Zheng Feihui, Chua Jacqueline, Ke Mengyuan, Tan Bingyao, Yu Marco, Hu Qinglan, Cheung Chui Ming Gemmy, Ang Marcus, Lee Shu Yen, Wong Tien Yin, Schmetterer Leopold, Wong Chee Wai, Hoang Quan V
Singapore Eye Research Institute, Singapore National Eye Center, Singapore.
SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.
Br J Ophthalmol. 2022 May;106(5):681-688. doi: 10.1136/bjophthalmol-2020-317632. Epub 2021 Jan 4.
To quantify retinal and choriocapillaris (CC) microvasculature in highly myopic (HM) eyes with myopic macular degeneration (MMD) using swept-source optical coherence tomography angiography (SS-OCTA).
162 HM eyes (spherical equivalent ≤ -6.0 dioptres or axial length (AL) ≥26.5 mm) from 98 participants were enrolled, including 60 eyes (37.0%) with tessellated fundus, 54 eyes (33.3%) with peripapillary diffuse chorioretinal atrophy (PDCA), 27 eyes (16.7%) with macular diffuse chorioretinal atrophy (MDCA) and 21 eyes (13.0%) with patchy or macular atrophy. PLEX Elite 9000 SS-OCTA was performed to obtain perfusion densities (PD) of the superficial and deep retinal capillary plexus, and CC signal voids (number, area and density).
Retinal PD decreased with increasing severity of MMD. Multivariable analysis showed that after adjustment of age and other factors, retinal PD decreased significantly in eyes with longer AL (β≤-0.51, p<0.001) and with an MMD severity of MDCA or worse (β≤-1.63, p<0.001). Reduced retinal PD were significantly associated with worse vision (β≤-0.01, p≤0.04). In terms of CC signal voids, multivariable analysis showed that longer AL (p<0.001), but not MMD severity (p≥0.12) was significantly associated with CC signal void changes in the earliest stage of MMD.
We demonstrate significant OCTA alterations in the retina and CC in HM eyes with varying severities of MMD. In eyes with early-stage PDCA, lower retinal PD and more extensive CC signal voids are predominantly associated with increasing AL. In contrast, in eyes with MDCA or worse, MMD itself was associated with sparser retinal and CC circulation.
使用扫频光学相干断层扫描血管造影（SS-OCTA）对患有近视性黄斑变性（MMD）的高度近视（HM）眼中的视网膜和脉络膜毛细血管（CC）微血管进行量化。
纳入了98名参与者的162只HM眼（等效球镜度≤-6.0屈光度或眼轴长度（AL）≥26.5毫米），其中包括60只（37.0%）眼底呈棋盘状的眼睛、54只（33.3%）视乳头周围弥漫性脉络膜视网膜萎缩（PDCA）的眼睛、27只（16.7%）黄斑区弥漫性脉络膜视网膜萎缩（MDCA）的眼睛以及21只（13.0%）斑片状或黄斑萎缩的眼睛。使用PLEX Elite 9000 SS-OCTA获取浅表和深层视网膜毛细血管丛的灌注密度（PD）以及CC信号缺失（数量、面积和密度）。
视网膜PD随着MMD严重程度的增加而降低。多变量分析显示，在调整年龄和其他因素后，眼轴较长（β≤-0.51，p<0.001）以及MMD严重程度为MDCA或更严重（β≤-1.63，p<0.001）的眼睛中，视网膜PD显著降低。视网膜PD降低与视力较差显著相关（β≤-0.01，p≤0.04）。就CC信号缺失而言，多变量分析显示，眼轴较长（p<0.001），而非MMD严重程度（p≥0.12）与MMD最早阶段的CC信号缺失变化显著相关。
我们证明了不同严重程度MMD的HM眼中视网膜和CC存在显著的OCTA改变。在早期PDCA的眼中，较低的视网膜PD和更广泛的CC信号缺失主要与眼轴增加有关。相比之下，在MDCA或更严重的眼中，MMD本身与视网膜和CC循环稀疏有关。
