近视人群盘周放射状毛细血管网血流与视网膜神经纤维层厚 度的相关性研究.

Objective: The current study aims to analyze the correlation between retinal nerve fiber layer (RNFL) thickness, choroidal microcirculation and radial peripapillary capillary (RPC) in myopes based on a new quantitative method. Methods: Between April 2019 and January 2020, 100 eyes with high myopia (HM group) and 82 eyes with low ⁃to ⁃moderate myopia (LMM group) were enrolled in the First Affiliated Hospital of Nanjing Medical University. All subjects underwent measurements of the best corrected visual acuity (BCVA), intraocular pressure, axial length (AL)and spherical equivalent (SE) before anterior segment examination via slip⁃lamp biomicroscopy, dilated fundus examination, color and red⁃free fundus photographs and optical coherence tomography angiography (OCTA). A 4.5 mm × 4.5 mm scanning area centered on the optic disc was scanned using a frequency domain OCTA instrument, which was divided into four quadrants centered on the optic disc by the software automatically. On the scanning laser ophthalmoscope (SLO) and choroidal vasculature images, one ophthalmologist contoured the peripapillary atrophy⁃β (PPA ⁃β)zones under the supervision of another veteran ophthalmologist before calculating the area and choroidal vessel density of PPA⁃β zone using PyCharm software. The correlation between AL, SE, the area and vessel density of PPA⁃β zone, peripapillary RNFL thickness and RPC vessel density was analyzed by Spearman correlation analysis and multivariate linear regression model. Results: The average RNFL thickness, RNFL thickness of nasal, superior and inferior, and RPC vessel density, as well as the area and choroidal vessel density of PPA⁃β zone was statistically significant between HM and LMM groups (P<0.05). SE, average peripapillary RNFL thickness and the choroidal vessel density of PPA⁃β zone were positively correlated with the average blood flow density of RPC (P<0.001), while AL and the area of PPA ⁃β zone were negatively correlated with RPC vessel density (P<0.001). The multivariable model revealed that only average RNFL thickness (P<0.001) and the area of PPA⁃β zone (P=0.014) were associated with average RPC vessel density. The results of Spearman correlation analysis for four quadrantile subgroups indicated that RNFL thickness remained positively correlated with RPC vessel density (P<0.001). Conclusion: Peripapillary RNFL thickness and the area of PPA⁃β zone were two crucial causes of RPC vessel density changes, which may indicate the close relationship between retinal constructure and microvascular changes and emphasize the importance of myopia⁃related optic neuropathy. [ABSTRACT FROM AUTHOR]