青少年近视患者屈光度与视网膜厚度及黄斑血流的相关性研究

doi:10.3760/cma.j.issn.1007-1245.2022.14.017

摘要/Abstract

摘要： 目的　探讨研究青少年近视患者屈光度与视网膜厚度及黄斑血流的相关性。方法　回顾性分析东莞光明眼科医院门诊部于2020年5月至2021年12月期间收治的青少年近视患者58例，其中低度近视19例、中度近视21例、高度近视18例。另选取视力正常的青少年22例作为对照组。低度近视组男10例、女9例，年龄（12.38±3.03）岁；中度近视组男11例、女10例，年龄（13.01±2.95）岁；高度近视组男9例、女9例，年龄（12.85±3.11）岁；对照组男11例、女11例，年龄（13.08±3.32）岁。采用德国蔡司公司的Cirrus HD-OCT-5000仪器，测量患者黄斑血流相关指标及视网膜厚度。对比近视组及对照组的全周、上方、下方、鼻侧及颞侧视网膜厚度；对比低、中、高度近视组的全周、上方、下方、鼻侧及颞侧视网膜厚度；对比低、中、高度近视组的黄斑血流相关指标。采用Pearson相关性分析法，分析患者屈光度与视网膜厚度及黄斑血流指标的相关性。计量资料采用独立样本t检验或F检验，计数资料采用χ²检验。结果　近视组的全周、上方、下方、鼻侧及颞侧视网膜厚度分别为（93.68±10.25）μm、（118.63±9.87）μm、（110.33±10.37）μm、（57.93±8.14）μm、（87.91±8.33）μm，均明显低于对照组［（105.43±8.52）μm、（134.77±9.65）μm、（133.26±8.08）μm、（79.43±9.66）μm、（102.44±6.78）μm］，差异均有统计学意义（均P<0.05）。低、中、高度近视组的全周、上方、下方、鼻侧及颞侧视网膜厚度依次下降，组间差异均有统计学意义（均P<0.05）。低、中、高度近视组的1区血管长度密度（VD1）、1区血流灌注密度（PD1）及4区血流灌注密度（PD4）比较，差异均无统计学意义（均P>0.05）；而4区血管长度密度（VD4）及黄斑中心凹无血管区（FAZ）指标，3组差异均有统计学意义（均P<0.05），随近视度数变大VD4、FAZ变小。经Pearson相关性分析发现，屈光度与视网膜厚度及FAZ呈负相关（r=-0.648，P<0.001；r=-0.312，P=0.003），与VD4无明显相关性（P>0.05）。结论　青少年近视患者的近视越严重，视网膜厚度越小，且FAZ越低，呈负相关性，但因果关系需进行多中心研究。

关键词: 青少年近视患者, 视网膜厚度, 黄斑血流, OCTA, 相关性

Abstract: Objective　To investigate the correlations between diopter and retinal thickness and macular blood flow in adolescent myopia patients. Methods　Fifty-eight adolescent myopia patients admitted to the outpatient department of Dongguan Guangming Eye Hospital from May 2020 to December 2021 were retrospectively analyzed, including 19 cases of low myopia, 21 cases of medium myopia, and 18 cases of high myopia, and 22 adolescents with normal vision were selected as the control group. In the low myopia group, there were 10 males and 9 females, aged (12.38±3.03) years; in the medium myopia group, there were 11 males and 10 females, aged (13.01±2.95) years; in the high myopia group, there were 9 males and 9 females, aged (12.85±3.11) years; in the control group, there were 11 males and 11 females, aged (13.08±3.32) years. The indexes related to macular blood flow and retinal thickness were measured by Cirrus HD-OCT-5000 instrument from Zeiss, Germany. The peripheral, upper, lower, nasal, and temporal retinal thicknesses were compared between the myopia group and the control group; the peripheral, upper, lower, nasal, and temporal retinal thicknesses were compared among the low, medium, and high myopia groups; the indexes related to macular blood flow in the low, medium, and high myopia groups were compared. Pearson correlation analysis was used to analyze the correlations between patients' diopter and retinal thickness and macular blood flow indexes. Independent sample t test or F test was used for the measurement data, and χ² test was used for the count data. Results　The peripheral, upper, lower, nasal, and temporal retinal thicknesses in the myopia group were (93.68±10.25) μm, (118.63±9.87) μm, (110.33±10.37) μm, (57.93±8.14) μm, and (87.91±8.33) μm, respectively, which were significantly lower than those in the control group [(105.43±8.52) μm, (134.77±9.65) μm, (133.26±8.08) μm, (79.43±9.66) μm, and (102.44±6.78) μm], with statistically significant differences (all P<0.05). In the low, medium, and high myopia groups, the peripheral, upper, lower, nasal, and temporal retinal thicknesses decreased successively, with statistically significant differences (all P<0.05). There were no statistically significant differences in the vascular density in zone 1 (VD1), perfusion density in zone 1 (PD1), and perfusion density in zone 4 (PD4) among the low, medium, and high myopia groups (all P>0.05); the vascular density in zone 4 (VD4) and foveal avascular zone (FAZ) showed statistically significant differences among the three groups (all P<0.05), and the VD4 and FAZ decreased with the increase of myopia. Pearson correlation analysis showed that diopter was negatively correlated with retinal thickness and FAZ (r=-0.648, P<0.001; r=-0.312, P=0.003), and was not significantly correlated with VD4 (P>0.05). Conclusion　The more severe myopia in adolescent myopia patients, the smaller the retinal thickness, and the lower the FAZ, showing a negative correlation, but the causal relationship needs to be studied in a multi-center.

Key words: Adolescent myopia, Retinal thickness, Macular blood flow, OCTA, Correlation

谷裕　陈振东　卞栏焰　杨玉芳. 青少年近视患者屈光度与视网膜厚度及黄斑血流的相关性研究[J]. 国际医药卫生导报, 2022, 28(14): 2001-2005.

Gu Yu, Chen Zhendong, Bian Lanyan, Yang Yufang. Correlations between diopter and retinal thickness and macular blood flow in adolescent myopia patients[J]. International Medicine and Health Guidance News, 2022, 28(14): 2001-2005.

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