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学龄期儿童黄斑区视网膜血流密度和厚度分析

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目的 观察并分析学龄期儿童黄斑区视网膜毛细血管血流密度和视网膜厚度与屈光度的相关性。方法 横断面研究。2022年5~12月于郑州大学第一附属医院眼科就诊的学龄期儿童182名纳入研究。其中,男性95名,女性87名;年龄6~12岁;等效球镜度(SE)+0。50~-6。00 D。根据右眼SE将受检者分为正视眼组(+0。50≤SE<-0。50D)、低度近视眼组(-0。50≤SE<-3。00D)、中度近视眼组(-3。00≤SE≤-6。00D),分别为54、71、57例。采用扫频源光相干断层扫描血管成像仪对右眼黄斑区6mm×6mm范围进行扫描。软件自动将黄斑中心凹6mm范围内视网膜划分为以黄斑中心凹为中心的3个同心圆,分别为直径1 mm的中心凹区、1~3mm的内环区、3~6mm的外环区。测量黄斑区6 mm范围内不同分区视网膜浅层毛细血管丛(SVP)、深层毛细血管丛(DVP)血流密度和视网膜厚度。单因素线性回归、多重线性回归、平滑曲线拟合、阈值效应分析黄斑不同分区SVP、DVP、视网膜厚度与屈光度的相关性。结果 正视眼组、低度近视眼组、中度近视眼组受检眼中心凹区、内环区、外环区SVP(F=6。64、26。06、22。69)、DVP(F=7。97、25。01、5。09)血流密度比较,差异有统计学意义(P<0。05)。单因素线性回归分析结果显示,中心凹区、内环区、外环区SVP(β=-0。56、-1。17、-0。79)、DVP(β=-1。03、-0。93、-0。45)血流密度均与SE呈正相关(P<0。05)。平滑曲线拟合、阈值效应、多重线性回归分析结果显示,中心凹区SVP、DVP血流密度与SE呈线性正相关(β=-0。91、-1。40,P<0。05);内环区、外环区SVP、DVP血流密度与SE为存在拐点(<3。00 D)的倒U型曲线关系。SE<-3。00D时,内环区、外环区SVP、DVP血流密度均与SE呈正相关(P<0。05);SE>-3。00D时,除内环区DVP血流密度外,其余均与SE呈负相关(P<0。05)。正视眼组、低度近视眼组、中度近视眼组受检眼内环区、外环区视网膜厚度比较,差异均有统计学意义(F=5。47、16。36,P<0。05);中心凹区视网膜厚度比较,差异无统计学意义(F=2。16,P>0。05)。单因素线性回归、多重线性回归分析结果显示,内环区、外环区视网膜厚度与SE呈负相关(β=1。99、3。05,P<0。05);中心凹区视网膜厚度与SE无相关性(β=-1。65,P>0。05)。结论 屈光度+0。50~-6。00 D的学龄期儿童,随屈光度增加,黄斑中心凹区视网膜毛细血管血流密度逐渐升高,内环区、外环区先升高后降低;内环区、外环区视网膜厚度逐渐降低,中心凹区视网膜厚度未发生显著变化。
Analysis of macular vascular density and retinal thickness of school-age children
Objective To observe the correlation between retinal capillary density and retinal thickness in the macula and spherical equivalent(SE)in school-age children.Methods A cross-sectional study.From May to December 2022,182 school-age children who visited the ophthalmology department of the First Affiliated Hospital of Zhengzhou University were included.There were 95 males and 87 females.The age ranged from 6 to 12 years,and the spherical equivalent(SE)was+0.50 to-6.00 D.They were divided into three groups based on the SE of the right eyes:54 eyes in emmetropia group(+0.50≤ SE<-0.50 D),71 eyes in low myopia group(-0.50≤SE<-3.00 D),and 57 eyes in moderate myopia group(-3.00≤ SE≤-6.00 D).The macular area of 6 mm X 6 mm was scanned using swept-source optical coherence tomography angiography and was divided into three concentric rings centered on the fovea,including the macular central fovea(0-1 mm diameter),inner ring(1-3 mm diameter)and outer ring(3-6 mm diameter).The retinal thickness and blood flow density of superficial vascular plexus(SVP)and deep vascular plexus(DVP)in different zones within 6 mm of the macular area were measured.The relationships between SE and SVP,DVP and retinal thickness in each ring region were investigated by univariate and multivariate linear regression analyses,smooth curve fitting,and threshold effects.Results There were significant differences in the SVP(F=6.64,26.06,22.69)and DVP(F=7.97,25.01,5.09)of macular central fovea,inner ring and outer ring among the emmetropia,low myopia and moderate myopia groups(P<0.05).Univariate linear regression analysis showed that the SVP(β=-0.56,-1.17,-0.79)and DVP(β=-1.03,-0.93,-0.45)of the three regions were positively correlated with SE(P<0.05).After smooth curve fitting,threshold effect analysis and multivariate linear regression analysis,the SVP and DVP in the macular central fovea were linearly positively correlated with SE(β=-0.91,-1.40;P<0.05),and SVP and DVP in the inner ring and outer ring showed an inverted U-shaped curve relationship with SE with the inflection(<3.00 D).When the SE was less than<3.00 D,the SVP and DVP in the inner ring and outer ring were positively correlated with SE(P<0.05).When the SE was higher than-3.00 D,except for the DVP in the inner ring region,the other parameters were negatively correlated with SE(P<0.05).There were significant differences in retinal thickness of the inner ring and outer ring(F=5.47,16.36;P<0.05),and no significant difference in the macular central fovea among the emmetropia,low and moderate myopia groups(F=2.16,P>0.05).By using univariate and multivariate linear regression analyses,the retinal thickness in the inner ring and outer ring were negatively correlated with SE(β=1.99,3.05;P<0.05).However,no correlation was found between retinal thickness and SE in the macular central fovea(β=-1.65,P>0.05).Conclusions In school-age children with SE between+0.50 D and-6.00 D,the retinal capillaries density of the macular central fovea gradually increase,and increase first and then decrease in the inner ring and outer ring with increasing SE.The retinal thickness of inner ring and outer ring gradually decrease and not change significantly in the macular central fovea.

Swept-source optical coherence tomography angiographyChildMacular vascular densityRetinal thickness

高莎莎、尚丽丽、符爱存、常铭航、贺音、王铭、金学民、雷博、张凤妍

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郑州大学第一附属医院眼科,郑州 450000

河南省眼科研究所河南省立眼科医院,郑州 450003

扫频源光相干断层扫描血管成像 儿童 黄斑区血管密度 视网膜厚度

河南省科技厅青年基金项目

232300421279

2024

中华眼底病杂志
中华医学会

中华眼底病杂志

CSTPCD北大核心
影响因子:0.928
ISSN:1005-1015
年,卷(期):2024.40(1)
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