OCTA对青少年近视人群视网膜微血管密度的观察

目的:基于光学相干断层扫描血管成像(OCTA)技术探讨青少年儿童近视与视网膜表层微血管密度及视网膜厚度的相关性。方法:横断面研究。共纳入2018年5─11月于四川大学华西医院眼科门诊就诊的7~14岁青少年近视患者105例(193眼)。对所有受检者进行光学相干断层扫描(OCT)和OCTA检查,量化分析黄斑中心凹视网膜厚度和各部位视网膜表层微血管密度。单因素方差分析比较低、中、高度近视组各部位视网膜微血管密度及视网膜厚度的差异。采用Pearson相关系数探讨视网膜厚度与各部位视网膜表层微血管密度的相关性。Spearman相关系数用于探讨等效球镜与中心凹、旁中心凹视网膜表层微血管密度以及视网膜厚度的关系;分段多项式函数分析等效球镜度与外环及直径6 mm完整视网膜表层微血管密度的关系。结果:旁中心凹、外环、直径6 mm完整区域视网膜表层微血管密度在低、中、高度近视组间比较差异均具有统计学意义( F=11.651、14.499、14.232,均 P<0.001)。年龄与中心凹视网膜厚度之间有较弱正相关关系( r=0.187, P=0.011),与各部位微血管密度均无相关性。等效球镜度与旁中心凹视网膜微血管密度有相关性( r=-0.301, P<0.001),与外环、直径6 mm完整区域视网膜表层微血管密度呈曲线相关( r=-0.319, P<0.001;r=-0.307, P<0.001)。但与中心凹视网膜表层微血管密度及视网膜厚度无显著相关性。此外,中心凹处视网膜厚度与微血管密度呈正相关( r=0.691, P<0.001),与其余部位微血管密度无相关性。 结论:青少年近视程度数与旁中心凹、外环及直径6 mm完整区域视网膜表层微血管密度呈负相关;中心凹处视网膜厚度与年龄、微血管密度呈正相关。

Retinal Vessel Density in Adolescent Myopia Based on OCTA: An Observational Study

Objective: To investigate the correlation between myopia and superficial retinal vascular density (SRVD) and retinal thickness in adolescent myopia using optical coherence tomography angiography (OCTA). Methods: This study was a prospective cross-sectional study. A total of 105 myopia patients (193 eyes) aged 7-14 years who visited the Department of Ophthalmology, West China Hospital, Sichuan University, from May 2018 to November 2018 were included. All patients were examined by optical coherence tomography (OCT) and OCTA. Patients were divided into three groups based on the degree of myopia:mild, moderate and severe. One-way analysis of variance was performed on the macular foveal retinal thickness and SRVD at various sites. Pearson correlation was performed between the retinal thickness and superficial retinal vessel density by Pearson correlation analysis. Spearman correlation was performed between the spherical equivalent (SE) and the SRVD and between the macular foveal retinal thickness and the SRVD at various sites. Results: The differences in the parafovea, outer ring and the entire 6 mm diameter of the SRVD in the mild, moderate and high myopia groups were statistically significant (F=11.651, 14.499, 14.232, P<0.001). There was a weak positive correlation between age and macular foveal retinal thickness (r=0.187, P=0.011), but there was no correlation between age and SRVD at any site. The SE was correlated with the parafoveal SRVD (r=-0.301, P<0.001), the curve was correlated with the SRVD outer ring and the entire SRVD area (r=-0.319, P<0.001; r=-0.307, P<0.001). However, there was no significant correlation between the SE and the foveal SRVD and macular foveal retinal thickness. The macular foveal retinal thickness was correlated with the foveal SRVD (r=0.691, P<0.001), but no correlation with parafoveal, outer ring and entire SRVD. Conclusions: The degree of myopia in adolescents is negatively correlated with the parafovea, outer ring and the entire SRVD. The macular foveal retinal thickness is positively correlated with age and the foveal SRVD.