Abstract:
Purpose: We employed automated analysis of scanning laser ophthalmoscopy (SLO) to determine if mechanical strains imposed on disc, and retinal and choroidal vessels during horizontal duction in children differ from those of adults.Methods: Thirty-one children aged 11.3 ± 2.7 (standard deviation) years underwent SLO in central gaze, and 35° ab- and adduction. Automated registration with deep learning-based optical flow analysis quantified vessel deformations as horizontal, vertical, shear, and equivalent strains. Choroidal vessel displacements in lightly pigmented fundi, and central disc vessel displacements, were also observed.Results: As in adults, strain in vessels during horizontal duction was greatest at the disc and decreased with distance from it. Strain in the pediatric disc was similar to published values in young adults,1 but in the peripapillary region was greater and propagated significantly more peripherally to at least three disc radii from it. During adduction in children, the nasal disc was compressed and disc vessels distorted, but the temporal half experienced tensile strain, while peripapillary tissues were compressed. The pattern was similar but strains were less in abduction (p < .001). Choroidal vessels were visualized in 24 of the 62 eyes and shifted directionally opposite overlying retinal vessels.Conclusions: Horizontal duction deforms the normal pediatric optic disc, central retinal vessels, peripapillary retina, and choroid, shearing the inner retina over the choroid. These mechanical effects occur at the sites of remodeling of the disc, sclera, and choroid associated with typical adult features that later emerge later, including optic cup enlargement, temporal disc tilting, and peripapillary atrophy.
摘要:
目的:我们采用扫描激光检眼镜(SLO)的自动分析来确定是否施加在椎间盘上的机械应变,儿童水平诱导时的视网膜和脉络膜血管与成人不同。方法:31名11.3±2.7(标准差)岁的儿童在中央注视中接受SLO,35°和内收。基于深度学习的光流分析的自动配准将血管变形量化为水平,垂直,剪力,和等效菌株。轻度色素沉着基底的脉络膜血管位移,和中央圆盘血管位移,也被观察到了。结果:与成年人一样,水平诱导过程中血管的应变在椎间盘处最大,并随着距椎间盘的距离而减小。小儿椎间盘的应变与年轻人的公开值相似,1,但在乳头状周围区域更大,并且从其向至少三个椎间盘半径向周围传播。在儿童的内收过程中,鼻盘被压缩,盘血管变形,但是时间的一半经历了拉伸应变,而乳头周围组织被压缩。模式相似,但外展菌株较少(p<.001)。在62只眼中的24只眼中可见脉络膜血管,并向上覆的视网膜血管方向移动。结论:水平前移可使正常儿童视盘变形,视网膜中央血管,乳头状视网膜,和脉络膜,在脉络膜上剪切内部视网膜.这些机械效应发生在椎间盘重塑的部位,巩膜,与典型的成人特征相关的脉络膜后来出现,包括光学杯放大,颞叶倾斜,和乳头周围萎缩.