Macular Blood Flow Parameters And Multimodal Imaging Study Of Choroidal Neovascularization Secondary To Pathological Myopia

Objective:With the development of science and technology and the change of people’s daily habits,the incidence of myopia is increasing year by year.Pathologic myopia(PM)has become an important blinding eye disease worldwide,with a prevalence of up to 10%in high myopia(HM),accounting for about 3%of the global population.As a serious complication of PM,choroidal neovascularization(CNV)is extremely difficult to treat clinically due to its complexity,suddenness,progression and blindness.Therefore,early detection and improvement of its clinical diagnosis and treatment plan are extremely important.In this clinical study,the imaging characteristics of optical coherence tomography angiography(OCTA)and superficial retinal blood flow density(SRFD),retinal blood flow density(SRFD),retinal blood flow density(SRFD)and retinal blood flow density(SRFD)in the mCNV patients and the contralateral healthy eye were observed.Deep retinal blood flow density(DRFD),the area of the foveal avascular area(FAZ)and the blood flow density(FD)in the annular area with a width of 300 μm around the FAZ,choriocapillary density(choriocapillaris flow density,CCD),OCT macular subfoveal choroidal thickness(SFCT)and compared with patients with simple high myopia and normal people,in order to provide a reference for early clinical diagnosis and treatment of mCNV and to pay attention to the progress of mCNV contralateral healthy eye.Methods:Retrospective study.From October 2019 to October 2021 in Qilu Hospital of Shandong University,patients who were initially diagnosed with monocular mCNV by fluorescein fundus angiography(FFA),optical coherence tomography(OCT),and OCTA were included and were not treated.30 patients were included as mCNV group,30 pure HM patients with matched age,sex and diopter without other eye diseases were included as HM group,and 30 age and gender matched normal healthy persons were included as normal controls Group.The diopter and best corrected visual acuity of the three groups were compared and measured;the SRFD,DRFD,FAZ area and FD in the annular area with a width of 300 μm around the FAZ were measured on the OCTA image of the mCNV group,the contralateral healthy eye,the HM group and the normal group;and SFCT);and fundus photography was performed on both eyes of patients with mCNV,and the fundus of the contralateral eye of mCNV was assessed by HM fundus lesion grading method ATN grading.SPSS25.0 software was used for statistical analysis of experimental data.Quantitative data conforming to normal distribution were expressed as mean±standard deviation(x±s);paired t test and test were used to analyze the basic data and macular blood flow of all patients.Parameters(age,gender,diopter,SRFD,DRFD,FAZ area,and FD,SFCT,CCD within the 300 μm wide annular area surrounding the FAZ)were analyzed,and<0.05 indicated a statistically significant difference.Result:A total of 90 patients with 120 eyes were included in this study,including 30 males and 60 females.There were statistically significant differences in FAZ area,FD,CT and CCD among the four groups.Pairwise comparison between groups showed that the average SRFD,DRFD,FD,CT,and CCD of the eyes in the mCNV group were lower than those in the HM group,and the average SRFD,DRFD,FD,CT,and CCD of the eyes in the HM group were smaller than those in the normal group,and the differences were statistically significant.(P<0.05);the average FAZ area of the affected eye in the mCNV group was smaller than that in the normal group,and the difference was statistically significant(P<0.05).Conclusions:1.Compared with normal eyes,the SRFD and DRFD of eyes with simple HM were lower,and the size and shape of FAZ also changed.2.The SRFD and DRFD of the mCNV-affected eyes decreased more,the FAZ decreased and the shape tended to be irregular.3.The contralateral eye of mCNV patients is usually also HM,and is often accompanied by severe fundus lesions.Using multimodal imaging,combined with ATN grading,reasonably evaluate the degree of fundus lesions in the contralateral eye of mCNV,in order to guide clinical diagnosis and treatment.