| Objective: To observe the difference of macular microcirculation and the changes of macular microcirculation after wearing corneal plastic lens in adolescents with myopia of different diopter,including the length and density of blood vessels in macular area,blood vessel width density,FAZ area,circumference and morphological index.To explore the pathogenesis of myopia,the principle and safety of corneal plastic lens.The differences of retinal blood density and FAZ morphology among myopia patients with different TCM syndromes were analyzed.Methods: All the 30 cases of juvenile myopic patients who met the standard were studied by taking the right eye(30 eyes).To determine the TCM syndrome type of the subjects,IOL Master 700 was used to obtain the axial length data,and zephyr OCTA was used to measure the blood flow density,FAZ area,circumference and morphological index in the superficial layer of the retina in macular area.According to the examination results,professional optometrists made CRT brand keratoplasty lens(OK lens)for patients.After wearing the OK lens for 1 day,2 weeks and 1month,the corresponding indicators were measured again.SPSS 26.0 was used to analyze the relevant data changes.Results:A total of 36 subjects were recruited for this study,and 6 subjects were unable to complete the whole study due to various reasons,or were separated by other factors.30 people finally met the standard,including 14 males and 16 females,with an age distribution of 10.9±2.193 years.There were 20 cases of low myopia,10 cases of moderate myopia,and no subjects of high myopia.In the judgment of TCM syndrome type,12 people had heart qi deficiency type,9 people had spleen and stomach weakness type,and 9 people had liver and kidney deficiency type.The specific results were analyzed as follow :1.The syndrome types of subjects constituted the most central qi deficiency type(40.0%),followed by spleen and stomach weakness type(30.0%)and liver and kidney insufficiency type(30.0%).There was no significant difference in the TCM syndrome type composition between the low-degree myopia group and the moderate myopia group(P > 0.05).2.The length density and width density of blood vessels in the para-macular central area(18.7±0.779 mm-mm-1)and width density(0.368±0.019 mm-1)in the moderate myopia group were lower than those in the low myopia group(20.7±0.834mm-1).0.440 ± 0.026 mm mm-1).The vascular length density(17.7±0.677 mm-1)and width density(0.346± 0.020 mm-1)in the intact macular area were also lower than those in the low-degree myopia group((19.4±0.701mm-1;0.411±0.023mm-1)).The difference was statistically significant(P < 0.05).The length density and width density of blood vessels in the central macular area were(9.5±1.196mm-1,0.172± 0.054)mm-1,and(9.1±1.039mm-1 0.179± 0.053 mm-1)in the low myopia group.There was no significant difference between(P > 0.05).3.The FAZ area(0.24± 0.160mm2),FAZ circumference(1.54± 0.593mm)and FAZ shape index(0.61±0.106)of the moderate myopia group were compared with those of the low myopia group(0.22±0.095;1.81±0.874;0.71±0.411;)There was no significant difference in(P > 0.05).4.The axial length was negatively correlated with the length density of blood vessels in the parietal macular area(20.3±1.423 mm-1),the length density of blood vessels in the intact area(19.1±1.271mm-1),the width density of blood vessels in the parietal macular area(0.416± 0.042mm-1),and the width density of blood vessels in the intact area(0.390± 0.038mm-1)(P < 0.05).There was no significant correlation with the vascular length density(9.3±1.456 mm-1)and the width density(0.177±0.052 mm-1)in the central area(P > 0.05).5.There was no significant correlation between axial length and FAZ area(0.23± 1.097mm2),circumference(2.03± 0.623mm),and morphological index(0.61±0.101)(P > 0.05).6.After 2 weeks of wearing the OK lens,the length density of blood vessels in the central area of the macular area(20.6±1.643 mm-1)),the width density(0.420±0.039 mm-1),the length density of blood vessels in the intact area(19.3±1.488 mm-1))and the width density(0.393±0.036 mm-1))increased 20.3±1.423mm-1;0.416±0.042 mm-1;19.1±1.271mm-1;0.390±0.038 mm-1);The difference was statistically significant.After 1 month,the length density of blood vessels in the central macular area(9.7±1.230 mm-1)and the width density(0.183±0.053 mm-1))were significantly higher than those in the endoscopic area(9.3±1.456 mm-1)).0.177± 0.052mm-1))before the increase,the difference has statistical significance.7.After wearing the OK lens for 1 day,2 weeks and 1 month,the area,circumference and shape index of FAZ showed no significant changes compared with those before wearing the lens,and the difference was not statistically significant(P > 0.05).8.In the para-macular central area and the intact area,the blood vessel length density of subjects with heart qi deficiency was lower than that of subjects with spleen and stomach weakness and liver and kidney insufficiency(P < 0.05).In the paracentral area,the blood vessel width density of qi-deficiency type was lower than that of spleen-stomach weakness type(P < 0.05).In the intact area,the blood vessel width density of qi-deficiency type was lower than that of liver-kidney deficiency type(P < 0.05).9.There was no significant difference in FAZ area,circumference and shape index among the short-sighted adolescents with heart qi deficiency,spleen and stomach weakness,and liver and kidney deficiency(p > 0.05).Conclusion:1.There was no significant difference in retinal blood flow density in macular fovea,while there was a difference in blood flow density between the paracentral area and the intact area.2.There was no significant difference between the FAZ area,circumference and morphological index of low to moderate juvenile myopic patients.3.The blood flow density in the para-central and intact areas of macular area increased after wearing the OK lens for 2 weeks in low-to-moderate myopia adolescents,and the blood flow density in the central area of macular area increased after 1 month,which may be related to reduced mechanical axial traction,delayed axial growth,and increased retinal oxygen demand.4.There was no significant change in FAZ area,circumference and shape index after wearing the OK lens in low to moderate juvenile myopia patients.5.Among the low-to-moderate juvenile myopic patients,the blood flow density of macular area was different in different regions among the three syndromes of heart qi deficiency,spleen and stomach weakness,and liver and kidney insufficiency,but there was no significant difference in FAZ morphology. |
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