Reduced Macular Vascular Density in Myopic Eyes.
Reduced Macular Vascular Density in Myopic Eyes.
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DOI：
10.4103/0366-6999.199844
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发表时间：
2017-02-20
影响因子：
6.1
通讯作者：
Li SN
中科院分区：
文献类型：
--
作者：
Fan H;Chen HY;Ma HJ;Chang Z;Yin HQ;Ng DS;Cheung CY;Hu S;Xiang X;Tang SB;Li SN
多普勒超声和荧光素眼底血管造影（fundus fluorescein angiography，FFA）可以观察近视眼患者血管系统的形态学改变，但这些研究存在局限性。多普勒超声提供低分辨率图像，主要从可视化的大血管获得，FFA是一种侵入性检查。光学相干断层扫描（OCT）血管造影是一种无创、高分辨率的血管密度测量方法。本研究的目的是利用OCT血管造影技术研究近视眼血管密度的变化。这项横断面研究共包括47名参与者的91只眼睛，包括对照组、中度和高度近视，通过OCT血管造影进行评价。于2015年8月5日至2016年4月1日在深圳爱尔眼科医院屈光科招募近视患者。正视眼来自健康志愿者。测量黄斑区和视盘区血管密度、神经节细胞复合体（GCC）厚度和视网膜神经纤维层（RNFL）厚度。分析了眼轴长度（AL）和屈光不正之间的关系。采用单因素方差分析、Pearson相关分析和广义估计方程进行统计分析。对照组黄斑区浅、深血管密度均最高（25.64% ± 3.76%和37.12% ± 3.66（21.15% ± 5.33%和35.35% ± 5.50%），高度近视组最低分别为19.64% ± 3.87%和32.81% ± 6.29%（F = 13.74和4.57，P均< 0.001）。浅层（β分别为-0.850和0.460）和深层（β分别为-0.766和0.396）黄斑血管密度与AL和等效球镜相关（均P < 0.001）。黄斑表面血管密度与GCC厚度相关（β = 0.244，P = 0.040），与等效球镜无关。视盘区的血管密度在三组间无差异，且与AL、等效球镜、RNFL厚度无关。结果表明，随着近视程度的增加，黄斑区的血管密度降低，而视盘区的血管密度无明显变化。
Morphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these studies have limitations. Doppler ultrasound provides low-resolution images which are mainly obtained from visualized large vessels, and FFA is an invasive examination. Optic coherence tomography (OCT) angiography is a noninvasive, high-resolution measurement for vascular density. The purpose of this study was to investigate the change of vascular density in myopic eyes using OCT angiography. This cross-sectional study includes a total of 91 eyes from 47 participants including control, moderate, and high myopia that were evaluated by OCT angiography. Patients with myopia were recruited from the Refractive Department, Shenzhen Aier Eye Hospital, from August 5, 2015 to April 1, 2016. Emmetropic eyes were from healthy volunteers. The vascular density at macula and optic disc regions, ganglion cell complex (GCC) thickness, and retinal nerve fiber layer (RNFL) thickness were measured. Their relationships with axial length (AL) and refractive error were analyzed. One-way analysis of variance (ANOVA), Pearson's correlation, and generalized estimating equation were used for statistical analysis. Both superficial and deep macular vascular density were highest in control (25.64% ± 3.76% and 37.12% ± 3.66%, respectively), then in moderate myopia (21.15% ± 5.33% and 35.35% ± 5.50%, respectively), and lowest in high myopia group (19.64% ± 3.87% and 32.81% ± 6.29%, respectively) (F = 13.74 and 4.57, respectively; both P < 0.001). Both superficial (β = −0.850 and 0.460, respectively) and deep (β = −0.766 and 0.396, respectively) macular vascular density were associated with AL and spherical equivalent (all P < 0.001). Superficial macular vascular density was associated with GCC thickness (β = 0.244, P = 0.040), independent of spherical equivalent. The vascular density in optic disc region had no difference among the three groups, and it was not associated with AL, spherical equivalent, or RNFL thickness. Our results suggested that with the increase of myopia, the vascular density decreased in macular region, but not in optic disc region.