高度屈光参差近视患者眼轴长度与黄斑形态关系研究

目的　分析高度屈光参差近视患者双眼眼轴长度(AL)与黄斑区浅层视网膜毛细血管丛(SCP)血流密度、深层视网膜毛细血管丛(DCP)血流密度、黄斑中心凹无灌注区面积(FAZ)和黄斑中心凹厚度(CMT)等的相关性。方法　选取2019年5月至2020年10月于绵阳万江眼科医院眼科屈光中心就诊的高度屈光参差的近视患者70例(140眼)。患者双眼中屈光度低眼纳入低屈光度组，屈光度高眼纳入高屈光度组。经睫状肌麻痹验光获得双眼等效球镜度(SE)，生物测量仪测量AL，光学相干断层扫描血管成像（OCTA）获得双眼SCP血流密度、DCP血流密度、FAZ和CMT，分析AL与各项指标的相关性。结果　低屈光度组SE为+1.75～-4.50（-0.92±1.57）D，AL为22.04～26.09（24.01±0.91）mm；高屈光度组SE为-3.00～-7.50（-4.89±1.29）D，AL为23.54～27.77（25.33±0.89）mm；双眼SE参差平均为3.97 D，AL参差平均为1.32 mm。两组患者间SE、AL、SCP血流密度、DCP血流密度、FAZ和CMT相比差异均有统计学意义（均为P=0.000）。相关性分析结果显示，AL与SE（Y=-1.862X+43.046，R²=0.714，P=0.000）、SCP血流密度（Y=-1.517X+83.430，R²=0.446，P=0.000）、DCP血流密度（Y=-0.766X+69.111，R²=0.166，P=0.000）、CMT（Y=-5.419X+404.485，R²=0.617，P=0.000）均呈负相关，与FAZ呈正相关性（Y=0.007X+1.33，R²=0.232，P=0.000）。结论　高度近视眼随AL增长出现SCP及DCP血流密度下降，CMT变薄，FAZ面积增大等变化。

Relationship between axial length and macular morphology in patients with high anisometropic myopia

Objective　To study the correlation between the axial length (AL) and vessel density in superficial capillary plexus (SCP-VD), vessel density in deep capillary plexus (DCP-VD), foveal avascular zone (FAZ), and central macular thickness (CMT) in patients with high anisometropic myopia. Methods　A total of 70 patients (140 eyes) with high anisometropic myopia treated in Mianyang Wanjiang Eye Hospital from May 2019 to October 2020 were selected. Eyes with low diopter were included in the low diopter group, and eyes with high diopter in the high diopter group. Spherical equivalent (SE) was measured by cycloplegic refraction, AL by biometer, SCP-VD, DCP-VD, FAZ and CMT by optical coherence tomography angiography. The correlation between AL and these indicators was analyzed. Results　In the low diopter group, the mean SE was +1.75--4.50(-0.92±1.57) D, and the mean AL was 22.04-26.09（24.01±0.91）mm). In the high diopter group, the mean SE was -3.00--7.50(-4.89±1.29) D , and the mean AL was 23.54-27.77(25.33±0.89) mm. The difference in the mean SE was 3.97 D, and the difference in the mean AL was 1.32 mm. There were statistical differences in SE, AL, SCP-VD, DCP-VD, FAZ, and CMT between the two groups (all P=0.000). AL was negatively correlated with SE (Y=-1.862X+43.046, R²=0.714, P=0.000), SCP-VD (Y=-1.517X+83.430, R²=0.446, P=0.000), DCP-VD (Y=-0.766X+69.111, R²=0.166, P=0.000), and CMT (Y=-5.419X+404.485, R²=0.617, P=0.000), and positively correlated with FAZ (Y=0.007X+1.33, R²=0.232, P=0.000). Conclusion　In eyes with high myopia, SCP-VD, DCP-VD, and CMT decrease, while FAZ increases with the increase of AL.