Study On Diffuse Chorioretinal Atrophy And Related Factors In High Myopia

Objective:To study the correlation between the changes of diffuse chorioretinal atrophy in high myopia with age,gender,family history,axial length,equivalent spherometry,best corrected vision,superficial capillary network vascular density of deep retina,deep capillary network vascular density,choroidal capillary Correlation of factors such as blood vessel density,aims to explore related factors affecting the changes of diffuse chorioretinal atrophy in high myopia.Methods:A prospective cohort study was adopted,including 146 patients(274 eyes)with high myopia who were admitted to the First Afiliated Hospital of Kunming Medical University from September 2019 to January 2020.All the selected patients used Angio-OCT,fundus photography,IOLMsater,etc.Ophthalmic examination equipment to detect the patient's eye axis length,equivalent sphericity,best corrected vision,superficial capillary network blood vessel density of the retina,deep capillary network blood vessel density,choroidal capillary density,and conduct a questionnaire survey to collect the patient's General information(including gender,age,family history,etc.).The macular retinal thickness zoning map(ETDRS Grid)for early treatment of diabetic retinopathy was applied to the 45° fundus photography centered on the fovea of the macular.It was divided into DCA(Diffuse chorioretionalatrophy,DCA)group and non-DCA group,and the two groups were compared.Differences in clinical data(general conditions and ophthalmic auxiliary examination indicators)between different eyes and different eyes with different degrees of DC A,drawing the correlation between the diffuse chorioretinal atrophy in high myopia with age,gender,family history,axial length,equivalent spherical mirror Degree,best corrected visual acuity,superficial capillary network vascular density,deep capillary network vascular density and choroidal capillary density.Results:1.General informationIn the comparison of the general data between the DCA group and the non-DCA group,the average age of the DCA group is older than that of the non-DCA group,and the proportion of patients with a family history in the DCA group is higher than that of the non-DCA group,and the difference was statistically significant(p<0.05).2.Eye examination indexIn the comparison of BCVA,SE,and AL,the BVCA level of the DCA group was lower than that of the non-DCA group,and the SE,AL levels of the DCA group were greater than that of the non-DCA group.The difference was statistically significant(p<0.05);In the comparison of SCP-VD,DCP-VD,CC-VD,the levels of SCP-VD,DCP-VD,and CC-VD in the DCA group were lower than those in the non-DCA group,and the difference was statistically significant(p<0.05);In the comparison of IOP,the difference was not statistically significant(p>0.05).3.Characteristics between eyes with different DCAdegreesIn the comparison of age and family history,age gradually increased from DO group to D3 group;while the proportion with family history gradually increased from DO group to D3 group,the difference was statistically significant(p<0.05);In the comparison of BCVA,SE and AL,BCVA level gradually decreased from DO group to D3 group;SE and AL gradually increased from DO group to D3 group,the difference was statistically significant(p<0.05);In the comparison of SCP-VD,DCP-VD and CC-VD,the levels of SCP-VD,DCP-VD,CC-VD gradually decreased from group DO to group D3,the difference was statistically significant(p<0.05);in the comparison of gender and IOP,the difference was not Statistical significance(p>0.05).4.Correlation between blood vessel density and other parametersIn high myopia DCA eyes,the blood vessel density is positively correlated with the best corrected visual acuity,and negatively correlated with the length of the eye axis and equivalent spherical power,the difference was statistically significant(p<0.05),but there is no Significant correlationwith other parameters(p>0.05).5?Multivariate logistic regression analysis of DCA in patients with high myopiaAfter enrolling the Age,Familyhistory,BCVA,SE,AL,SCP-VD,DCP-VD,CC-VD,the Multivariate logistic regressionmodel is estabilshed,the logistic regression analysiss howed that family history(OR=1.701,95%CI:0.928-3.116,p=0.036),Age(OR=1.051,95%CI:1.023-1.081,p=0.000),SE(OR=1.238,95%CI:1.027-1.493,p=0.023),AL(OR=1.478,95%CI:1.097-1.993,p=0.033),SCP-VD(OR=0.866,95%CI:0.757-0.991,p=0.036),CC-VD(OR=0.497,95%CI:0.003-0.136,p=0.013)are the inde-pendent influencing factor of the occurrence of DCA in patients with high myopia.Family history,Age,SE,and AL are the risk factors,and SCP-VD,CC-VD are the protective factors.6?The ROC curve analysis of the DCA changes in the diagnosis of high myopia by various parametersROC curve analysis showed that Age,AL,SE,BCVA,SCP-VD,DCP-VD,CC-VD have certain diagnostic value for high myopiaDCA,and their AUC and 95%CI are:0.654(0.583,0.725),0.705(0.638,0.771),0.711(0.644,0.777),0.603(0.529,0.677),0.65 7(0.590,0.723),0.606(0.539,0.674),0.636(0.566,0.706);TheJordan index of Age,AL,SE,BCVA,SCP-VD,DCP-VD,CC-VD for the diagnosis of DCA eyes with high myopia are:0.245,0.317,0.338,0.162,0.254,0.216,0.25,and the corresponding optimal cutoffs are:30.5 years old,27.46mm,-9.44D,0.90,50.45%,52.25%,58.3%;the sensitivity and specificity of Age,AL,SE,BCVA,SCP-VD,DCP-VD,CC-VD of the diagnosis of DCA with high myopia are:(61.8%,63%),(51.7%,80%),(49.4%,84%),(27%,89%),(85.4%,40%),(98.9%,23%),(69.7%,55.3%).Conclusion:1.Compared with non-DCA eyes with high myopia,DCA eyes have older age,longer eye axis,higher equivalent spherical degree,worse best corrected visual acuity,superficial and deep capillary network blood vessel density and choroidal capillary Features of lower blood vessel density.And with the expansion of the scope of DCA change,the above trend becomes more obvious.2.In DCA eyes with high myopia,the blood vessel density is positively correlated with the best corrected visual acuity and negatively correlated with the length of the eye axis and the equivalent spherical power.3.Patients with high myopia with a family history,older age,higher equivalent spherical degree,and longer axial length were more likely to develop DCA,while patients with higher superficial capillary vascular density and choroidal capillary density were less likely to develop DCA.4.Age,axial length,equivalent sphericity,best corrected vision,superficial capillary network vascular density,deep capillary vascular density,choroidal capillary density and age have a certain predictive value for the change of DCA in highmyopia.