不同级别豹纹状眼底对黄斑区视网膜血管密度及厚度的影响

目的　运用光学相干断层扫描血管成像技术（optical coherence tomography angiography，OCTA）对不同级别豹纹状眼底黄斑区视网膜进行测量，探究不同级别豹纹状眼底黄斑区视网膜浅层及深层血管密度和厚度的差异。方法　前瞻性非随机对照研究。收集2019年1月至2019年6月在首都医科大学附属北京同仁医院眼科就诊的高度近视（SE＜-6.00 D）眼底豹纹状改变的患者共52例（63眼），按照眼底豹纹状改变的级别将其分为四组:0级组(18眼)、1级组(22眼)、2级组(12眼)、3级组(11眼）。选取黄斑中心凹周围区、黄斑旁中心凹以及黄斑中心凹为观察指标，通过OCTA自动分层获得黄斑区视网膜浅层和深层的血管密度及视网膜厚度，采用秩和检验、方差分析以及SNK检验对数据进行分析。结果　四组患者的年龄呈非正态分布，差异无统计学意义（P=0.64）。黄斑中心凹周围区以及黄斑旁中心凹区:四组患者间视网膜浅层及深层血管密度差异均有统计学意义（均为P<0.05）；视网膜厚度:以0级组作为参照组，0级组与1级组、2级组、3级组差异均有统计学意义（均为P<0.05），且呈负相关关系。在黄斑中心凹区域:四组患者间视网膜浅层及深层血管密度和黄斑区视网膜厚度差异均无统计学意义（均为P＞0.05）。结论　随着豹纹状眼底级别的加深，眼底黄斑中心凹周围区以及旁中心凹区视网膜浅层及深层血管密度有统计学差异，且视网膜厚度随豹纹状眼底的级别加重呈进行性变薄趋势。OCTA可为评估不同级别豹纹状眼底视网膜的组织结构变化提供参考资料。

Effects of different grades of fundus tessellation on macular retinal vessel density and thickness

Objective　To explore the effect of different grades of fundus tessellation on macular retinal superficial and deep vessel density and thickness by using optical coherence tomography angiography (OCTA).Methods　This was prospective, non-randomized, controlled study. From January 2019 to June 2019, 52 patients (63 eyes) with fundus tessellation (SE＜-6.00 D) was included of Beijing Tongren Hospital. We divided patients into 4 groups according to the different grades of fundus tessellation, including 0-grade group (18 eyes), 1-grade group (22 eyes), 2-grade group (12 eyes), 3-grade group (11 eyes). The macular region was divided into the fovea, the parafovea zone and the perifovea zone. Macular superficial and deep vascular density and retinal thickness were measured by OCTA. Rank-sum test, analysis of variance, SNK test were used to analyze the collected data from the four groups.Results　The age of 4 groups patients showed abnormal distribution, and the difference was not statistically significant (P=0.64). In the perifovea and parafovea zone, there were significant differences in the macular retinal superficial and deep vascular density and retinal thickness (all P＜0.05). As for retinal thickness, taking the 0- grade group as the reference, the difference was statistically significant between 0-grade group and 1-grade, 2-grade and 3-grade groups (all P<0.05), with a negative correlation. In the fovea: There were no significant differences in the macular retinal superficial, deep vascular density and retinal thickness (all P>0.05).Conclusion　With the increasing degree of fundus tessellation, there are statistical differences in macular retinal superficial and deep vascular density of the perifovea and parafovea zone, and retinal thickness gradually becomes thinner with the increasing degree of fundus tessellation in a linear pattern. OCTA can effectively and conveniently detect the macular retinal vessel density and thickness in different grades of fundus tessellation.