摘要
目的通过相干光层析血管成像术(OCTA)观察不同程度近视人群在长时间(>30 min)近距离(<30 cm)学习前后视网膜微循环血流的变化情况。方法横断面病例对照研究。于2021年8月至2022年4月随机选取在本院实习的240名仅佩戴框架眼镜(SE)的医学生纳入研究,根据等效球镜(SE)的不同分为三组,其中低度近视组79例(-0.5 D~-3 D),中度近视组85例(>-3 D~-6 D),高度近视76例(>-6 D)。在充分休息后即学习前、长时间(>30 min)近距离(<30 cm)学习后以及极目远眺15 min 3个时间点通过相干光层析血流成像术(OCTA)对受试者进行扫描,3次取其平均数,获取视网膜中心凹无血管区(FAZ)面积、周长(PERIM)、眼轴/血流空白区域面积(AL/FD)、视网膜外层及浅层毛细血管(Flow out、Flow cap)、视神经纤维层(RNFL)厚度、视盘及周围血流密度(CPVD)等参数并对其变化情况进行分析。结果低度近视组、中度近视组、高度近视组三组年龄、性别比较,差异均无统计学意义(均P>0.05)。三组受试眼黄斑区FAZ面积、PERIM比较,逐渐增加,差异均有统计学意义(H=208.7,H=197.043,均P<0.001)。三组受试眼Flow out、Flow cap、RNFL、CPVD比较,逐渐减少,差异均有统计学意义(H=173.028,H=156.773,H=174.270,H=119.571,均P<0.001);在经过长时间(>30 min)近距离(<30 cm)的学习后三组受试者与学习前相比,Flow out、Flow cap、CPVD均显著低于学习前,差异均具有统计学意义(均P<0.05)。在三组分别进行极目远眺15 min后。低度近视组和中度近视组各项指标可恢复到学习前,差异均无统计学意义(均P>0.05),高度近视组各项指标未恢复到学习前,介于学习前和学习后,差异均具有统计学意义(均P<0.05)。结论OCTA检查提示在高强度用眼后近视患者的黄斑区视网膜整体血流密度下降,在远眺休息后可以得到一定程度的恢复,可作为防控近视新思路及观察高强度用眼后近视患者视网膜微血管变化的指
Objective To observe the changes of retinal microcirculation blood flow before and after long⁃term(>30 min)short⁃distance(<30 cm)learning in people with different degrees of myopia by optical coherence tomography an⁃giography(OCTA).Methods A cross⁃sectional case⁃control study.240 medical students who only wore spectacles from August 2021 to April 2022 were randomly selected and were divided into three groups according to the difference of equiva⁃lent spherical lenses,of which 79 cases were in the low myopia group(-0.5 D~-3 D),85 cases of moderate myopia group(-3 D~-6 D),and 76 cases of high myopia group(>-6 D).The subjects were scanned by OCTA at 3 time points after sufficient rest,that is,before learning,after long⁃term(>30 min)short⁃range(<30 cm)learning,andafter 15 minutes of staring into the distance.The foveal avascular zone(FAZ),the perimeter(PERIM),the area of the eye ax⁃is/blood flow blank area(AL/FD),the outer and superficial retinal capillaries(flow out,flow cap),the thickness of the optic nerve fiber layer(RNFL),optic disc and peripheral blood flow density(CPVD)and other parameters and their changes were analyzed.Results There was no significant difference in age and gender among the three groups(P>0.05).Comparing the area and perimeter(PERIM)of the macular area of the three groups of eyes,the FAZ area gradual⁃ly increased,and the difference was statistically significant(H=208.7,H=197.043,P<0.001,P<0.001).The difference of flow out,flow cap,RNFL,and CPVD gradually decreased between the three groups of eyes(H=173.028,H=156.773,H=174.270,H=119.571,P<0.001,P<0.001,P<0.001,P<0.001).After a long(>30 min)close⁃distance(<30 cm)study,the three groups of subjects had lower flow out,flow cap,and CPVD than before the study(P<0.001,P<0.001,P<0.001).After each of the three groups performed a 15 minutes gazing from the dis⁃tance,the difference of indexes of the low myopia group and the moderate myopia group was not statistically significant(P>0.05),but the high myopia group was statistically
作者
申洁
范宇晨
代应辉
岳晓丽
Shen Jie;Fan Yuchen;Dai Yinghui;Yue Xiaoli(Department of Ophthalmol-ogy,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《临床眼科杂志》
2023年第6期481-487,共7页
Journal of Clinical Ophthalmology
基金
安徽省高校自然科学科研项目重点项目(KJ2021A0766)。
关键词
近视
相干光层析血管成像术
视网膜微循环
血流密度
Myopia
Optical coherence tomography angiography
Retinal microcirculatio
Blood flow density
