应用OCTA观察青少年近视患者配戴角膜塑形镜后眼底微循环的变化

Changes in fundus microcirculation of myopic adolescents after wearing orthokeratology observed by optical coherence tomography angiography

摘要:

目的：应用光学相干断层扫描血管成像(OCTA)观察青少年近视患者配戴角膜塑形镜后眼底微循环的变化。方法：前瞻性研究。收集2021-04/2022-06于我院就诊并选择角膜塑形镜矫正视力的中低度青少年近视患者40例40眼，分别于戴镜前、戴镜后1、3、6mo评估裸眼远视力、眼轴，并采用OCTA观察视网膜浅层血流密度(SVD)和深层血流密度(DVD)、视网膜厚度(CRT)、中心凹无血管区面积(FAZ-A)和周长(FAZ-P)、视神经纤维层(RNFL)厚度、盘周放射状毛细血管血流密度(RPCD)变化情况。结果：戴镜后1、3、6mo，纳入患者裸眼远视力较戴镜前显著改善(P<0.001)，眼轴长度无显著变化(P>0.05)。戴镜前后，纳入患者中心凹象限SVD、中心凹和下方象限DVD均有差异(P<0.01)，但CRT、FAZ-A和FAZ-P、RNFL厚度、RPCD均无差异(P>0.05)。结论：低中度青少年近视患者配戴角膜塑形镜可显著改善视力，黄斑区局部视网膜血流密度增加。

Abstract:

AIM: To observe changes in fundus microcirculation of myopic adolescents after wearing orthokeratology by applying optical coherence tomography angiography(OCTA).METHODS: Prospective study. A total of 40 cases(40 eyes)of adolescents with low to moderate myopia who chose orthokeratology to correct visual acuity at our hospital from April 2021 to June 2022 were collected. The uncorrected distant visual acuity and axial length were evaluated at 1, 3 and 6mo before and after wearing orthokeratology, respectively. Furthermore, the changes in superficial vessel density(SVD), deep vessel density(DVD), central retinal thickness(CRT), foveal avascular zone area(FAZ-A), foveal avascular zone perimeter(FAZ-P), retinal nerve fiber layer(RNFL)thickness and radial peripapillary capillaries density(RPCD)were observed by applying OCTA.RESULTS: The uncorrected distant visual acuity was significantly improved at 1, 3 and 6mo after wearing orthokeratology(P<0.001). There was no statistically significant difference in axial length before and after wearing orthokeratology(P>0.05). Moreover, there were significant differences in both SVD of fovea quadrant and DVD of fovea and lower quadrant(P<0.01), but there were no differences in CRT, FAZ-A and FAZ-P, RNFL thickness and RPCD(P>0.05).CONCLUSION: Wearing orthokeratology can significantly improve visual acuity and increase local retinal vessel density in the macula in adolescents with low to moderate myopia.