Xu Yingnan, Yang Weihua, Long Tan, Shang Weihong, Xu Xiangzhong, Wang Jinfan, Yao Jin, Li Keran
Department of Ophthalmology, The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China.
Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China.
Front Neurosci. 2022 May 19;16:867463. doi: 10.3389/fnins.2022.867463. eCollection 2022.
Myopia has become an important public health problem to be solved urgently. Posterior chamber phakic implantable Collamer lens (ICL) implantation is one of the latest and safest products for myopia correction worldwide. This prospective cross-sectional case series aimed to observe changes in the macular retinal thickness, retinal nerve fiber layer (RNFL) thickness of para-optic disk region, and blood flow density after posterior ICL implantation in patients with high myopia using optical coherence tomography angiography (OCTA). A total of 67 eyes of 67 patients with high myopia, who underwent ICL implantation at The Affiliated Eye Hospital of Nanjing Medical University from January 2020 and December 2020, were included. The spherical equivalent (SE) of the operative eyes was >-6.00 D. The changes in vision, intraocular pressure (IOP), SE, and vault were observed pre-operatively, and follow-up were performed 1 week, 1 month, and 3 months. OCTA was used to observe the changes in the CRT, retinal thickness of paracentral fovea, FAZ, superficial and deep retinal blood flow density in the macular area, RNFL thickness of para-optic disk region, and blood flow density before and after ICL implantation. The uncorrected distance visual acuity (UDVA) and best corrected distance visual acuity (CDVA) of the patients post-operation were significantly improved ( < 0.001). The IOP increased in comparison with other time points at 1 week post-operation ( < 0.05). There were no significant changes in CRT post-operation. The retinal thickness in the upper, lower, nasal, and temporal quadrants of the paracentral fovea increased significantly at 1 month and 3 months post-operation ( < 0.05). The FAZ area at all postoperative time points were decreased ( < 0.001). At 3 months post-operation, the blood flow density of the superficial and deep retinal layers in the upper, lower, and nasal macular area were significantly reduced ( < 0.05). At 1 month post-operation, the RNFL thickness in the temporal para-optic disk region and blood flow density were significantly reduced ( = 0.001 and < 0.05, respectively). ICL implantation for highly myopic eyes led to an increase of the retinal thickness in the upper, lower, nasal, and temporal regions of the paracentral fovea; reduction of RNFL thickness in the temporal area of para-optic disk; decrease in FAZ area; and decrease in the blood flow density of some deep and superficial retinal layers as well as that of the temporal para-optic disk region.
近视已成为一个亟待解决的重要公共卫生问题。后房可植入式Collamer人工晶状体（ICL）植入术是全球范围内用于近视矫正的最新且最安全的产品之一。本前瞻性横断面病例系列旨在使用光学相干断层扫描血管造影（OCTA）观察高度近视患者后房型ICL植入术后黄斑视网膜厚度、视盘旁区域视网膜神经纤维层（RNFL）厚度及血流密度的变化。纳入了2020年1月至2020年12月在南京医科大学附属眼科医院接受ICL植入术的67例高度近视患者的67只眼。手术眼的等效球镜度（SE）＞-6.00D。术前观察视力、眼压（IOP）、SE及前房深度的变化，并在术后1周、1个月和3个月进行随访。使用OCTA观察ICL植入术前、后中心视网膜厚度（CRT）、中心凹旁视网膜厚度、黄斑无血管区（FAZ）、黄斑区视网膜浅层和深层血流密度、视盘旁区域RNFL厚度及血流密度的变化。患者术后的未矫正远视力（UDVA）和最佳矫正远视力（CDVA）均显著提高（P＜0.001）。术后1周时IOP较其他时间点升高（P＜0.05）。术后CRT无显著变化。术后1个月和3个月时，中心凹旁视网膜上、下、鼻侧和颞侧象限的视网膜厚度显著增加（P＜0.05）。所有术后时间点的FAZ面积均减小（P＜0.001）。术后3个月时，黄斑上、下和鼻侧区域视网膜浅层和深层的血流密度显著降低（P＜0.05）。术后1个月时，视盘颞侧旁区域的RNFL厚度及血流密度显著降低（分别为P = 0.001和P＜0.05）。高度近视眼ICL植入术导致中心凹旁视网膜上、下、鼻侧和颞侧区域的视网膜厚度增加；视盘颞侧区域RNFL厚度降低；FAZ面积减小；部分视网膜浅层和深层以及视盘颞侧旁区域的血流密度降低。
