Study On The Relationship Between Choroidal Circulation And Syndrome Types Of Traditional Chinese Medicine In High Myopia

Objective:The purpose of this study was to observe the choroidal thickness of macula and the blood flow of posterior ciliary artery in high myopia patients with deficiency of Qi-Blood and deficiency of Liver-Kidney Yin,and to analyze the changes of choroidal circulation and its influencing factors,to explore the correlation between choroidal circulation and TCM Syndrome types,and provide theoretical basis and evaluation index for TCM treatment of high myopia.Method:Patients aged 18-60 years with high myopia were included in the study.According to the diagnostic standard of TCM syndrome type,38 cases(76 eyes)of deficiency of Qi-Blood and38 cases(76 eyes)of deficiency of Liver-Kidney Yin were selected,and named with Qi-Blood deficiency group(QDG)and Liver-Kidney Yin deficiency group(LYDG).In addition,38 healthy volunteers(76 eyes)without myopia were selected as normal control group(NCG).Dioptre,best corrected visual Acuity(BCVA)(Logmar),ocular axial length,macular choroidal thickness and peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI)of SPCA in the three groups were assessed,SPSS22.0 software was used for statistical analysis.Results:1.Dioptre,BCVA,and axial length: diopter was-6.750(-7.875,-6.625)D,BCVA was 0(0,0.10),and axial length was 26.55 ? 0.66 mm in patients of QDG;Diopter was-10.875(-12.438,-9.031)D,BCVA was 0.2(0.10,0.40),and axial length was 27.93?0.81 mm in patients of LYDG;Diopter was-0.125(-0.375,-0.125)D,BCVA was 0(0,0)),and axial length was24.09?0.58 mm in.patients of NCG.Diopter and BCVA in three groups were evaluated by nonparametric test.The results showed that H = 185.138,121.168,the difference was statistically significant(all P < 0.05).Two-by-two comparison showed that the difference of Diopter and BCVA among the three groups was statistically significant(all P < 0.05).One-way Anova was used to analyze the axial length among the three groups,the results showed that F = 604.601,the difference was statistically significant(P < 0.05);two-by-two comparison showed that the difference of axial length among the three groups was statistically significant(all P < 0.05).The diopter of the normal control group was higher than that of the two high myopia groups,and BCVA was better than that of the two high myopia groups.The diopter of LYDG was lower than that of QDG,and BCVA was worse than that of QDG.2.The average choroidal thickness of macula of QDG was 209.62?49.89μm,that of LYDG was 174.01?52.75μm and that of NCG was 258.20?29.58μm.Two-by-two comparison showed that the difference of average macular choroidal thickness among the three groups was statistically significant(all P < 0.05).The average choroidal thickness of macula in two high myopia groups was lower than that in NCG,and the average choroidal thickness of macula in LYDG was lower than that in QDG.3.The blood flow parameters of SPCA:PSV was 13.68 ? 1.54cm/s,EDV was4.46 ? 1.82cm/s,and RI was 0.68 ? 0.11 in QDG;PSV was 11.61 ? 1.57cm/s,EDV was3.32 ? 1.07cm/s,RI was 0.72 ? 0.06 in LYDG.PSV was 15.28 ? 1.48cm/s,EDV was5.64?1.99cm/s,RI was 0.64?0.11 in NCG.One-way Anova analysis showedthe difference was statistically significant(all P <0.05).two-by-two comparison showed that the differences of PSV,EDV and RI among the three groups(all P < 0.05).The PSV and EDV in the two high myopia groups were lower than those in the NCG,and the RI was higher than that in NCG.The PSV and EDV of NYDG were higher than those of QDG and RI were higher than that of QDG.4.Pearson correlation coefficients between macular choroidal thickness and axial lengthof QDG was-0.596,that of LYDG was-0.664.There was a negative correlation betweenaverage choroidal thickness and axial length in two high myopia groups(P<0.05).Spearmancorrelation coefficients between macular choroidal thickness and diopter of QDG was0.258,that of LYDG was 0.562.There was a positive correlation between macular choroidalthickness and diopter in two high myopia groups(P<0.05).5.Pearson correlation coefficients between blood flow parameters of SPCA(PSV,EDV,RI)and axial length of QDG were-0.454,-0.468,0.462,that of LYDG were-0.572,-0.434,0.292.There was a negative correlation between blood flow parameters of SPCA(PSV,EDV)and axial length in two high myopia groups(P<0.05).There was a positive correlation between blood flow parameters of SPCA(RI)and axial length in two high myopia groups(P<0.05).Spearman correlation coefficients between blood flow parameters of SPCA(PSV,EDV,RI)and diopter of QDG were 0.442,0.325,-0.263,that of LYDG were 0.461,0.369,-0.281.There was a positive correlation between blood flow parameters of SPCA(PSV,EDV)and diopter in two high myopia groups(P<0.05).There was a negative correlation between blood flow parameters of SPCA(RI)and diopter in two high myopia groups(P<0.05).6.Pearson correlation coefficients between macular choroidal thickness and SPCA blood flow parameters(PSV,EDV,RI)of QDG were 0.298,0.323,-0.318,that of LYDG were0.622,0.557,-0.432,that of NCG were 0.552,0.725,-0.656.There was a positive correlation between mean choroidal macular thickness and blood flow parameters of SPCA(PSV,EDV)in three groups(P<0.05).There was a negative correlation between mean choroidal macular thickness and blood flow parameters of SPCA(RI)in three groups(P<0.05).Conclusions:1.Patients with high myopia had longer axis and decreased BCVA.Patients with Liver and Kidney Yin deficiency syndrome had lower diopter(higher myopia degree),longer axis and lower BCVA than patients with Qi and Blood deficiency syndrome.2.The mean choroid thickness of macula in patients with high myopia becomes thinner,and the decrease of mean choroid thickness in patients with Liver and Kidney Yin deficiency syndrome is more significant than that in patients with Qi and Blood deficiency syndrome.3.SPCA blood flow parameters of patients with high myopia are worse than those of healthy people without myopia.SPCA blood flow parameters of patients with high myopia of Lver and Kidney Yin deficiency are worse than those of patients with Qi and Blood deficiency.4.Mean choroidal macular thickness in patients with high myopia was positively correlated with dioptre,PSV and EDV,but negatively correlated with axial length and RI.PSV and EDV were positively correlated with diopter but negatively correlated with axial length.RI was negatively correlated with diopter but positively correlated with axial length.