Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea; Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea.
Ophthalmology. 2018 Aug;125(8):1224-1233. doi: 10.1016/j.ophtha.2018.02.002. Epub 2018 Mar 12.
To investigate the positional change of central retinal vasculature and vascular trunk to deduce the change in the lamina cribrosa (LC) during axial elongation.
Prospective cohort study.
Twenty-three healthy myopic children (46 eyes).
Participants had undergone a full ophthalmologic examination and axial length measurement every 6 months for 2 years. Using spectral-domain OCT, circle scans centered around the optic disc in the glaucoma progression analysis mode, which enabled capturing of the same positions throughout the entire study period, and enhanced depth imaging of the deep optic nerve head complex were performed. Infrared imaging of the circle scans was used to measure the changes in the angles between the first and final visits. The angle between the major superior and inferior retinal arteries was measured along the circle scan twice: from the center of the circle scan and from the central retinal vascular trunk, respectively. The positional change of the retinal vascular trunk also was measured.
Change in vascular angle and position of vascular trunk with axial elongation and associated factors.
The vascular angle measured from the center of the circle scan did not change (P = 0.247), whereas the angle measured from the central retinal arterial trunk decreased with axial elongation (P < 0.001). A generalized estimating equation analysis revealed that the factors associated with angle decrease were axial elongation (P = 0.004) and vascular trunk dragging (P < 0.001). The extent of vascular trunk dragging was associated with axial elongation (P < 0.001) and increased border length with marginal significance (P = 0.053), but the extent of dragging could not be explained fully by their combination. The major directionality of dragging was mostly to the nasal side of the optic disc, with large variations among participants.
During axial elongation, the retinal vasculature at the posterior pole was unchanged, whereas the position of the central vascular trunk was dragged nasally. Because the central retinal vascular trunk is embedded in the LC, its dragging indicates nasal shifting of the LC, which could explain the vulnerability of myopic eyes to glaucomatous optic neuropathy.
研究中心视网膜血管和血管主干的位置变化，以推断视盘筛板（LC）在眼轴伸长过程中的变化。
前瞻性队列研究。
23 名健康近视儿童（46 只眼）。
参与者每 6 个月接受一次全面眼科检查和眼轴长度测量，共进行 2 年。使用频域光相干断层扫描（OCT），在青光眼进展分析模式下对视盘中央进行圆形扫描，该模式可在整个研究期间捕获相同的位置，并对视神经头深部复合体进行增强深度成像。对圆形扫描的红外图像进行分析，以测量从第一次就诊到最后一次就诊的角度变化。在圆形扫描上两次测量大上和大下视网膜动脉之间的夹角：一次从圆形扫描的中心，一次从中央视网膜血管主干。还测量了视网膜血管主干的位置变化。
血管角度和血管主干位置随眼轴伸长的变化及其相关因素。
从圆形扫描中心测量的血管角度没有变化（P=0.247），而从中央视网膜动脉主干测量的角度随眼轴伸长而减小（P<0.001）。广义估计方程分析表明，与角度减小相关的因素是眼轴伸长（P=0.004）和血管主干牵拉（P<0.001）。血管主干牵拉的程度与眼轴伸长（P<0.001）和边缘长度增加有显著相关性（P=0.053），但牵拉的程度不能完全由两者的组合来解释。牵拉的主要方向大多是视盘的鼻侧，参与者之间的差异很大。
在眼轴伸长过程中，视盘后极的视网膜血管保持不变，而中央血管主干的位置被牵拉向鼻侧。由于中央视网膜血管主干嵌入 LC 中，其牵拉表明 LC 向鼻侧移位，这可以解释近视眼易发生青光眼视神经病变的原因。
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