Park James, Snow Zachary, Zhou Henry W, Karani Rabia, Diaconita Vlad, Oh Daniel, Inam Onur, Tezel Tongalp H
Department of Ophthalmology, Edward S. Harkness Eye Institute, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA.
Department of Ophthalmology, University of Miami Health System, Bascom Palmer Eye Institute, Miami, FL, USA.
Transl Vis Sci Technol. 2025 Aug 1;14(8):39. doi: 10.1167/tvst.14.8.39.
To investigate adaptive changes in retinal and choroidal vasculature with increasing retinal surface area in myopia.
Widefield optical coherence tomography angiography and enhanced depth imaging (EDI)-OCT images of the retina were used to acquire digital images of the choroidal and retinal vasculature in 32 eyes with axial myopia and 14 emmetropic control population eyes. Retinal vessel density was calculated using Otsu's method and used for quantitative comparison of retinal vascular architecture and perfusion ability with increasing retinal surface area. The choroidal vascularity index was also calculated from skeletonized 15 × 9 mm swept-source EDI-OCT images. Correlations were sought between increasing myopia and the retinal vessel density and choroidal vascularity index.
Increased axial myopia was negatively correlated with retinal vessel density (r2 = 0.35, P < 0.001) and positively correlated with choroidal vascularity index (r2 = 0.31, P < 0.001).
Increased retinal surface area in myopia results in decreased retinal vascular surface coverage. The inadequacy of retinal vascular coverage is compensated for by increased choroidal vascularity index in high myopes. This adaptive change may enable oxygen diffusion from choroidal vessels to the relatively thinner retina, thereby supplementing the oxygen needs of the inner retinal neurons.
Adaptive changes in the choroidal vessels to supply more oxygen to the inner retina can explain why myopic patients exhibit a decreased risk of diabetic retinopathy and its vision-threatening complications despite being vulnerable due to inadequate retinal vascular coverage.
研究近视患者视网膜和脉络膜血管系统随视网膜表面积增加的适应性变化。
使用超广角光学相干断层扫描血管造影和视网膜增强深度成像（EDI）-OCT图像，获取32只轴性近视眼睛和14只正视对照人群眼睛的脉络膜和视网膜血管数字图像。采用大津法计算视网膜血管密度，并用于定量比较视网膜血管结构和灌注能力随视网膜表面积增加的变化。还从15×9mm扫频源EDI-OCT图像的骨架化图像中计算脉络膜血管指数。研究近视程度增加与视网膜血管密度和脉络膜血管指数之间的相关性。
轴性近视增加与视网膜血管密度呈负相关（r2 = 0.35，P < 0.001），与脉络膜血管指数呈正相关（r2 = 0.31，P < 0.001）。
近视患者视网膜表面积增加导致视网膜血管表面覆盖减少。高度近视患者视网膜血管覆盖不足通过脉络膜血管指数增加得到补偿。这种适应性变化可能使氧气从脉络膜血管扩散到相对较薄的视网膜，从而补充视网膜内层神经元的氧气需求。
脉络膜血管的适应性变化为视网膜内层提供更多氧气，可以解释为什么近视患者尽管因视网膜血管覆盖不足而易患疾病，但患糖尿病性视网膜病变及其威胁视力的并发症的风险却降低。
