Correlation Between Peripapillary Vascular Density,retinal Nerve Fiber Layer And Visual Field In High Myopia

ObjectiveStudy some basic characteristics of high myopia and to explore the correlation between peripapillary vascular density,retinal nerve fiber layer and visual field in high myopia patients use Optical Coherence Tomography Angiography(OCTA)and Humphrey perimetry.MethodsThis study is a cross-sectional study,including young patients with high myopia aged 18-60 years,whose diopter of main optometry is ?-6.00D.All patients underwent ophthalmic examinations such as diopter,ocular axis,vascular density,nerve fiber layer thickness,visual field,etc.The dB value of each point measured by Humphrey perimetry is converted to 1/L,and the average value of 1/L of each area is obtained according to the modified Garway-Heath partition,namely the visual field mean sensitivity(VFMS)of the area.The Retinal Nerve Fiber Layer(RNFL)thickness and vascular density(VD)values measured by OCT A were used to adjust the ocular magnification of high myopia with Bennett magnification formula(t=p × q × s),and the actual RNFL thickness was calculated.Through K-S single sample test,the overall distribution is normal.After controlling gender factors,linear regression analysis is performed on the eye axis and RNFL,VD,VFMS,overall average RNFL,average VD,and average VFMS in each region to analyze their changing trends with the eye axis.Then all affected eyes were divided into three groups(?24.00 mm?25.99 mm,?26.00 mm?27.99 mm,??28.00mm)according to the length of the ocular axis.The differences between the three groups were compared by Kruskal-Wallis single factor ANOVA(K sample)and the differences between the groups were compared in pairs.After controlling the confounding factors,the correlation between the two variables of the disc circumference RNFL,VD and the corresponding area VFMS of each group is analyzed,and the absolute values of the population,Mean Deviation(MD)and Pattern Standard Deviation(PSD)are correlated with the average RNFL and VD respectively To explore the relationship between disc structure and function in high myopia.Finally,multiple linear regression analysis is used to analyze the biggest influence factors on the total VFMS.ResultsBasic data of total sample:In this study,there were 134 subjects,241 eyes,including 44 males,78 eyes,90 females,163 eyes,with an age of 30.49±9.64 and an average MD of-2.65±1.73 dB.The average PSD is 2.63±1.31dB;The average RNFL is 126.34±17.38 ? m;The average VD was 50.65±4.00%.The average VFMS is 1072.21±360.66(1/L)After controlling gender,the linear regression analysis of ocular axis and variables in each region showed that average VD had negative correlation with ocular axis(P=0.000),while average RNFL,average VFMS had no significant correlation with ocular axis(p>0.05):After division,the nasal,temporal,temporal superior,TS),temporal inferior(TI),nasal superior(NS),and nasal inferior(NI)regions of RNFL are positively correlated with the ocular axis(p<0.05),while the remaining regions are not significantly correlated with the ocular axis(p>0.05).the nasal and NI regions are most affected by the ocular axis(R2:0.098 and 0,120,respectively);The upper,inferior,temporal,TS,TI,superior temporal(ST),inferior temporal(IT),superior nasal(SN),and inferior nasal(IN)regions of VD are negatively correlated with the ocular axis(p<0.05).the remaining regions of VD are not significantly correlated with the ocular axis(p>0.05).the temporal and ST regions are most affected by the ocular axis(R2:0.073 and 0.087,respectively)There was no significant correlation between VFMS and ocular axis(P>0.05).All eyes were divided into three groups according to the axis of eye.The general data of the three groups were compared:there was no significant difference in the Best Corrected Visual Acuity(BCVA),intraocular pressure,visual field MD value,PSD value,RNFL(TS,TI,SN,NS region),average RNFL,VD(IN,NS,NI region),VFMS and average VFMS among the three groups(P>0.05).The diopter gradually increased with the increase of the ocular axis(P=0.000);The gender differences among the three groups were significant(p<0.05)RNFL,VD and VFMS were used to analyze the structure-function correlation:RNFL and VD were positively correlated in all regions,except ST,IT and TS,NS in the first group and the third group(P<0.05).There was no correlation between RNFL,VD and VFMS(P>0.05).After partition,RNFL or VD and VFMS were significantly correlated in other regions except SN and IN(P<0.05).Correlation analysis of RNFL,VD,MD and PSD:in the whole group,2 groups and 3 groups,VD-MD was positive correlation(P<0.05),VD-PSD was negative correlation(P<0.05);in the whole group and in each group,RNFL was not correlated with MD and PSD(P>0.05).The most influential factors on total VFMS are age and thickness of RNFL NI regionConclusions1.The changes of RNFL and VD in the eyes of patients with high myopia are the same2.The structural changes of optic disc area may be earlier than the functional changes when the axial changes occur in simple high myopia3.The changes of optic disc structure and function may be small in young patients with high myopia,so there is no significant correlation or the correlation intensity is weak.When the length of optic axis is more than 28mm,the changes of structure and function are larger,and the correlation intensity is strong4.Vascular density is better than RNFL in studying the relationship between structure and function in high myopia.OCTA can be used as an important assistant tool in the study of structure and function in high myopia...