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光学相干断层扫描血管造影显示角膜塑形镜佩戴后近视青少年黄斑区微血管变化。

Optical coherence tomography angiography reveals macular microvascular changes in myopic adolescents following orthokeratology lens wear.

机构信息

Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

出版信息

Eur J Ophthalmol. 2024 Sep;34(5):1299-1307. doi: 10.1177/11206721241260456. Epub 2024 Jun 11.

Abstract

BACKGROUND

This study aimed to investigate the 6-month effects of wearing orthokeratology (OK) lenses on the retina vessel density (VD), vessel diameter index (VDI), and foveal avascular zone (FAZ) of myopia children using optical coherence tomography angiography, and to further investigate the underlying mechanisms of Orthokeratology in myopia control.

METHODS

Sixty-two eyes form 62 subjects were included in the study. Baseline and 6-month measurements of axial length (AL), anterior chamber depth (ACD), FAZ area, FAZ perimeter, FAZ circularity, vessel density (VD) and VDI from both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were obtained.

RESULTS

The mean age of the participants was 11.02 years (range: 8 years to 15 years), with 41.9% males and 58.1% females. Six months after orthokeratology, ACD decreased significantly, and AL remain unchanged. SCP-VD and DCP-VD significantly increased after treatment without obvious change of VDI, and FAZ parameters remained unchanged. During follow-up period, SCP-VD increased in all subgroups especially in mild myopia group, and DCP-VD increased significantly in all subgroups except for the group 8-10 years.

CONCLUSION

After the 6-month treatment of orthokeratology in myopia children, the macular microvasculature changed significantly. We observed a significant increase of vessel densities in both SCP and DCP without obvious effect on vascular morphology. The changes of DCP-VD tended to be more sensitive in the elder subgroup, and the efficacy of orthokeratology might be greater in mild myopia group. OCT-A may provide additional information on myopia progression and the mechanisms of controlling myopia with OK lens treatment.

摘要

背景

本研究旨在使用光相干断层扫描血管造影术(OCT-A)研究角膜塑形术(OK)镜片对近视儿童视网膜血管密度(VD)、血管直径指数(VDI)和中心凹无血管区(FAZ)的 6 个月影响,并进一步探讨角膜塑形术控制近视的潜在机制。

方法

该研究纳入了 62 名(62 只眼)受试者。测量了基线和 6 个月时的眼轴长度(AL)、前房深度(ACD)、FAZ 面积、FAZ 周长、FAZ 圆度、浅层毛细血管丛(SCP)和深层毛细血管丛(DCP)的血管密度(VD)和 VDI。

结果

参与者的平均年龄为 11.02 岁(范围:8 岁至 15 岁),其中男性占 41.9%,女性占 58.1%。角膜塑形治疗 6 个月后,ACD 显著下降,而 AL 保持不变。治疗后 SCP-VD 和 DCP-VD 显著增加,而 VDI 无明显变化,FAZ 参数保持不变。在随访期间,所有亚组的 SCP-VD 均增加,尤其是轻度近视组,除 8-10 岁组外,所有亚组的 DCP-VD 均显著增加。

结论

在近视儿童角膜塑形治疗的 6 个月后,黄斑微血管发生了显著变化。我们观察到 SCP 和 DCP 的血管密度均显著增加,而血管形态无明显变化。DCP-VD 的变化在年龄较大的亚组中更为敏感,角膜塑形术在轻度近视组中的疗效可能更大。OCT-A 可能为近视进展和 OK 镜治疗控制近视的机制提供额外信息。

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