| High myopia generally refers to myopia whose diopter is more than-6.00D.Its diopter deepened and the axial length of the eyeball extended constantly,which will lead to a series of fundus complications.Such as:posterior staphyloma,peripapillary atrophy,undus tessellatio,lacquer cracks,choroidal neovascularization,macular hemorrhage,macular retinoshisis,macular hole,retinal detachment,dome-shaped macular and so on.People with high myopia accopanied by severe macular degeneration always tend to have significant damage in visual acuity,there have been a lot of relevant research reports.But there are not many studies on the changes in visual function of high myopia without obvious degeneration in central visual acuity or macular degeneration.The pathological rules of these high myopia patients need to be further discussed.OjectiveBy inspecting the high myopia without obvious macular degeneration by MP-3 microperimeter and optical coherence tomography(HD-OCT),to analysis the changing rule of the retina light sensitivity,the retinal thickness,2°and 4° fixation rate in the different macular area within the scope of 10°,and discusses its influence factors,to provide reference for the choice of treatment method and treatment timing in the early stage of high myopia.Materials and methodData of myopic patients in the first affiliated hospital of Zhengzhou university from June 2019 to December 2019 were collected.They were aged between 18 and 60 years old.All patients underwent standard ophtalmic examination,and the best corrected vision all was?0.8.According to the results of OCT examination,fundus photography and B-ultrasound examination(fundus fluorescein angiography was performed when noninvasive ophthalmologic examination failed to confirm some of the degeneration),except undus tessellatio and peripapillary atrophy,the fundus showed no obvious macular degeneration(such as diffuse/patchy chorioretinal atrophy,macular atrophy,macular epiretinal membrane,retinoshisis,macular hole,chorioretinal detachment,myopic CNV,lacquer cracks,Fuchs spot and so on).Diopter more than-6.00D was the high myopia group,and diopter between-6.00D and-0.50D was the moderate and low myopia group.The ages of the two groups were matched,123 eyes(82 cases)were in the high myopia group,there were 52 males and 71 females among them,78 eyes(53 cases)in the moderate and low myopia group,there were 32 males and 46 females among them.The age,diopter and axes length of the high myopia group were(32.50±11.80)years,(-7.91±1.55)D and(27.08±0.82)mm.Respectively,the age diopter and axes length of the moderate and low myopia group were(31.94±12.34)years,(-2.62±1.50)D and(25.39±0.72)mm.Applied microperimeter(Nidek MP-3)and optical coherence tomography(CIRRUS HD-OCT)to detect the retina mean light sensitivity(MLSc,MLSu,MLSn,MLS1,MLSt,MLSo),retinal thickness(RTc,RTu,RTn,RT1,RTt,RTo),2°and 4°fixation rate(P1,P2)of the central,upper,nasal,lower,temporal and overall.macular region within the scope of 10°.Compared the MLS,RT,P1,P2 and fixation stability in different macular areas between the two groups(The microvirometer system automatically analyzes the fixation according to the two parameters P1 and P2:fixation stability:2°fixation rate? 75%;Fixation relatively unstable:2°fixation rate<75%,4°fixation rate?75%;fixation instability:4°fixation rate<75%),and observed the relationship between the retinal light sensitivity in different macular area of the high myopia group and the age,diopter,axis length and retina thickness.Statistical analysis methodSPSS 21.0 statistical software was used for statistical analysis of the data,and the measured data were expressed as(x±s).The independent samplet-test and chi-square test were used to analyze the basic data of the two groups.The data of retinal mean light sensitivity,retinal thickness of different macular regions and 2°,4°fixation rate satisfied the homogeneity of normal and variance,and independent sample t-test was used.The fixation stability of the two groups was compared by chi-square test.Pearson correlation analysis was used to analyze the factors affecting retinal light sensitivity and its relationship with retinal thickness in the high myopia group.P<0.05 was considered statistically significant.Results1.comparison of the retinal mean light sensitivity(MLS)of each region between the two groupsCompared the MLSc,MLSu,MLSn,MLS1,MLSt,MLSo between the high myopia group(26.01±1.38,27.03±1.45,27.35±1.38,27.21±1.34,27.27±1.45,26.98±1.45)and the moderate and low myopia group(26.50±1.56,27.68±1.24,27.99±1.28,27.61±1.36,27.78±1.44,27.41±1.23),except for the lower area(t=1.857,P=0.065),the MLS of the high myopia group in the central,upper,nasal,temporal and overall macular area was lower than that in the moderate and low myopia group,and the difference was statistically significant(t=2.111,2.872,2.905,2.172,2.270,P=0.036,0.005,0.004,0.031,0.024).2.comparison of the retinal thickness(RT)of each region between the two groupsThe retina thickness in the central macular area of the high myopia group(254.15±25.17)was thicker than that of the moderate and low myopia group(245.70±20.27),with a statistically significant difference(t=-2.173,P=0.031).The retina thickness in the upper,nasal,lower and temporal macular area of the high myopia group(312.54±16.56,310.79±14.85,307.39±17.03,302.16±15.38)was thinner than that in the moderate and low myopia group(318.56±11.59,317.26±13.17,313.35±15.99,307.72±15.86),and the difference was statistically significant(t=2.418,2.760,2.184,2.193,P=0.017,0.006,0.030,0.030).The overall retinal thickness of macular area of 10° was thinner in the high myopia group(297.41±12.69)than the moderate and low myopia group(300.52±12.52),but the difference was not statistically significant.3.The relationship between the retinal mean light sensitivity(MLS)and the retinal thickness(RT)The retinal mean light sensitivity in the upper,nasal and temporal macular area was positively correlated with the retina thickness(r=0.203,0.203,0.191,P=0.024,0.025,0.034),and negatively correlated in the central macular area(r=-0.233,P=0.010),while the correlation in the lower and the overall macular area within the scope of 10° was not statistically significant(r=0.129,0.169,P=0.154,0.062).4.Factors affecting the retinal mean light sensitivity(MLS)Age:the retina mean light sensitivity of each region of the macular area was negatively correlated with age(r=-0.255,-0.223,-0.212,-0.206,-0.214,-0.226,P=0.004,0.013,0.019,0.022,0.017,0.012).Diopter:except the lower(r=0.155,P=0.087),the MLS of the central,upper,nasal,temporal and overall macular area were positively correlated with diopter(r=0.182,0.227,0.295,0.200,0.201,P=0.043,0.011,0.001,0.027,0.026).Eye axis:except for the lower(r=-0.160,P=0.076),the MLS of the central,upper,nasal,temporal and overall macular area were positively correlated with the axis length(r=-0.188,-0.241,-0.301,-0.208,-0.217,P=0.038,0.007,0.001,0.021,0.016).5.Comparison of the 2°,4°fixation rate(P1,P2)and fixation stability between the two groupsThere was no statistically significant difference between the P1,P2 of the high myopia group(87.48±9.23,94.98±5.98)and the P1,P2 of the moderate and low myopia group(90.02±7.47,96.72±4.35)(t=1.780,1.924;P=0.077,0.056).In the high myopia group,fixation stable in 107 eyes(86.99%),fixation relatively unstable in 12 eyes(9.76%),and fixation unstable in 4 eyes(3.25%).In the moderate and low myopia group,fixation stable in 72 eyes(92.23%),fixation relatively unstable in 4 eyes(5.13%),and fixation unstable in 2 eyes(2.56%).There was no significant difference in fixation stability between the two groups(?2=1.445,P=0.536).Conclusion1.In patients with high myopia,the changes of retinal light sensitivity and retinal thickness have occurred before the macular area has no obvious structural change and central visual impairment,and the fixation function can remain basically stable.2.The retinal light sensitivity detected by microvirometer can be used as an important index to evaluate the visual function in the early stage of high myopia,and it can provide importent reference for the choice of treatment method and treatment timing. |
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