病理性近视患者视网膜深层毛细血管丛减少与视网膜外层改变和视力损害相关性分析OA

Objective To explore the relationship between the reduction of deep retinal capillary plexus and changes in the outer layer of the retina and visual impairment in patients with pathological myopia.Methods A retrospec-tive case-control study.Optical coherence tomography(OCT)and OCT angiography(OCTA)images were analyzed in 21 control eyes,48 simple high myopia eyes,and 22 pathological myopia eyes.The thickness of the outer retinal sublayer and the density of the inner retinal microvascular network were quantified,including the superficial retinal capillary plexus(SCP)and the deep retinal capillary plexus(DCP).The retinal sublayer thickness and microvascular density among the three groups were compared,and the correlation between sublayer thickness and microvascular density and best corrected visual acuity(BCVA)were determined.Results In pathological myopia,the density of DCP,thickness of muscular layer and ellipsoid area(MEZ),thickness of chimeric zone and retinal pigment epithelium layer(IZ+RPE),and thickness of choroid were lower than those in simple high myopia(all P<0.05).The decrease in DCP density in pathological myopia is associated with thinning of MEZ and IZ+RPE(all P<0.05),but not in simple high myopia(all P>0.05).Unit linear regres-sion showed that axis length,femininity,outer plexiform layer(OPL),MEZ,IZ+RPE,choroidal thickness,and SCP and DCP densities were correlated with BCVA(all P<0.05).Multiple regression analysis showed that poor BCVA was only asso-ciated with a decrease in thinner MEZ,thinner choroid,and DCP(all P<0.05).Conclusions Pathological myopia results in changes in internal retinal microvascular density and external retinal sublayer thickness,especially a decrease in DCP and thinning of MEZ,which are significantly related to the deterioration of BCVA.