Jiang Siyu, Liu Xianjie, Li Yongshan, Jia Wenli, Du Xinying, Sheng Xue, Chen Yutong, Ma Xiaoli
Department of Ophthalmology, The First Hospital of China Medical University, Shenyang, China.
Quant Imaging Med Surg. 2024 Dec 5;14(12):8614-8628. doi: 10.21037/qims-24-829. Epub 2024 Nov 11.
The eyeball axial length (AL) is an important biological indicator of myopia, which has been widely studied. However, little research has been conducted on the relationship between eye shape and fundus structural changes in myopia. This study aimed to analyze the relationship between the shape of the posterior pole of the eye, and choroidal characteristics by comparing with the relationship between AL and choroidal characteristics. And to investigate the clinical significance of the shape of the posterior pole in the pathophysiological changes related to myopia.
In this study, the data of 147 eyes (22 emmetropic and 125 myopic) of participants aged 20-30 years, examined in 2021, were collected. Optical coherence tomography (OCT) was used to analyze the posterior-pole images, choroidal thickness (ChT), choroidal vascular volume (CVV), and three-dimensional choroidal vascular index (3DCVI). The least squares method was used to fit the ellipse that was most consistent with the actual shape of the posterior pole. Multiple stepwise regression analysis was used to investigate the relationships between the fitting posterior-pole vertex curvature (fPVC), and ChT, CVV, and 3DCVI.
The mean AL of the participants was 25.15±1.35 mm (22.30-27.92 mm), the mean spherical equivalent was -3.59±2.62 D (+0.5 to -11.75 D), and the mean fPVC was 0.158±0.036 mm-1. The fPVC was positively correlated with the AL (r=0.639, P<0.001)and negatively correlated with the spherical equivalent (r=-0.666, P<0.001). The AL and fPVC were independently negatively correlated with the ChT and CVV in the macular region (0-6 mm). In the peripheral area (6-9 mm), the fPVC (ChT: β=-0.529, P<0.001; CVV: β=-0.441, P<0.001) was more closely associated with the ChT and CVV than the AL (ChT: β=-0.140, P=0.127; CVV: β=-0.127, P=0.190). The 3DCVI may be nonlinearly correlated with the AL and fPVC, and the relationship curve between the fPVC and 3DCVI was clearer than that between the AL and 3DCVI.
In addition to the AL, the shape of the posterior pole is related to the ChT and choroidal vascular changes, and more closely related to the peripheral choroid than AL. Our findings provide another perspective for the prevention and monitoring of myopic-related pathological changes in clinical practice.
眼轴长度（AL）是近视的一项重要生物学指标，已得到广泛研究。然而，关于近视患者眼形与眼底结构变化之间的关系，相关研究较少。本研究旨在通过比较AL与脉络膜特征之间的关系，分析眼后极部形状与脉络膜特征之间的关系。并探讨眼后极部形状在近视相关病理生理变化中的临床意义。
本研究收集了2021年检查的147只眼（22只正视眼和125只近视眼）的20 - 30岁参与者的数据。采用光学相干断层扫描（OCT）分析眼后极部图像、脉络膜厚度（ChT）、脉络膜血管容积（CVV）和三维脉络膜血管指数（3DCVI）。使用最小二乘法拟合与眼后极部实际形状最相符的椭圆。采用多元逐步回归分析研究拟合的眼后极部顶点曲率（fPVC）与ChT、CVV和3DCVI之间的关系。
参与者的平均AL为25.15±1.35mm（22.30 - 27.92mm），平均等效球镜度为 - 3.59±2.62D（+0.5至 - 11.75D），平均fPVC为0.158±0.036mm⁻¹。fPVC与AL呈正相关（r = 0.639，P < 0.001），与等效球镜度呈负相关（r = - 0.666，P < 0.001）。AL和fPVC在黄斑区（0 - 6mm）与ChT和CVV独立呈负相关。在周边区域（6 - 9mm），fPVC（ChT：β = - 0.529，P < 0.001；CVV：β = - 0.441，P < 0.001）与ChT和CVV的相关性比AL（ChT：β = - 0.140，P = 0.127；CVV：β = - 0.127，P = 0.190）更密切。3DCVI可能与AL和fPVC呈非线性相关，且fPVC与3DCVI之间的关系曲线比AL与3DCVI之间的更清晰。
除AL外，眼后极部形状与ChT及脉络膜血管变化有关，且与周边脉络膜的关系比AL更密切。我们的研究结果为临床实践中近视相关病理变化的预防和监测提供了另一个视角。
