Discipline of Optometry, University of KwaZulu-Natal, Durban, South Africa.
Ophthalmic Physiol Opt. 2024 Nov;44(7):1453-1463. doi: 10.1111/opo.13385. Epub 2024 Aug 27.
The aim of this study was to investigate the association between macula thickness and vessel density in African myopic and emmetropic eyes through the use of Spectral Domain Optical Coherence Tomography (OCT).
The study population comprised African adults aged 18-35 years old. The study was conducted at a University eye clinic located in Durban, South Africa. Purposive sampling was utilised to obtain 59 participants of whom 24 were myopes and 35 were emmetropes. Vessel density (VD), foveal avascular zone (FAZ) and retinal thickness (RT) were obtained using the Heidelberg Spectralis OCT with angiography. Thereafter, a multivariate linear regression was used to investigate associations between the spherical equivalent myopic refractive error and VD, FAZ and RT for the myopic group only.
Myopic participants had a mean spherical equivalent (MSE) and standard deviation (SD) of -4.79 D (1.27) while the emmetropic group had an MSE (SD) of -0.32 D (0.46). Both superficial and deep VD were significantly decreased at the central fovea (radius (r) = 0.4 mm), peri-foveal (r = 1.10-1.45 mm) and para-foveal (r = 0.75-1.10 mm) sectors in myopes when compared with emmetropes. Myopes showed a significant reduction in RT in the inner retinal layer across the inferior and temporal zones of the peri-foveal region as well as the inferior and temporal zones of the para-foveal region when compared with emmetropes. A significantly smaller FAZ was found at both the superficial and deep vascular plexuses (p < 0.001). In African myopes, significant associations were not found between MSE and VD or FAZ and macula retinal thickness.
Retinal vascular and thickness reduction may occur in young African adults with moderate myopia. A broad-based study targeting VD and IRT in African myopes is proposed to confirm preclinical myopic macula disruptions in adults of African ethnicity. OCT angiography should be considered when monitoring progressive myopia.
本研究旨在通过使用频域光相干断层扫描（OCT）来研究非洲近视和正视眼中黄斑厚度与血管密度之间的关系。
研究人群包括年龄在 18-35 岁之间的非洲成年人。该研究在南非德班的一所大学眼科诊所进行。采用目的抽样法获得 59 名参与者，其中 24 名为近视者，35 名为正视者。使用海德堡 Spectralis OCT 血管造影仪获取血管密度（VD）、中心无血管区（FAZ）和视网膜厚度（RT）。然后，仅对近视组进行多元线性回归分析，以研究等效球镜近视屈光不正与 VD、FAZ 和 RT 之间的关系。
近视组的平均等效球镜（MSE）和标准差（SD）为-4.79 D（1.27），而正视组的 MSE（SD）为-0.32 D（0.46）。与正视者相比，近视者的中央凹（r=0.4 mm）、旁中心凹（r=1.10-1.45 mm）和旁中心凹（r=0.75-1.10 mm）的浅层和深层 VD 均显著降低。与正视者相比，近视者在内视网膜层中，在旁中心凹区域的下侧和颞侧以及旁中心凹区域的下侧和颞侧的 RT 显著降低。在浅层和深层血管丛中，FAZ 明显较小（p<0.001）。在非洲近视者中，MSE 与 VD 或 FAZ 与黄斑视网膜厚度之间未发现显著相关性。
在患有中度近视的年轻非洲成年人中，可能会出现视网膜血管和厚度减少。建议对非洲近视者进行广泛的 VD 和 IRT 研究，以确认非洲裔成年人的近视性黄斑病变处于临床前阶段。在监测进展性近视时，应考虑 OCT 血管造影。
