Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland.
PLoS One. 2019 Jul 18;14(7):e0219785. doi: 10.1371/journal.pone.0219785. eCollection 2019.
To assess the superficial retinal vessel density (SRVD) and foveal avascular zone (FAZ) in myopic children using optical coherence tomography angiography (OCTA).
174 eyes of 89 subjects with myopia and 101 eyes of 54 age-matched, emmetropic volunteers (control group) were enrolled in this study. The mean age of the subjects and controls was 13.9 (SD ± 2.3) and 13.1 (SD ± 2.4), respectively. Myopia was defined as spherical equivalent <- 1.0 diopter. Emmetropic subjects were defined as having spherical equivalent from + 0.5 to - 0.5 diopter. The mean axial length (AL) in myopic patients was 24.58 mm (SD ± 1.22) and 22.88 mm (SD ± 0.65) in the controls. Every patient underwent a complete ophthalmological examination and OCTA, using AngioVue (Optovue). The FAZ area and superficial retinal vessel density, including whole SRVD, fovea SRVD and parafovea SRVD, were analyzed. Foveal thickness (FT) and parafoveal thickness (PFT) were also taken into consideration.
Whole SRVD, parafovea SRVD and PFT were significantly higher in controls than in the myopic subjects (p < 0.001, p = 0.007, p < 0.01, respectively). The FAZ area was significantly larger in the myopic group compared to the controls (p = 0.010). Fovea SRVD and FT did not differ significantly between the groups (p = 0.740, p = 0.795 respectively). In overall subjects we found significant correlation between axial length and all the investigative parameters: age, FAZ area, whole SRVD, parafovea SRVD, fovea SRVD, PFT, FT (p < 0.001, p = 0.014, p = 0.008, p < 0.005, p = 0.014, p = 0.010, p = 0.024, respectively). Analyzing only myopic group we confirmed that AL was significantly correlated with age, whole SRVD and parafovea SRVD (p < 0.001, p = 0.014, p = 0.009, respectively). Similarly, in this group the spherical equivalent also correlated with age, whole SRVD and parafovea SRVD (p < 0.001, p = 0.007, p = 0.005, respectively). Such correlations were not confirmed in the non-myopic group.
Our results suggest that superficial retinal vessel density is decreased and FAZ area is enlarged in the entire group of the myopic children compared to emmetropic subjects. Longitudinal observation of these young patients is needed to determine the relevance of the microvascular alterations in future.
使用光相干断层扫描血管造影术（OCTA）评估近视儿童的浅层视网膜血管密度（SRVD）和中心凹无血管区（FAZ）。
本研究纳入了 89 名近视儿童的 174 只眼和 54 名年龄匹配的正视志愿者（对照组）的 101 只眼。受试者和对照组的平均年龄分别为 13.9（SD ± 2.3）和 13.1（SD ± 2.4）。近视定义为等效球镜<-1.0 屈光度。正视者定义为等效球镜在+0.5 至-0.5 屈光度之间。近视患者的平均眼轴（AL）长度为 24.58mm（SD ± 1.22），对照组为 22.88mm（SD ± 0.65）。每位患者均接受了全面的眼科检查和使用 AngioVue（Optovue）的 OCTA。分析了 FAZ 区域和浅层视网膜血管密度，包括全 SRVD、中心凹 SRVD 和旁中心凹 SRVD。还考虑了中心凹厚度（FT）和旁中心凹厚度（PFT）。
对照组的全 SRVD、旁中心凹 SRVD 和 PFT 均显著高于近视组（p<0.001，p=0.007，p<0.01，分别）。与对照组相比，近视组的 FAZ 区域明显更大（p=0.010）。中心凹 SRVD 和 FT 两组间无显著差异（p=0.740，p=0.795）。在所有受试者中，我们发现眼轴与所有研究参数之间存在显著相关性：年龄、FAZ 面积、全 SRVD、旁中心凹 SRVD、中心凹 SRVD、PFT、FT（p<0.001，p=0.014，p=0.008，p<0.005，p=0.014，p=0.010，p=0.024，分别）。仅分析近视组，我们证实 AL 与年龄、全 SRVD 和旁中心凹 SRVD 显著相关（p<0.001，p=0.014，p=0.009，分别）。同样，在该组中，等效球镜也与年龄、全 SRVD 和旁中心凹 SRVD 相关（p<0.001，p=0.007，p=0.005，分别）。这些相关性在非近视组中未得到证实。
我们的结果表明，与正视者相比，近视儿童的浅层视网膜血管密度降低，FAZ 区域扩大。需要对这些年轻患者进行纵向观察，以确定未来微血管改变的相关性。
