Department of Ophthalmology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Fundus Disease, Shanghai, China.
Biomed Res Int. 2020 Mar 24;2020:7361492. doi: 10.1155/2020/7361492. eCollection 2020.
To evaluate the influence of systemic and ocular factors on the foveal avascular zone (FAZ) area in young Chinese subjects' healthy eyes.
The current observational, cross-sectional study included 344 eyes from 172 healthy individuals (103 women, 69 men). Optical coherence tomography angiography realized with the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to assess the area of superficial FAZ. To determine the related factors and to reveal their potential correlations with the FAZ area, comprehensive examinations including both systemic and ocular ones were executed. Systemic examination involved factors including age, gender, and body mass index, while ocular examination involved factors including BCVA, refractive error, intraocular pressure, axial length (AL), anterior chamber depth, and central corneal thickness. Especially for fundus examination, central macular thickness (CMT), retinal volume, mean retinal thickness, macular blood flow area/vessel density in the superficial retinal layer (SRL) and deep retinal layer (DRL), mean retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness, C/D rate, rim area, and subfoveal choroid thickness were assessed, using mixed-effects regression models to appropriately account for intereye correlation. Subgroup analyses were performed based on gender and high myopia categories.
The mean FAZ area was 0.30 ± 0.11 mm and varied significantly across gender ( = 0.0024). AL, CMT, and RNFL thickness were found significantly correlated with the FAZ area in the univariate regression analysis (AL, = 0.0005; CMT, < 0.0001; and RNFL thickness, = 0.0461). According to the multivariate results, CMT and macular blood flow in SRL were negatively correlated with FAZ (CMT: < 0.0001; macular blood flow in SRL: = 0.00223). Mean retinal thickness, mean GCL thickness, and macular blood flow in DRL were positively correlated with FAZ (mean retinal thickness: = 0.0005; mean GCL thickness: < 0.0001; and macular blood flow in DRL: = 0.0099). Correlation results among these filtered factors and FAZ were more pronounced in non-high-myopic eyes than in high-myopic eyes and had a significant difference when data of male and female subjects were processed separately from each other.
The present cross-sectional study performed comprehensive systemic and ocular examinations in young Chinese adults and filtered factors affecting FAZ. We indicated that among all the assessed candidate factors, gender, AL, retinal thickness, macular blood flow, RNFL, and GCL thickness affected the FAZ area most significantly. Such findings would facilitate future research concerning the role of FAZ variation in fundus diseases.
评估全身和眼部因素对中国年轻健康人群的中心凹无血管区（FAZ）面积的影响。
本研究为观察性、横断面研究，共纳入 172 例（103 名女性，69 名男性）172 名健康个体的 344 只眼。采用基于分段谱振幅去相关血管造影（SSADA）算法的光学相干断层扫描血管造影术评估浅层 FAZ 面积。为了确定相关因素，并揭示其与 FAZ 面积的潜在相关性，进行了包括全身和眼部检查在内的综合检查。全身检查包括年龄、性别和体重指数，眼部检查包括最佳矫正视力（BCVA）、屈光不正、眼内压、眼轴（AL）、前房深度和中央角膜厚度。特别是对于眼底检查，评估了中央黄斑厚度（CMT）、视网膜容积、平均视网膜厚度、浅层视网膜层（SRL）和深层视网膜层（DRL）的黄斑血流面积/血管密度、平均视网膜神经纤维层（RNFL）厚度、神经节细胞层（GCL）厚度、C/D 比、边缘面积和中心凹下脉络膜厚度，使用混合效应回归模型适当考虑眼间相关性。根据性别和高度近视类别进行了亚组分析。
FAZ 面积的平均值为 0.30 ± 0.11mm，性别间差异有统计学意义（P = 0.0024）。单变量回归分析显示，AL、CMT 和 RNFL 厚度与 FAZ 面积显著相关（AL，P = 0.0005；CMT，P < 0.0001；和 RNFL 厚度，P = 0.0461）。根据多变量结果，CMT 和 SRL 中的黄斑血流与 FAZ 呈负相关（CMT，P < 0.0001；SRL 中的黄斑血流，P = 0.00223）。平均视网膜厚度、平均 GCL 厚度和 DRL 中的黄斑血流与 FAZ 呈正相关（平均视网膜厚度，P = 0.0005；平均 GCL 厚度，P < 0.0001；和 DRL 中的黄斑血流，P = 0.0099）。在非高度近视眼中，这些过滤因素与 FAZ 之间的相关性结果比高度近视眼中更明显，当分别处理男性和女性受试者的数据时，差异具有统计学意义。
本横断面研究对中国年轻成年人进行了全面的全身和眼部检查，并对影响 FAZ 的过滤因素进行了研究。结果表明，在所评估的候选因素中，性别、AL、视网膜厚度、黄斑血流、RNFL 和 GCL 厚度对 FAZ 面积的影响最为显著。这些发现将有助于未来研究 FAZ 变化在眼底疾病中的作用。
