Correlations Of The Retinal Nerve Fiber Layer Around The Optic Disc In Different Grades Of Tessellations In High Myopia

Objective:To observe the effects of different grades of leopard-striped fundus in high myopia on the retinal nerve fiber layer around the optic disc,and to explore the related factors of leopard-striped fundus in high myopia.Methods:A cross-sectional study of 120 patients（170 eyes）with high myopia（HM）without obvious pathological fundus changes who were admitted to the ophthalmology clinic of the Second Hospital of Jilin University from September 2019 to December 2021.After strict screening,85 patients（112 eyes）with high myopia were finally included.All patients underwent vision test,spherical equivalent（SE）,intraocular pressure（IOP）,and fundus experiment under slit lamp,fundus photography,optical coherence tomography angiograph（OCTA）and other tests.General information of the patient including eye gender,gender,age,past medical history and family medical history were recorded.The fundus tessellations（FT）are divided into four groups namely grade 0 leopard-like fundus（G0）,grade 1 leopardlike fundus（G1）,and grade 2 leopard-like fundus.Fundus（G2）,grade 3 leopard pattern fundus（G3）according to the extent and severity of the exposed choroidal vessels in the fundus photography.OCTA was used to measure the peripapillary retinal nerve fiber layer thickness（p-RNFLT）and the peripapillary vessel density（PVD）around the optic disc,and the scan area was 4.5×4.5 mm.To analyze the effect of leopard-like fundus on p-RNFLT and the relationship between FT and other biological parameters,bivariate analysis was used to study the relationship between biological parameters and the degree of leopard-like fundus.Factors that were statistical different between groups were included in the multivariate logistic regression analysis,and P<0.05 was defined as statistical significance.Results:A total of 85 patients with high myopia and 112 eyes were included in this study.Among them,44 eyes were male and 68 eyes were female.Through the K-S singlesample test,the total sample was basically compound normal distribution,described by （?）±s;the mean age is:（38.71±16.60）years old;the average spherical equivalent power is:-（8.15±2.15）D.The leopard-striped fundus was grouped according to fundus photography: grade 0 in 24 eyes（21.4%）;grade 1 in 17 eyes（15.2%）;grade 2in 32 eyes（28.6%）;grade 3 in 39 eyes（34.8%）.There was no significant gender difference between the leopard-striped fundus groups（P>0.05）.There were statistically significant differences in age,SE,p-RNFLT and PVD in different degrees of leopard-like fundus groupings in patients with high myopia（P<0.05）.Correlation analysis: The severity of leopard-like fundus was positively correlated with age（r=0.352,P<0.05）.Correlation analysis between p-RNFLT and PVD in different parts and leopard-like fundus: p-RNFLT between different grades of leopard-like fundus was statistically different（P<0.05）.The RNFLT of TS and ST sites at the optic disc were positively correlated with the leopard-striped fundus grade（r>0,P<0.05）,that is,with the aggravation of the leopard-striped fundus,the RNFLT at the TS and ST sites were positively correlated（r>0,P<0.05）was thickened;while p-RNFLT in the rest of the eyes became thinner with the aggravation of the leopard-like fundus（r<0,P<0.05）.In addition to the PVD at the inferior nasal（IN）and the inferior temporal（IT）,TS,inferior temporal（TI）,and superior nasal（SN）,ST,nasal inferior（NI）,and superior nasal（nasal superior,NS）decreased（r<0,P<0.05）.P-RNFLT,superior RNFLT and inferior RNFLT were negatively correlated with the severity of leopard-striped fundus grade（r<0,P<0.05）;PVD above the optic disc and PVD below the optic disc were negatively correlated（r <0,P<0.05）.There was no significant difference in optic disc area and disc rim width among different leopard-like fundus grades（P>0.05）.The statistically significant related factors were included in multivariate unordered logistic regression analysis.The results showed that the severity of leopard-striped fundus in high myopia was associated with age（OR=1.044,95%CI: 0.944-1.097,P<0.05）,SE（OR=0.873,95%CI: 0.778～1.096,P<0.05）,but no significant correlation with pRNFLT（P>0.05）.Conclusions:1.Age and SE are independent risk factors for the aggravation of leopard-striped fundus in high myopia;2.With the aggravation of the leopard-striped fundus in high myopia,the RNFLT at the TS and ST sides of the optic disc increases,and the rest of the retina becomes thinner;3.With the aggravation of the leopard-striped fundus in high myopia,except the PVD at the IT and IN sides below the optic disc were not affected by the leopard-like fundus grading,the PVD in other parts decreased significantly with the aggravation of the leopard-striped fundus.