利用SS-OCTA分析不同屈光状态下儿童脉络膜厚度变化

Analysis of Choroidal Thickness Changes in Children Exposed to Different Refractive States Using SS-OCTA

摘要: 目的：应用扫频源光学相干断层扫描血管成像(SS-OCTA)观察不同屈光状态下儿童的脉络膜厚度变化。方法：59例(118只眼) 6~13岁的儿童受试者作为研究对象，分为远视组、正视组和近视组。分别测量受试者的眼部参数包括屈光度(等效球镜，SE)、眼轴长度(AL)、和黄斑区下脉络膜厚度(CT)、黄斑区中心凹下脉络膜厚度(SFCT)。CT是使用ETDRS网格自动生成的以黄斑中心凹为中心的9个区域的区域下脉络膜厚度，SFCT是黄斑区中心凹下点的脉络膜厚度。结果：远视、正视和近视组三组受试者屈光度对比，差异有统计学意义(P < 0.001)。受试者的屈光度从远视向近视方向发展时眼轴变长，三组间眼轴对比差异有统计学意义(P < 0.001)。三组脉络膜厚度有显著差异，近视组脉络膜厚度最薄，正视次之，远视组最厚(P < 0.001)。各组ETDRS网格中脉络膜厚度分布一致性良好，以黄斑中心凹为中心，内圈象限CT高于外圈象限CT，鼻象限的CT均明显比其他区域薄，颞象限的CT明显比其他区域厚。并且，三组AL与SFCT均呈负相关。结论：儿童屈光度从远视向近视方向发展时眼轴变长，黄斑中心凹及黄斑中心凹周围脉络膜厚度均随着眼轴的增长而变薄。AL与SFCT呈负相关，随访观察脉络膜厚度的变化可能在一定程度上预测近视的发展。

Abstract: Objective: Sweep-source optical coherence tomography angiography (SS-OCTA) was used to observe the choroidal thickness changes in children with different refractive conditions. Method: Fifty-nine (118 eyes) pediatric subjects aged 6~13 years were divided into hyperopic group, emmetropia group and myopia group. The ocular parameters included refraction (equivalent, SE), axial length (AL), and subchoroidal thickness (CT), and subfoveal choroidal thickness (SFCT). The CT is the regional inferior choroidal thickness of nine sectors centered on the macular fovea and automatically generated using an ETDRS grid., and the SFCT is the choroidal thickness at the subfoveal point of the macular region. Results: Significant differences were found between the three subjects of hyperopia, emmetropia and myopia groups (P < 0.001). The AL became longer as the refraction progressed from hyperopia to myopia, and the AL was significantly different between the three groups (P < 0.001). Choroidal thickness was significantly different between the three groups, with the thinnest choroidal thickness in the myopic group, followed by emmetropia, and the thickest in the hyperopia group (P < 0.001). The distribution of choroidal thickness in the ETDRS grid was consistent, centered on the macular fovea, the inner quadrant CT was higher than the outer quadrant CT, the CT in the nasal quadrant was significantly thinner than other areas, and the CT in the temporal quadrant was significantly thicker than other areas. Moreover, all three groups were negatively correlated with SFCT. Conclusions: In children, the refraction develops from hyperopia to myopia, and both the macular fovea and the perifoveal choroidal thickness are thinner with the growth of the eye axis. AL is inversely associated with SFCT, and follow-up observation of changes in choroidal thickness may predict the development of myopia to some extent.