Analysis Of Macular Retinal Thickness,Blood Flow Density And Visual Function In High Myopia

Objective:By the detection and correlation analysis of the various indicators of the retina in the macular area in patients with high myopia,and then make a preliminary prediction of the pathological changes of high myopia clinically,to provide guiding reference for early clinical intervention.Methods:Patients with high myopia and health cases who were admitted to Shanxi Eye Hospital from December 2018 to December 2019 were screened.Relatives more than three generations for all cases lived in North China.The healthy normal vision group(15eyes in 20cases);The high myopia(HM)group(26 eyes in 40 cases)were divided into the HM1 group(-6.0 D to-9.0 D),HM2 group(>-9.0D)according to spherical equivalent(SE);The pathological myopia(PM)group(31 eyes in 39 cases)were divided into the PM1 group(-6.0 D to-9.0 D),PM2 group(>-9.0D)according to spherical equivalent(SE).All cases underwent routine eye examinations.MAIA microperimeter was used to measure the retinal sensitivity(RS),fixation stability(FS),and macular integrity(MI);Optical coherence tomography was used to measure the retinal pigment epithelium(RPE),retinal thickness(RT),and choroidal thickness(CT);Optical coherence tomography angiography was used to measure the blood flow density of the superficial central fovea,parafovea and various directions of parafovea of the macula.Differences between the three groups of cases were compared.And the correlation analysis of each index with the axial length(AL)and SE was performed.Under different diopters,the differences of various indicators in the high myopia group and the pathological myopia group were compared.Results:1.For the comparison of indicators of the RS,FS,and MI in the PM group,the HMgroup,and the normal vision group,there were statistical differences(P <0.05).The HM group was lower than the normal vision group,and the PM group was lower than the HM group.2.For the comparison of the indicators of average RPE thickness,average RT,and average CT among the three groups,there were statistical differences(P <0.05).The HM group was lower than the normal vision group,and the PM group was lower than the HM group.3.For the comparison of the blood flow density distribution of the parafovea and various areas of parafovea among the three groups,there were statistical differences(P<0.05).The HM group was lower than the normal vision group,and the PM group was lower than the HM group.4.There was no correlation between the indicators in the normal vision group and AL and SE(P> 0.05);There was a negative correlation between AL in the HM group and PM group and P1(%)and P2(%),and there was a positive correlation between it and63% BCEA and 95% BCEA;There was a positive correlation between SE in the HM group and PM group and P1(%)and P2(%),and there was a negative correlation between it and 63% BCEA and 95% BCEA;There was a negative correlation between the retinal thickness and parafovea SVD in the HM group and PM group and AL and SE(P <0.05).5.For the comparison of various indicators in the comparison between the HM1 group and the HM2 group,and the comparison between the PM1 group and the PM2 group,there were statistical differences(P <0.05).For the average RT,average CT,and retinal sensitivity indicators in the comparison between the HM1 group and the PM1 group,and between the HM2 group and the PM2 group,there were statistical differences(P <0.05).For the average RT,average CT and retinal sensitivity indicators in the HM2 group and PM1 group,there were statistical differences(P <0.05).However,for the fixation stability,average RPE thickness,and he blood flow density of the parafovea decrease,there were not statistical differences(P> 0.05).Conclusion:1.Compared with patients with high myopia,the fixation stability,the blood flow density of the parafovea decrease and each retinal thickness in patients with pathologically high myopia reduce under the condition of good central vision.2.For high myopia,with the increase of the axial length and the diopter,each retinal thickness and the blood flow density of the parafovea decrease,and the fixation stability is affected.3.This indicates that the fixation stability,the blood flow density of the parafovea decrease,retinal pigment epithelium thickness and other indicators of patients with pathological myopic with good diopter will change significantly earlier.Thus,for patients with pathological myopic with good diopter,it is suggested that the above indicators are included in the monitoring scope to quickly give clinical intervention and try to slow the process of the disease.