目的：观察高度近视黄斑裂孔性视网膜脱离(MHRD)患者术后光学相干断层扫描成像(OCT)及光学相干断层扫描血管成像(OCTA)检查指标的变化特征及其与视功能的相关性。

方法：选取2019-01/2023-10于保定市第一中心医院进行治疗的高度近视MHRD患者78例为研究对象，均行玻璃体切除联合内界膜填塞术治疗，观察术后1、3、6 mo时患者最佳矫正视力(BCVA)与OCT、OCTA指标变化特征，包括黄斑中心凹脉络膜毛细血管层血流面积(CBFA)、血流密度与椭圆体带缺损直径(DEZA)，并采用Pearson相关分析与多元线性回归分析术后不同时间点BCVA与CBFA、DEZA、血流密度的相关性。

结果：术后1、3、6 mo时患者BCVA分别为1.75±0.79、1.49±0.53、1.08±0.44，各时间点比较均有差异(均P<0.05)。术后1、3、6 mo，患者CBFA分别为1.67±0.24、1.82±0.13、1.94±0.15 mm²，DEZA分别为813.27±453.16、590.89±421.38、427.58±385.34 μm，血流密度分别为24.36±7.81、27.74±8.12、31.54±8.59，各项指标各时间点比较均有差异(均P<0.05)。Pearson相关性分析显示，术后1 mo，高度近视MHRD患者的DEZA、血流密度与BCVA无相关性(均P>0.05)，CBFA与BCVA(LogMAR)呈负相关(P<0.05)； 术后3、6 mo时，高度近视MHRD患者的CBFA、血流密度与BCVA(LogMAR)呈负相关，DEZA与BCVA(LogMAR)呈正相关(均P<0.05)。多元线性回归分析显示，术后3、6 mo，CBFA、血流密度及DEZA均为BCVA的重要影响因素(均P<0.05)。

结论：高度近视MHRD患者术后视功能逐渐提升，且与术后CBFA、DEZA、血流密度密切相关，建议术后定期监测OCT、OCTA指标变化。

METHODS: A total of 78 MHRD patients with high myopia who were treated in the Baoding No.1 Central Hospital from January 2019 to October 2023 were selected as the study objects, all of which underwent vitrectomy combined with internal limiting membrane tamponade. The changes in the best corrected visual acuity(BCVA), OCT and OCTA parameters, including choriocapillary blood flow area(CBFA), diameter of ellipsoid zone absence(DEZA)and blood flow density were observed at 1, 3 and 6 mo after surgery. Pearson correlation analysis and multiple linear regression analysis were conducted to analyze the correlation between BCVA and CBFA, DEZA, and blood flow density at different time points after surgery.

RESULTS: BCVA of enrolled patients at 1, 3, and 6 mo after surgery were 1.75±0.79, 1.49±0.53, and 1.08±0.44, respectively, and the differences at different points were statistically significant(all P<0.05). At 1, 3, and 6 mo after surgery, the patient's CBFA was 1.67±0.24, 1.82±0.13, and 1.94±0.15 mm², respectively, the DEZA was 813.27±453.16, 590.89±421.38, and 427.58±385.34 μm, respectively, and the blood flow density was 24.36±7.81, 27.74±8.12, and 31.54±8.59, respectively. The differences in above indicators at different time points were statistically significant(all P<0.05). Pearson correlation analysis found that there was no significant correlation between DEZA, blood flow density and BCVA in patients with high myopia and MHRD at 1 mo after surgery(all P>0.05). However, CBFA was negatively correlated with BCVA(LogMAR; P<0.05); at 3 and 6 mo after surgery, CBFA and blood flow density were negatively correlated with BCVA(LogMAR)in patients with high myopia and MHRD, while DEZA was positively correlated with BCVA(LogMAR; all P<0.05). Multiple linear regression analysis showed that CBFA, blood flow density, and DEZA were important influencing factors of BCVA at 3 and 6 mo after surgery(all P<0.05).

CONCLUSION:Visual function of patients with high myopia and MHRD gradually increases after surgery, and is closely related to postoperative CBFA, DEZA and blood flow density. It is recommended to regularly monitor changes in OCT and OCTA indicators after surgery.