近视患者眼轴长度与黄斑区血流密度和厚度的相关性分析  

Correlation between axial length and macular blood flow density and thickness in myopic eyes

作　　者：张璐 丁琴 杜霖 陆思林 马晓玉 刘洪 陈晓 Zhang Lu;Ding Qin;Du Lin;Lu Silin;Ma Xiaoyu;Liu Hong;Chen Xiao(Hubei Clinical Center of Laser Ophthalmopathy,Department of Ophthalmology,PLA Central Theater Command General,Wuhan 430070,China)

机构地区：[1]解放军中部战区总医院眼科湖北省激光眼底病临床中心,武汉430070

出　　处：《中华眼底病杂志》2025年第2期119-125,共7页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察不同近视屈光度患眼黄斑区视网膜、脉络膜血流密度和厚度变化情况,初步分析其与眼轴长度(AL)的相关性。方法回顾性临床研究。2022年10月至2023年5月于解放军中部战区总医院眼科拟行屈光手术的近视患者56例86只眼纳入研究。根据等效球镜度数(SE)将患眼分为低度近视组(A组)、中度近视组(B组)、高度近视组(C组)、超高度近视组(D组),分别为19、21、27、19只眼。所有患眼均行光相干断层扫描血管成像(OCAT)检查以及AL测量。屈光度数以SE表示。采用超声生物测量仪行AL测量。采用OCTA仪对黄斑区3 mm×3 mm范围进行扫描,软件自动将其划分为以黄斑中心凹为中心的2个同心圆,分别是直径1 mm的中心凹区及1~3 mm的旁中心凹区,后者再分为上方、鼻侧、下方、颞侧,共计5个区域。测量黄斑不同分区浅层毛细血管丛(SCP)、深层毛细血管丛(DCP)、脉络膜毛细血管丛(CC)、脉络膜层的血流密度以及视网膜、脉络膜厚度。多组间比较采用单因素方差分析;AL与血流密度和厚度的相关性采用Pearson相关性分析。结果A组、B组、C组、D组患眼黄斑不同分区SCP血流密度、中心凹区DCP血流密度比较,差异均无统计学意义(P>0.05);上方、鼻侧、下方、颞侧DCP血流密度比较,差异均有统计学意义(P<0.05);黄斑不同分区CC、脉络膜层血流密度比较,差异均有统计学意义(P<0.05)。4组间黄斑不同分区视网膜厚度比较,中心凹区差异无统计学意义(P>0.05),上方、鼻侧、下方、颞侧差异均有统计学意义(P<0.05);黄斑不同分区脉络膜厚度比较,差异均有统计学意义(P<0.05)。脉络膜厚度组间两两比较,颞侧:C组与A组,差异有统计学意义(P<0.05);黄斑不同分区:D组与A组、B组、C组,差异均有统计学意义(P<0.05)。相关性分析结果显示,AL与上方、鼻侧、下方、颞侧DCP血流密度(r=−0.504、−0.500、−0.460、−0.465)、视网膜厚Objective To observe the changes of retinal and choroidal blood flow density and thickness in macula of different myopic dioptre eyes,and to analyze the correlation between retinal and choroidal blood flow density and axial length(AL).Methods A retrospective clinical study.From October 2022 to May 2023,86 eyes of 56 myopic patients scheduled for refractive surgery in Department of Ophthalmology,PLA Central Theater CommandGeneral were included into the study.According to the equivalent spherical specular degree(SE),19,21,27 and 19 eyes of low myopia group(group A),moderate myopia group(group B),high myopia group(group C)and super high myopia group(group D)were observed.Optical coherence tomography angiography(OCTA)and AL measurement were performed in all patients.The diopter was expressed in SE.AL was measured by ultrasonic bio-meter.OCTA scanner was used to scan the macular region in the range of 3 mm×3 mm.The software automatically divided the macular region into two concentric circles with the fovea as the center,which were 1 mm in diameter respectively,the paracentric fovea of 1-3 mm was divided into 5 regions:superior,nasal,inferior and temporal.The superficial capillary plexus(SCP),deep capillary plexus(DCP),choroidal capillary plexus(CC),choroidal blood flow density,retinal and choroidal thickness were measured.The correlation between AL and blood flow density and thickness was analyzed by Pearson correlation analysis.Results There was no significant difference in SCP blood density and DCP blood density in the fovea in groups A,B,C and D(P>0.05).There were significant differences in DCP flow density among superior,nasal,inferior and temporal areas(P<0.05),the difference was significant(P<0.05).There was no significant difference in the fovea area between the four groups(P>0.05),but there was significant difference in the superior,nasal,inferior and temporal areas(P<0.05).Different macular regions:there were statistically significant among group A,group B,and group C,group D(P<0.05).Results of correlation a

关 键 词：近视 眼轴 局部血流 血流密度 脉络膜厚度 视网膜厚度 

分 类 号：R778.11[医药卫生—眼科]