Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Ophthalmic Physiol Opt. 2024 Jul;44(5):987-999. doi: 10.1111/opo.13314. Epub 2024 Apr 29.
The aim of this study was to investigate the microcirculatory characteristics of the dome-shaped macula (DSM), its complications in highly myopic eyes and to explore the factors associated with a DSM.
This cross-sectional case-control study included a total of 98 subjects (98 eyes): 49 eyes with DSM and 49 eyes without DSM. The axial length (AL) of the myopic eyes was matched 1:1 to eliminate the effect of AL differences on the results. Choroidal (CT) and scleral thickness (ST) and other structural parameters were assessed by swept-source optical coherence tomography (SS-OCT). OCT angiography was used to measure microcirculatory parameters in highly myopic eyes.
Subjects with DSM had thinner subfoveal choroidal thickness (46.01 ± 13.25 vs. 81.62 ± 48.26 μm; p < 0.001), thicker subfoveal scleral thickness (SFST; 331.93 ± 79.87 vs. 238.74 ± 70.96 μm; p < 0.001) and thinner foveal CT (66.86 ± 24.65 vs. 107.85 ± 52.65 μm; p < 0.001) compared to subjects without DSM. The foveal choroidal perfusion area (0.72 ± 0.04 vs. 0.76 ± 0.04 mm; p < 0.001) and foveal choroidal vascularity index (0.15 ± 0.04 vs. 0.33 ± 0.14; p < 0.001) were significantly lower in eyes with DSM. Retinoschisis (81.6% vs. 38.8%; p < 0.001) was more common in eyes with DSM. Eyes with horizontal DSM had worse best-corrected logMAR visual acuity than eyes with round DSM (0.34 ± 0.22 vs. 0.23 ± 0.22; p = 0.03). DSM height (98.95 ± 65.17 vs. 104.63 ± 44.62 μm; p = 0.05) was lower in the horizontal DSM. SFST (OR = 1.06, p = 0.04) and foveal choroidal vascularity index (OR = 0.711, p = 0.02) were significantly associated with DSM. DSM width (p < 0.001), foveal choroidal perfusion area (p = 0.01), foveal choriocapillaris perfusion area (p = 0.02) and parafoveal choroidal vascularity index (p = 0.03) were the most significantly associated factors with DSM height.
The microcirculatory characteristics of eyes with DSM differed from those without DSM. Microcirculatory abnormalities were significantly associated with a DSM. The height of the DSM was associated with decreased blood perfusion.
本研究旨在探讨穹顶形黄斑（DSM）的微循环特征、高度近视眼中的并发症，并探讨与 DSM 相关的因素。
本横断面病例对照研究共纳入 98 例患者（98 只眼）：49 只眼有 DSM，49 只眼无 DSM。通过扫频源光学相干断层扫描（SS-OCT）评估脉络膜（CT）和巩膜厚度（ST）等结构参数。采用 OCT 血管造影术测量高度近视眼中的微循环参数。
与无 DSM 的患者相比，有 DSM 的患者的黄斑下脉络膜厚度更薄（46.01±13.25μm 比 81.62±48.26μm；p<0.001），黄斑下巩膜厚度更厚（SFST；331.93±79.87μm 比 238.74±70.96μm；p<0.001），黄斑下 CT 更薄（66.86±24.65μm 比 107.85±52.65μm；p<0.001）。与无 DSM 的患者相比，有 DSM 的患者的黄斑下脉络膜灌注面积更小（0.72±0.04mm 比 0.76±0.04mm；p<0.001），黄斑下脉络膜血管指数更低（0.15±0.04 比 0.33±0.14；p<0.001）。DSM 中更常见视网膜劈裂（81.6%比 38.8%；p<0.001）。水平型 DSM 的最佳矫正视力 logMAR 比圆形 DSM 差（0.34±0.22 比 0.23±0.22；p=0.03）。水平型 DSM 的 DSM 高度（98.95±65.17μm 比 104.63±44.62μm；p=0.05）较低。SFST（OR=1.06，p=0.04）和黄斑下脉络膜血管指数（OR=0.711，p=0.02）与 DSM 显著相关。DSM 宽度（p<0.001）、黄斑下脉络膜灌注面积（p=0.01）、黄斑下脉络膜毛细血管灌注面积（p=0.02）和旁黄斑脉络膜血管指数（p=0.03）是与 DSM 高度最显著相关的因素。
DSM 眼的微循环特征与无 DSM 眼不同。微循环异常与 DSM 显著相关。DSM 的高度与血液灌注减少有关。
