Department of Ophthalmology, Hunan Children's Hospital, Changsha, China.
College of Pharmacy, Changsha Medical University, Changsha, China.
Semin Ophthalmol. 2023 Aug;38(6):584-591. doi: 10.1080/08820538.2023.2169581. Epub 2023 Jan 19.
To explore the retinal microvasculature of the optic nerve head and macula and their associations with the optic nerve head deformation in high myopia.
One hundred sixty-seven eyes from patients with high myopia (HM) were enrolled in a cross-sectional study. We have evaluated and measured characteristics like the tilt ratio of the optic disc, interpupillary vascular density (IVD), peripapillary vascular density (PVD), macular vascular density (MVD), subfoveal choroidal thickness (SFCT) and foveal avascular zone (FAZ). The subjects were classified as a non-tilt group (control group) and a tilt group based on the tilt index. The above parameters were utilized to compare the two groups. In addition, we collected the data from the subjects' right eyes to analyze variance, the Kruskal-Wallis test, and the least significant difference.
The patients were divided into the non-tilt group of ninety-one eyes and the tilt group of seventy-six eyes. We found that the IVD in the tilt group was more significant than in the non-tilt group (t = -2.794, = .006). On the other hand, the PVD was less in the tilt group than in the non-tilt, especially in the NS, NI and IN directions (t = 3.782; t = 3.07; t = 2.086; < .05). Interestingly, the values of PVD were the highest in temporal, second in superior and inferior and lowest in nasal. Concerning the fovea-DMVD (including fovea, parafovea and perifovea), we characterized them as more minor in the tilt group when compared to those in the non-tilt group ( < .05).
Herein, we discovered that the retinal microvasculature differed significantly in patients with HM according to the ONH morphology. In this population, lower PVD and thinner SFCT were associated with higher odds of the tilted optic disc. In addition, the other two characteristics, the IVD and DMVD, were affected by the ONH deformation. Finally, we showed that PVD demonstrated better predictability of rapid myopic progression than MVD.
探讨高度近视患者视神经头和黄斑区视网膜微血管及其与视神经头变形的关系。
本横断面研究纳入了 167 只高度近视（HM）患者的眼睛。我们评估和测量了视盘倾斜比、瞳孔间血管密度（IVD）、视盘周围血管密度（PVD）、黄斑血管密度（MVD）、中心凹下脉络膜厚度（SFCT）和中心凹无血管区（FAZ）等特征。根据倾斜指数，将受试者分为非倾斜组（对照组）和倾斜组。利用上述参数比较两组。此外，我们还收集了右眼的数据进行方差分析、Kruskal-Wallis 检验和最小显著差异检验。
患者被分为 91 只非倾斜眼和 76 只倾斜眼。我们发现，倾斜组的 IVD 比非倾斜组更显著（t = -2.794， =.006）。另一方面，倾斜组的 PVD 比非倾斜组少，尤其是在 NS、NI 和 IN 方向（t = 3.782；t = 3.07；t = 2.086； <.05）。有趣的是，PVD 值在颞侧最高，其次是上侧和下侧，鼻侧最低。至于黄斑区-DMVD（包括黄斑中心凹、旁中心凹和中心凹周围），我们发现倾斜组的 DMVD 值明显低于非倾斜组（ <.05）。
在此，我们发现 HM 患者的 ONH 形态不同，视网膜微血管也有显著差异。在该人群中，较低的 PVD 和较薄的 SFCT 与倾斜视盘的发生几率较高相关。此外，其他两个特征，即 IVD 和 DMVD，也受到 ONH 变形的影响。最后，我们表明 PVD 比 MVD 更能预测近视的快速进展。
