高度近视眼中的脉络膜小动脉和黄斑脉络膜血管：基于 OCT 血管造影的研究。

Cilioretinal Arteries and Macular Vasculature in Highly Myopic Eyes: An OCT Angiography-Based Study.

机构信息

Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China; Key Laboratory of Myopia, Ministry of Health, Shanghai, China; Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China; Key NHC Key Laboratory of Myopia, Fudan University, Shanghai, China; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.

Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.

出版信息

Ophthalmol Retina. 2020 Oct;4(10):965-972. doi: 10.1016/j.oret.2020.05.014. Epub 2020 May 26.

DOI:10.1016/j.oret.2020.05.014

PMID:32470652

Abstract

PURPOSE

To determine the association between the presence of cilioretinal arteries and the macular vasculature in highly myopic eyes using OCT angiography (OCTA).

DESIGN

Retrospective, observational case series.

PARTICIPANTS

Four hundred eighty-one highly myopic eyes of 481 patients.

METHODS

Fundus photographs were reviewed to determine the presence of a cilioretinal artery and its distribution, based on whether its path or visible branches reached the region within 500 μm of the foveal center. The macular vasculature was analyzed in OCTA images, including the vessel density (VD), fractal dimension (FD), and foveal avascular zone (FAZ). The associations between the presence of a cilioretinal artery and its distribution and between the macular vasculature and visual acuity were evaluated.

MAIN OUTCOME MEASURES

Cilioretinal arteries, macular vasculature, and their associations.

RESULTS

Of the eyes included, 17.05% (82/481) had a cilioretinal artery. Based on the OCTA analysis, the eyes with cilioretinal arteries showed significantly higher VD and FD in both superficial and deep capillary plexuses and smaller FAZ than those without (all P < 0.001). However, these differences were not found in the subgroup of eyes with an axial length of more than 30 mm. Eyes with cilioretinal arteries that reached the central foveal area showed significantly higher VD and FD in both capillary plexuses and smaller FAZ than those that did not (all P < 0.05). Better best-corrected visual acuity was identified in the eyes with cilioretinal arteries than in those without (0.09 ± 0.14 logarithm of the minimum angle of resolution [logMAR] vs. 0.21 ± 0.27 logMAR, respectively; P < 0.001). In particular, eyes with cilioretinal arteries that reached the central foveal area had better visual acuity than those without (0.05 ± 0.06 logMAR vs. 0.16 ± 0.20logMAR, respectively; P = 0.005).

CONCLUSIONS

This OCTA-based study suggested that cilioretinal arteries in highly myopic eyes potentially may improve the macular vasculature and influence visual function.

摘要

目的

利用光学相干断层扫描血管造影术（OCTA）确定高度近视眼中存在脉络膜小动脉与黄斑血管之间的关系。

设计

回顾性观察性病例系列。

参与者

481 例 481 只高度近视眼。

方法

通过眼底照相确定脉络膜小动脉的存在及其分布，基于其路径或可见分支是否到达距中心凹 500μm 内的区域。在 OCTA 图像中分析黄斑血管，包括血管密度（VD）、分形维数（FD）和中心凹无血管区（FAZ）。评估脉络膜小动脉的存在及其分布与黄斑血管和视力之间的关系。

主要观察指标

脉络膜小动脉、黄斑血管及其相关性。

结果

纳入的眼中有 17.05%（82/481）存在脉络膜小动脉。基于 OCTA 分析，有脉络膜小动脉的眼在浅层和深层毛细血管丛中的 VD 和 FD 均显著更高，FAZ 更小（均 P<0.001）。然而，在眼轴长度大于 30mm 的亚组中并未发现这些差异。到达中央中心凹区域的脉络膜小动脉眼在浅层和深层毛细血管丛中的 VD 和 FD 均显著更高，FAZ 更小（均 P<0.05）。有脉络膜小动脉的眼的最佳矫正视力优于无脉络膜小动脉的眼（分别为 0.09±0.14 最小分辨角对数视力[logMAR]和 0.21±0.27logMAR；P<0.001）。特别是到达中央中心凹区域的脉络膜小动脉眼的视力优于无脉络膜小动脉的眼（分别为 0.05±0.06logMAR 和 0.16±0.20logMAR；P=0.005）。