摘要
目的量化分析长期超高海拔和中高海拔环境暴露对眼底微循环的影响。方法横断面研究。以超高海拔地区(>3500~5500 m)健康居民(超高海拔组)和中高海拔地区(>1500~3500 m)健康居民(中高海拔组)为观察对象,以平原地区健康居民为对照组,所有纳入者均行OCTA扫描和SD-OCT扫描,使用ImageJ软件量化眼底图像,计算并比较各组研究对象的眼底微循环参数。视网膜微循环参数包括:视网膜血流密度(RVD)、视网膜血管骨架密度(RSD)、分形维数(FD)、中央凹无血管区(FAZ)面积、神经节细胞复合体层(GCC)厚度;脉络膜微循环参数包括:中央凹下脉络膜厚度(SFCT)、血管腔面积(LA)、脉络膜总面积(TCA)和脉络膜血流指数(CVI)。结果超高海拔组居民RVD为(32.52±3.57)%,RSD为(15.05±4.24)%,FD为1.68±0.08,与对照组相比均显著降低(均为P<0.001);超高海拔组居民GCC平均厚度为(98.76±10.26)μm,较对照组GCC平均厚度显著变薄(P<0.001);超高海拔组TCA为(2.15±0.49)mm^(2),LA为(1.17±0.36)mm^(2),SFCT为(318.12±76.50)μm,与对照组比较均显著增加(均为P<0.001),但是超高海拔组居民CVI与对照组相比显著降低(P<0.001)。而中高海拔组居民眼底微循环参数与对照组相比差异均无统计学意义(均为P>0.05)。结论长期超高海拔环境暴露会引起眼底发生以视网膜和脉络膜血流密度下降为主要特点的缺血缺氧改变,而长期中高海拔环境暴露不会引起眼底微循环改变。
Objective To quantitatively analyze the effect of long-term ultrahigh-altitude and mid-high-altitude exposure on fundus microcirculation.Methods In the cross-sectional study,healthy residents from ultrahigh-altitude areas(>3500-5500 m)and those from mid-high-altitude areas(>1500-3500 m)were included as subjects.Meanwhile,healthy residents from plain areas were included as the control group.All subjects underwent optical coherence tomography angiography(OCTA)and spectral domain optical coherence tomography(SD-OCT)scans.Fundus images were quantified using ImageJ,and fundus microcirculation metrics were calculated and compared among these groups.Retinal microcirculation metrics included retinal vessel density(RVD),retinal skeleton density(RSD),fractal dimension(FD),foveal avascular zone(FAZ)area,and ganglion cell complex(GCC)thickness.Choroidal microcirculation metrics included subfoveal choroidal thickness(SFCT),luminal area(LA),total choroidal area(TCA),and choroidal vascularity index(CVI).Results In the ultra-high altitude group,the RVD was(32.52±3.57)%,the RSD was(15.05±4.24)%,and the FD was 1.68±0.08,all of which were significantly lower compared with the control group(all P<0.001).The average thickness of GCC in the ultrahigh-altitude group was(98.76±10.26)μm,which was significantly thinner than the average thickness of GCC in the control group(P<0.001).The TCA in the ultrahigh-altitude group was(2.15±0.49)mm^(2),the LA was(1.17±0.36)mm^(2),and the SFCT was(318.12±76.50)μm,all of which were significantly higher compared with the control group(all P<0.001).However,the CVI was significantly decreased in the ultrahigh-altitude group compared with the control group(P<0.001).There were no significant differences in fundus microcirculation metrics between the mid-high-altitude group and the control group(all P>0.05).Conclusion Long-term ultrahigh-altitude exposure may induce ischemia and hypoxia in the fundus,primarily characterized by a decrease in the retinal and choroidal blood flow density,whereas long-term mid-high-altitude exposure cannot cause changes in the fundus microcirculation.
作者
马金兰
陈丽
许琪
罗一青
余萍
MA Jinlan;CHEN Li;XU Qi;LUO Yiqing;YU Ping(Department of Ophthalmology,Affiliated Hospital of Qinghai University,Xining 810000,Qinghai Province,China;Department of Ophthalmology,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,Shaanxi Province,China)
出处
《眼科新进展》
北大核心
2025年第6期476-480,485,共6页
Recent Advances in Ophthalmology
基金
青海省“昆仑英才”中青年科技人才托举项目(编号:2021QHSKXRCTJ35)
四川省科技厅区域合作项目(编号:2022YFQ0070)。
作者简介
马金兰(ORCID:0000-0002-5658-4709),女,1987年出生,青海人,博士,副主任医师,中国女医师协会眼科分会青年委员,青海省“昆仑英才·高端创新创业人才”。主要研究方向:玻璃体及视网膜疾病。E-mail:majinlan0108@126.com。
