与AL呈负相关(r=-0.547,-0.657,均P<0.001)。进一步对AL和3D-CVI、CCD分别进行受试者工作特征曲线分析,结果提示平均3D-CVI降低的AL界值为28.93 mm,曲线下面积为0.883(P<0.001,灵敏度为0.690,特异度为0.944);平均CCD降低的AL界值为28.26 mm,曲线下面积为0.884(P<0.001,灵敏度为0.793,特异度为0.832)。结论高度近视患者3D-CVI和CCD均降低,随着AL增长,CCD早于3D-CVI发生改变。Objective To evaluate the three-dimensional choroidal vascularity index(3D-CVI)and choriocapillaris blood flow density(CCD)changes in patients with high myopia using ultra-widefield swept-source optical coherence tomography angiography(SS-OCTA),and to investigate the relationship between axial length(AL)and choroidal vascular structure changes in high myopia.Methods A cross-sectional study was performed.A control group of 168 eyes of 168 normal subjects,and a high myopia group of 182 eyes of 182 high myopia patients were enrolled from November 2021 to October 2022 at the Peking University People's Hospital.All subjects underwent an ultra-widefield SS-OCTA scan with an area of 24 mm×20 mm.Full-field average and central area 3D-CVI and CCD were compared between the two groups.Correlation analysis and receiver operating characteristic curve analysis were used for 3D-CVI,CCD and AL,respectively.The AL cut-off values were determined when 3D-CVI and CCD were reduced.The study followed the Declaration of Helsinki,and the study protocol was approved by the Ethics Committee of Peking University People's Hospital(No.2021PHB058-001).All participants voluntarily signed an informed consent form.Results The mean 3D-CVI and central 3D-CVI in the high myopia group were(31.37±7.85)%and(29.63±9.00)%,respectively,which were significantly lower than(32.86±4.25)%and(35.01±3.96)%in the control group(t=2.241,7.337;both at P<0.05).The mean CCD in the high myopia group was(45.59±3.63)%,which was significantly lower than(46.47±1.36)%in the control group(t=3.038,P=0.003).Correlation analysis showed that mean 3D-CVI and CCD were negatively correlated with AL in the high myopia group(r=-0.547,-0.657;both at P<0.001).Receiver operating characteristic curve analysis of 3D-CVI,CCD and AL suggested that the AL cut-off value of mean 3D-CVI-reduction was 28.93 mm and the area under the curve of 0.883(P<0.001,sensitivity=0.690,specificity=0.944).The AL cut-off value of mean CCD-reduction was 28.26 mm and the area under the curve was 0.884(P<

关 键 词：高度近视 脉络膜 扫频源光学相干断层扫描血管成像 脉络膜血管指数 脉络膜毛细血管 

分 类 号：R778.11[医药卫生—眼科]