Song Dongjie, Han Yutong, Zhang Zongchan, Ge Jiayun, Chen Kuangqi, Tong Jianping, Shen Ye
Department of Ophthalmology, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China, 322000.
Department of Ophthalmology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Int J Med Sci. 2025 Jun 20;22(12):3032-3043. doi: 10.7150/ijms.113035. eCollection 2025.
High myopia (HM) is a leading cause of visual impairment worldwide and the choroid plays a key role in HM progression. Intraocular pressure (IOP) may also be involved in HM development, while the relationship between IOP and choroidal microcirculation in HM patients remains poorly characterized. To investigate the correlation between IOP and choroidal microcirculation in HM individuals using swept-source optical coherence tomography angiography (SS-OCTA). This cross-sectional observational study enrolled 118 eyes of 118 participants aged 18-30, comprising 64 HM eyes (axial lengths (AL) ≥ 26mm) and 54 mild-to-moderate myopic (MM) eyes (AL < 26 mm). Data on spherical equivalent (SE), AL and central corneal thickness (CCT) were collected. IOP was measured using a non-contact tonometer (NCT) and corrected with a formula to minimize the effect of CCT. Based on ETDRS classification, choroidal thickness (ChT) and vascular parameters including choriocapillaris layer vessel density (ChCVD), choroidal vascular index (CVI), choroidal vascular volume (CVV), choroidal stromal volume (CSV) and choroidal stromal density (CSI) were calculated from SS-OCTA. In this cohort, HM eyes exhibited higher corrected IOP ( < 0.05) and lower ChT, CVV and CSV across all grids compared to MM eyes ( 0.001). Increased CSI and decreased CVI were also observed in most sectors of the HM eyes ( < 0.05). After adjusting for age, gender and AL, corrected IOP was correlated with SE, ChT, CVI and CSI in the subfoveal central and inner nasal grids among HM patients ( < 0.05). No significant correlation was found between AL and corrected IOP ( > 0.05). In our population, compared to MM eyes, HM eyes showed higher IOP levels, which were negatively correlated with SE but not AL. Additionally, elevated IOP was observed to be associated with reduced choroidal thickness and vascularity in specific macular regions. The potential link between IOP and choroidal microcirculation may be involved in HM progression.
高度近视（HM）是全球视力损害的主要原因，脉络膜在高度近视进展中起关键作用。眼压（IOP）也可能参与高度近视的发展，而高度近视患者眼压与脉络膜微循环之间的关系仍未得到充分描述。本研究旨在使用扫频光学相干断层扫描血管造影（SS-OCTA）研究高度近视个体眼压与脉络膜微循环之间的相关性。这项横断面观察性研究纳入了118名年龄在18至30岁之间参与者的118只眼睛，其中包括64只高度近视眼睛（眼轴长度（AL）≥26mm）和54只轻度至中度近视（MM）眼睛（AL<26mm）。收集了等效球镜度（SE）、眼轴长度和中央角膜厚度（CCT）的数据。使用非接触眼压计（NCT）测量眼压，并用公式进行校正以最小化中央角膜厚度的影响。根据ETDRS分类，从SS-OCTA计算脉络膜厚度（ChT）和包括脉络膜毛细血管层血管密度（ChCVD）、脉络膜血管指数（CVI）、脉络膜血管体积（CVV）、脉络膜基质体积（CSV）和脉络膜基质密度（CSI）在内的血管参数。在该队列中，与MM眼睛相比，高度近视眼睛在所有网格中均表现出更高的校正眼压（<0.05）以及更低的脉络膜厚度、脉络膜血管体积和脉络膜基质体积（<0.001）。在高度近视眼睛的大多数区域也观察到脉络膜基质密度增加和脉络膜血管指数降低（<0.05）。在调整年龄、性别和眼轴长度后，高度近视患者黄斑中心凹下方和鼻侧内侧网格中的校正眼压与等效球镜度、脉络膜厚度、脉络膜血管指数和脉络膜基质密度相关（<0.05）。未发现眼轴长度与校正眼压之间存在显著相关性（>0.05）。在我们的研究人群中，与MM眼睛相比，高度近视眼睛显示出更高的眼压水平，其与等效球镜度呈负相关，但与眼轴长度无关。此外，观察到眼压升高与特定黄斑区域的脉络膜厚度和血管化减少有关。眼压与脉络膜微循环之间的潜在联系可能参与了高度近视的进展。
