Imaging Features Of Retina In Patients With High Altitude Polycythemia

Objective: Through to the high altitude with plateau erythrocytosis disorder(hereinafter referred to as high disease,HAPC),patients with fundus retinal imaging examination,using optical coherence tomography angiography(OCTA),the data for the quantification of artificial intelligence,observe whether HAPC patients with fundus structure is changed,the normal structure of fundus HAPC patients,To evaluate the possible fundus pathologic changes and the risk of developing fundus retinal disease in HAPC patients.In order to provide patients with HAPC with correct preventive measures and diagnosis and treatment for potential fundus diseases,so as to reduce the incidence and damage degree of fundus lesions,delay the progression of the disease,and improve the prognosis.Methods:From November 2020 to October 2021,60 patients(120 eyes in total)with high altitude polycythemia who were admitted to The Affiliated Hospital of Qinghai University and had a long life history in high altitude area and no low altitude life history in recent 1 year were selected as the case group.Sixty normal people(120 eyes in total)living in high altitude area with similar sex ratio and age ratio were selected as control group.Two groups of researchers performed OCTA,recorded and analyzed the examination results of each patient,and finally calculated the retinal nerve fiber layer thickness(RNFL)in the four quadrants of optic disc.Diameter of retinal arteries and veins in each quadrant of optic disc;Relationship between RNFL thickness and Hb content.Use correlation analysis software and statistical method to get the corresponding results.Results:1.Compared with healthy control group in high altitude area,RNFL thickening in the nasal quadrant of optic disc in HAPC patients was statistically significant(P<0.05);There were no significant differences in temporal quadrant RNFL thickness,upper quadrant RNFL thickness,lower quadrant RNFL thickness and average RNFL thickness between the control group and the high altitude healthy group(P>0.05).2.Compared with the healthy control group in high altitude area,the diameter of retinal dynamic(A)and static(V)vessels in each quadrant of optic disc in HAPC patients increased,and there was no statistical significance in the increase of artery diameter in the superior temporal quadrant(P>0.05).The increase of arteriovenous diameter in the remaining quadrants was statistically significant(P<0.05).3.Compared with the healthy control group in the high altitude area,RNFL thickness and Hb content in the nasal quadrant of patients with HAPC had statistical significance(P<0.05),while RNFL thickness and Hb content in the remaining quadrant had no statistical significance(P>0.05).Conclusions:1,DVD each quadrant RNFL thickness physiological differences,HAPC patients DVD lateral rhinotomy RNFL thickness increase,may be associated with the anatomical structure and blood flow density,through to the DVD each quadrant RNFL thickness measurement and calculation,prompt the disease of retinal pathological changes of the potential,affecting the retina and DVD area normal physiological structure and function.2.The proportion of fundus arteries and veins in normal people is about 2/3.The diameter of retinal arteries and veins in HAPC patients will be enlarged,and the proportion of arteries and veins diameter will change compared with normal people,which is similar to pathological changes caused by ischemia and hypoxia.These findings suggest that patients with HAPC are at risk for pathological changes in fundus microvascular structure and retinal disease.