近视儿童的角膜形态与脉络膜毛细血管灌注相关。

Corneal morphology correlates with choriocapillaris perfusion in myopic children.

机构信息

Institute of Medical Technology, Peking University Health Science Center, Beijing, China.

Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing , 100044, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2022 Oct;260(10):3375-3385. doi: 10.1007/s00417-022-05675-w. Epub 2022 Apr 30.

DOI:10.1007/s00417-022-05675-w

PMID:35488909

Abstract

AIMS

The present study investigated the difference in choriocapillaris (CC) perfusion between different AL/K ratio groups with similar spherical equivalent refraction (SER) and analyzed factors affecting CC perfusion.

METHODS

This cross-sectional study included 129 children with low-to-moderate myopia. Axial length (AL), average K-reading (Ave-K), and SER were measured. Choroidal vascularity, including the total choroidal area (TA), choroidal luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), CC flow voids (FVs), and FVs%, was obtained using optical coherence tomography angiography.

RESULTS

Participants with similar SER were divided into two groups (high AL/K ratio, n = 57; low AL/K ratio, n = 72). The high AL/K group had lower LA, TA, and CVI (P < 0.01) and lower FVs (inner ring and fovea, P < 0.05) and FVs% (outer ring, inner ring, and fovea, P < 0.05). The AL/K ratio and FVs% were negatively correlated in the outer ring (r = - 0.174, P < 0.05) and inner ring (r = - 0.174, P < 0.05). The Ave-K and inner FVs (r = 0.178, P < 0.05), outer FVs% (r = 0.175, P < 0.05), and inner FVs% (r = 0.196, P < 0.05) were positively correlated. In stepwise multiple regression for the outer ring, the horizontal CVI was related to FVs (β = 0.175, P < 0.05), and the vertical CVI was related to FVs% (β = 0.232, P < 0.01). Independent risk factors associated with inner FVs area were vertical CVI (β = 0.329; P < 0.001) and SER (β = - 0.196, P < 0.05); FVs% was also associated with vertical CVI (β = 0.360, P < 0.01) and SER (β = - 0.196, P < 0.05).

CONCLUSION

With a similar SER, myopic eyes with a higher AL/K ratio maintained more CC perfusion and lower CVI, which may indicate rapid myopic progression. Low K-reading eyes had more CC perfusion and less CVI, which may explain the relatively poor myopia control efficacy in the clinic.

摘要

目的

本研究旨在探讨不同等效球镜（SER）但 AL/K 比值不同的脉络膜血供差异，并分析影响脉络膜血供的因素。

方法

本横断面研究纳入了 129 名低度至中度近视的儿童。测量眼轴（AL）、平均 K 读数（Ave-K）和 SER。采用光学相干断层扫描血管造影术（OCTA）获得脉络膜血管密度，包括脉络膜总面积（TA）、脉络膜管腔面积（LA）、基质面积（SA）、脉络膜血管指数（CVI）、脉络膜血流空穴（FVs）和 FVs%。

结果

将具有相似 SER 的参与者分为两组（高 AL/K 比值组，n=57；低 AL/K 比值组，n=72）。高 AL/K 组的 LA、TA 和 CVI 较低（P<0.01），且 FVs（内环和黄斑中心凹，P<0.05）和 FVs%（外环、内环和黄斑中心凹，P<0.05）较低。外环（r=-0.174，P<0.05）和内环（r=-0.174，P<0.05）中 AL/K 比值与 FVs%呈负相关。Ave-K 与内环 FVs（r=0.178，P<0.05）、外环 FVs%（r=0.175，P<0.05）和内环 FVs%（r=0.196，P<0.05）呈正相关。在外环的逐步多元回归中，水平 CVI 与 FVs 相关（β=0.175，P<0.05），垂直 CVI 与 FVs%相关（β=0.232，P<0.01）。与内环 FVs 面积相关的独立危险因素是垂直 CVI（β=0.329；P<0.001）和 SER（β=-0.196，P<0.05）；FVs%也与垂直 CVI（β=0.360，P<0.01）和 SER（β=-0.196，P<0.05）相关。