• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Decreased retinal microvasculature densities in pterygium

    2021-12-17 02:43:20FengWangQianMinGeHuiYeShuXuLinLiaoRongBinLiangQiuYuLiLiJuanZhangGuiPingGaoYiShao
    International Journal of Ophthalmology 2021年12期

    Feng Wang, Qian-Min Ge, Hui-Ye Shu, Xu-Lin Liao, Rong-Bin Liang, Qiu-Yu Li,Li-Juan Zhang, Gui-Ping Gao, Yi Shao

    1Department of Ophthalmology, Meizhou Pepole’s Hospital,Meizhou 514000, Guangdong Province, China

    2Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Jiangxi Centre of National Clinical Ophthalmology Research Centre, Nanchang 330006, Jiangxi Province, China

    3Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Shatin, New Territories 999077, Hong Kong, China

    Abstract

    ● KEYWORDS: retinal microvasculature; density;pterygium; optical coherence tomography angiography

    INTRODUCTION

    Pterygium is a common disease of the ocular surface involving deposition of a triangular mass of fibrovascular tissue from the bulbar conjunctiva to the cornea, usually occurring on the nasal side, and seriously affecting visual acuity[1]. Its pathological mechanism has not been elucidated.Ultraviolet radiation, wind, and dust generally affect the prevalence of pterygium[2]with a incidence up to 39% among people over 50 years old[3]. Pterygium not only affects the patient’s appearance, but also leads to a astigmatism, eye irritation, and dry eyes. Furthermore, the recurrence of pterygium can also cause serious complications such as symblepharon and restriction of eyeball movement[3]. Hill and Maske[4]reported that neovascularization might be involved in the occunrrence and development of ptergium, which is further evidenced by Aspiotiset al[5], he reported that the microvascular (MIR) density from 52 ptergium speciments was significantly increased than that of 7 normal conjunctival tissues analyzed by using the immunohistochemistry staining.Jabbarpoor Bonyadi[6]present spectral domain optical coherence tomography (SD-OCT) findings of bilateral photic maculopathy following pterygium excision; the operations were done under local anaesthesia. They think the use of coaxial light for surgical field illumination during entire procedure were predisposing factors to photic maculopathy.Photic maculopathy has been well documented in sun-gazing[7].Zhouet al[8]found there was a significant increase up in retinal vasculature parameters in macular after cataract surgery.Long-term follow up studies showed that the increase could persist for up to six months. They speculated that the increase in light exposure after intraocular lens (IOL) replacement may be responsible for long-term fundus change. Pterygium that invades the cornea can also block light from entering the refractive media. Whether pterygium can affect the changes of microvessels in the fundus macular area has not been reported at present. Therefore, in-depth studies of pterygium are actively demanded for the prevention and recurrence and disease by throwing light on the its mechanism with great significance.

    Misraet al[9]investigated the changes in visual acuity after pterygium surgery, and found that both unaided and best spectacle corrected visual acuity were improved significantly in 1mo postoperatively, and the improvement was persistent and maintained for 3mo postoperatively. The macular area of the human fundus is largely responsible for the human’s overall vision, because it is the primary distribution locus for the visual cells and retinal ganglion cells[10-11]. It is important to understand the coupling between the macular vascular system and the dense macular neurons. For non-invasive retinal vasculature assessment, in previous studies the researchers used Doppler OCT to monitor blood flow in large vessels, but such method is not sensitive enough to monitor the blood flow of small vessels[12]. To accurately quantify retinal vasculature,optical coherence tomography angiography (OCTA) offers data with good repeatability and reproducibility, which is capable of measuring both macrocirculation and microcirculation[13].Recently, benefited by the application of OCTA technique as a novel non-invasive measurement. Therefore, in this study,we applied the OCTA technique to investigate the retinal microvasculature alteration in pterygium, and the correlation with the disease course and area size of pterygium.

    SUBJECTS AND METHODS

    Ethical Approval This study was approved by the Ethics Committee of Medical School of Nanchang University and performed in accordance with the Declaration of Helsinki principles. Informed consent was obtained from all individual participants included in the study.

    In this study, 18 left eyes from 18 female patients with pterygium and 18 left eyes from 18 female healthy controls were enrolled. All subjects were evaluated by a retinal specialist from the First Affiliated Hospital of Nanchang University between 2017 and 2018. The age with all the subjects was between 40 and 48 years old, with average age of 46±10y.

    All patients underwent clinical examination and ophthalmological assessment at the first visits. The inclusion criteria included: 1) female patients first diagnosed with primary pterygium occurring in the nasal side in her left eye;2) head of the pterygium invaded 2.0-7.0 mm toward the corneal limbus; 3) a disease history of 7-20y, with an average of 6.70±5.01y; 4) binocular fixation was good, and the diopter difference between the two eyes not exceed 2 D; 5) intraocular pressure was 11-21 mm Hg (1 mm Hg=0.133 kPa) with normal fundus conditions.

    The exclusion criteria included: 1) eye surgery or trauma;2) corneal diseases (including the large cornea,the small cornea,keratoconus,etc.); 3) eye disease or other systemic diseases affecting eye circulation, such as glaucoma,hypertension, diabetes,etc; 4) drug treatment within the past two weeks; 5) fundus examination indicated highly myopic and pathological macular changes (including macular holes, neovascularization, atrophy,etc.); 6) severe cataracts, mblyopia, and patients wearing contact lenses;7) systemic diseases including mental and central nervous system disorders; 8) pregnancy and lactating women; 9)pseudopterygium and fibromyalgia; 10) pupil dilation and dilation agent sensitive. The demographic characteristics and clinical findings of patients with pterygium and healthy controls were summarized in Table 1.

    All subjects underwent complete ophthalmological evaluations,including: 1) Slit lamp examination. Slit lamp microscopy was used to examine the anterior segment of the eye, and to detect ocular inflammation, corneal opacity or severe cataracts with image refraction, and the size of any pterygium, and the scope of corneal limbus invasion. 2) Visual acuity. A logarithmic visual acuity chart was used, and the binocular vision and the best corrected visual acuity was obtained for all the subjects.3) Intraocular pressure. A TDT tonometer (BiCOM, Long Beach, NY, USA) was used to measure intraocular pressure three times. The intraocular pressure measured in both eyes was less than 21 mm Hg. The difference between the two measurements was ≤3 mm Hg, and the average value was calculated. 4) Dimensional parameters of pterygium include:length (defined as the distance from the corneal limbus to the edge of the pterygium), height (defined as the distance between the relative edge of the pterygium and the corneal limbus),and area (as defined as the surface area of the cornea invaded by pterygium) were calculated using the Image J of the National Institutes of Health, Bethesda, MD, USA (Figure 1)[14].Corneal diameters were measured with digital calipers from 18 patients. The images were calibrated with pixels/mm(mean=368.12 and standard deviation=9.74 pixels/mm). Theaccuracy of the measurements per mm was 0.025 mm. Given the possibility that different corneal diameters have different types of effects on the pterygium, three new parameters were defined and calculated from the length, height, and area of the pterygium by using corneal diameters (D). The length, hight,and area of each pterygium were measured 5 times to generate an average.

    Table 1 Demographic characteristics and clinical findings of patients with pterygium and healthy controls

    To simultaneously visualize the retinal cross sections and microvasculature, OCTA imaging was performed with the RTVue Avanti XR system (Optovue, Fremont, CA, USA).The scan speed was set to 70 000 A-scans/second, with a central wavelength of 840 nm and bandwidth of 45 nm super light-emitting diode[15]. Imaging was performed using angiographic[16-17]repeated B-scans of 6×6-mm2scan patterns of 216 A-scans (along the X-axis) each at 216 raster positions,focused at the foveal center, and the acquisitiontime was 3.9s.The superficial and deep microvasculature from the retina may be obtained from the automatic fractionation. We acquired 6×6-mm2OCTA images by a series of 2 volume scans: 1 horizontal and 1 vertical gratings. For each eye, 3-dimensional 6×6-mm2en-face OCT angiograms were calculated. Motion artifacts were corrected using orthogonal scan alignment algorithm. Density was calculated using SSADA algorithm.The retinal superficial blood flow layer was defined as 3 μm below the inner limiting membrane to 15 μm below the inner plexiform layer, and the retinal deep blood flow layer was defined as 15-70 μm below the inner plexiform layer. The superficial retinal layer consists of ganglion cells and inner plexiform layer, while the deep retinal layer consists of inner nuclear layer and outer plexus layer. These layers contain the entire retinal vascular system[18]. Patients with pterygium invading the pupil and affecting the examination were given point-eye dilatation examination with short-acting dilatation agent. We can better understand the relationship between pterygium and macular vascular density area (Figure 2), and the zoning method for area of macular retinal is shown in Figure 3.

    Figure 1 Illustration of dimensional parameters of pterygium Clinical photographic imaging by using the camera mounted with Zeiss slit lamp and NIH Image J software to measure the size [length(green), height (red), corneal area invasion (yellow)].

    Figure 2 Illustration of the pterygium and macular vascular density area A left corneal limbus pterygium in nasal side and its corresponding macular vascular area.

    Figure 3 The 6×6-mm2 OCTA image of the macular region of the retina A, D: The original OCTA image of superficial and deep retinal vascular plexus respectively, based on the ETDRS partition method, which divided the image into 4 quadrants of vertical and horizontal regions, followed by R, S, L, and I; B, E: The original image of large retinal vessels in the superficial and deep retina, respectively, based on the hsmispheric partition method, which divided the ring area into 4 quadrants, followed by SR, SL, IL, and IR; C, F: The skeletonized microvessel images captured from the superficial and deep retinal vascular plexus, respectively, based on central annuli partition method after removal of the avascular zone (0.6 mm diameter of the fovea), a circular region of 0.6 to 2.5 mm in diameter is defined as the ring with bandwidth of 0.95 mm.The annular region is divided into 6 thin rings with a bandwidth of 0.16 mm. I: Inferior; IL: Inferior left; IR: Inferior right; L: Left; R: Right; S:Superior; SL: Superior left; SR: Superior right.

    Statistical Analysis All data were analyzed by statistical software packages (StatSoft v7.1; Tulsa, OK, USA), and MedCalc software (v10; MedCalc Software, Mariakerke,Belgium). Continuous variables were calculated as the mean±standard deviation. Univariate analysis of variance(ANOVA) was used to analyze the microvessel density in each area of each group. Minimum significant differences were used to assess the difference between the two using a specific test.Pvalues <0.05 were considered to indicate statistically significant differences. The correlation between macular vascular density and the disease course and size of pterygium area was analyzed using Graphpad prism 7.0, and then SPSS 23.0 (IBM Corp, Armonk, NY, USA) was used to plot the receiver operating characteristic curves (ROC) of microvessel density in the retinal epithelium to differentiate between healthy and diseased subjects.

    RESULTS

    By analysis of the microvessel, macrovascular (MAR) ring,and microvessel density in superficial layer (Figure 4) and deep layer (Figure 5) between the two groups, we found that the vascular density of superficial microvessel (SMIR) in the pterygium group was decreased significantly when compared to the healthy control group (P<0.05; Figure 4A). Similarly,the vascular density of deep total microvessel (DTMI) and deep microvessel (DMIR) also decreased significantly(P<0.05; Figure 5A). However, MAR density was not significantly altered in either layer. Using the hemispheric partition and Early Treatment Diabetic Retinopathy Study(ETDRS) method for comparison, we found that the vascular density of superior right (SR), inferior right (IR), and right (R)in superficial layer was decreased significantly (P<0.05; Figure 4B and 4C), and the vascular density in SR, IR, and R in the deep layer decreased significantly (P<0.05; Figure 5B and 5C)as well. Using the central annuli method for comparison, we found that the vascular density in region of superficial central SC1, SC2, and SC3 in the superficial layer was decreased significantly (P<0.05; Figure 4D). For the deep retinal layers,the vascular density in the regions of deep central (DC)2 and DC3 also decreased significantly (P<0.05; Figure 5D). No statistically significant differences were observed in other regions (P>0.05).

    The retinal vessel density measured by OCTA showed the best sensitivity and specificity to differentiate pterygium from healthy control. In the superficial layer, the SC2 density had the highest positive likelihood ratios in the pterygium group,while SC1 showed the lowest negative likelihood ratio (Figure 6).ROC analysis revealed that SC2 had the highest sensitivity and specificity with the area under curve (AUC) 0.85 (95%CI:0.72-0.98), and SC1 had the lowest sensitivity and specificity with the AUC 0.63 (95%CI: 0.44-0.82; Figure 6). Similarly, in the deep retinal layer, the DC2 density had the highest positive likelihood ratios in the pterygium group, while the IR showed the lowest negative likelihood ratio (Figure 6). ROC analysis revealed that DC2 had the highest sensitivity and specificity with the AUC 0.85 (95%CI: 0.72-0.98), and IR had the lowest sensitivity and specificity with the AUC 0.72 (95%CI: 0.54-0.89; Figure 6).

    Figure 4 Comparisons of macula retinal vessel density (D box) between pterygium and control subjects in the superficial layer Compared with the control group, there were significant differences in the densities of SMIR in macular region of pterygium patients (P<0.05),but no statistically differences in densities in the STMI and SMAR region (all P>0.05). In the pterygium group, the microvessel density in SR,IR, R, SCl, SC2, and SC3 region was significantly decreased compared to the control group (P<0.05). No statistically significant differences was observed in other partitions (P>0.05). aP<0.05, pterygium vs control. SMIR: Superficial microvessels; SMAR: Superficial macrovascula; STMI:Total superficial microvessels; DMAR: Deep macrovascula; IR: Inferior right; R: Right; SR: Superior right; SC: Superficial central annuli.

    Figure 5 Comparisons of macula retinal vessel density (D box) between pterygium and control subjects in the deep layer Compared with the control group, there were significant differences in the densities of DTMI and DMIR in macular region of pterygium patients (P<0.05),but no statistically differences in densities in DMAR region (all P>0.05). Meanwhile, the microvessel density of the SR, IR, R, DC2, and DC3 region in the pterygium group was significantly altered (P<0.05). No statistically significant differences were observed in other regions. aP<0.05,pterygium vs control. DMIR: Deep microvessel; DTMI: Deep total microvessel; DMAR: Deep macrovascula; I: Inferior; IL: Inferior left; IR:Inferior right; L: Left; R: Right; S: Superior; SL: Superior left; SR: Superior right; DC: Deep central annuli.

    Figure 6 ROC analysis of microvessel densities in the superficial and deep layers A: Representative of ROC obtained with the densities of the superficial layer in pterygium group. The density for largest areas under the AUC of the SC2 was 0.85 (95%CI: 0.72-0.98), and the density for lowest areas under the AUC of SC1 was 0.63 (95%CI: 0.44-0.82). B: Representative of ROC obtained with the density of the deep vessel in the pterygium group. The density for largest areas under the AUC of the DC2 was 0.85 (95%CI: 0.72-0.98), and the density for lowest areas under the AUC of IR was 0.72 (95%CI: 0.54-0.89). ROC: Receiver operating characteristic curve; DMIR: Deep microvessel; SMIR: Superficial microvessels; DTMI: Deep total microvessel; AUC: Area under curve; IR: Inferior right; R: Right; SR: Superior right; SC1, 2: Superficial central annuli 1, 2; DC1, 2: Deep central annuli 1, 2.

    We next investigated the correlation among MIR, SR, IR,SC1, SC2, and SC3 in the superficial retinal layer with disease course in pterygium group. In the pterygium group, the correlation coefficient of SMIR density and disease course was-0.7662, and the correlation coefficient of the SR density with disease course was -0.6038. And the correlation coefficient of IR density with disease course was -0.6234, and the correlation coefficient of the SC1 density and disease course was -0.7762.Besides, the correlation coefficient of SC2 density with disease course was -0.7123, and the correlation coefficient of the SC3 density with disease course was -0.6615. No correlation in other region density with disease course was found (|r|<0.47,P>0.05). These results indicated that decreased macular density in superficial layer of MIR, SR, IR, SCI, SC2 and SC3 might be negatively correlated with the disease course, suggesting that the longer the disease course, the lower vascular density in those regions.

    Besides, we also analyzed the correlation between the vascular density of superficial retinal and the area size of pterygium.Our analyzed data showed that in the pterygium group, the correlation coefficient of SMIR density with the area size of pterygium was -0.9508, and the correlation coefficient of the SR density with the area size of pterygium was -0.8935. The correlation coefficient of IR density with pterygium area size was -0.9359, and the correlation coefficient of the R density with the area size of pterygium was -0.6043. Besides, the correlation coefficient of SC1, SC2 and SC3 densities with the area size of pterygium was -0.8217, -0.8976, and -0.7757,respectively (Table 2). No correlation in other region density with area size of pterygium was found (|r|<0.47,P>0.05).These results indicated that decreased macular density in superficial layer of MIR, SR, IR, R, SCI, SC2 and SC3 might be negatively correlated with the area size of pterygium,suggesting that the bigger the area size of pterygium, the lower vascular density in those regions.

    Furthermore, in deep retinal layer, we also analyzed the vascular densities of deep retinal (DMIR), and showed that in the pterygium group, the correlation coefficient of DTMI density with disease course was -0.7003, and the correlation coefficient of the DMIR density with disease course was-0.6901. And the correlation coefficient of SR density with disease course was -0.7795, and the correlation coefficient of the IR density with disease course was -0.7198. Besides,the correlation coefficient of R, DC2, and DC3 density with disease course was -0.7608, -7504 and -0.7195, respectively(Table 2). No correlation in other region density with disease course was found (|r|<0.47,P>0.05). These results indicated that decreased macular density in deep layer of microvascular(TMI), MIR, SR, IR, R, C2, and C3 might be negatively correlated to the disease course, suggesting that the longer the disease course, the lower vascular density in those regions.

    Besides, we also analyzed the correlation between the vascular density of deep retinal and the area size of pterygium, and showed that in the pterygium group, the correlation coefficient of DTMI density with the area size of pterygium was -0.9563,and the correlation coefficient of the DMIR density with the area size of pterygium was -0.9508. And the correlation coefficient of SR density with pterygium area size was -0.8935,and the correlation coefficient of the IR density with the area size of pterygium was -0.9359. Besides, the correlationcoefficient of R, DC2 and DC3 densities with the area size of pterygium was -0.6043, -0.8976, and -0.7757, respectively(Table 2). No correlation in other region density with area size of pterygium was found (|r|<0.47,P>0.05).These results indicated that decreased macular density in deep layer of TMI,MIR, SR, IR, R, C2, and C3 might be negatively correlated to the area size of pterygium, suggesting that the bigger the area size of pterygium, the lower vascular density in those regions.

    Table 2 Correlation analysis of density in superficial retinal layer and deep retinal layer with the disease course and the area size of pterygium

    DISCUSSION

    In this study, we used OCTA to investigate the retinal microvasculature alteration in pterygium. To our knowledge,this was the first study to discover and report that the vascular density decreased in the macular area of patients with pterygium, and the major vascular alterations occurred mainly on the bitamporal side. We further found that the decreased vascular density of the macula was negatively correlated to the disease course and to the area size of pterygium. There is quite few technique used in the study of retinal, choroid,and retrobulbar blood circulation[19-20]. OCTA has revealed many details of the superficial and deep retinal layers[21].Many studies have shown that OCTA can be used to diagnose choroidal neovascularization (CNV), age-related macular degeneration (AMD)[22], retinal vein occlusion (RVO)[21],abnormal retinal vessels[23], and even non-permeable AMD[24]and melanocyte tumors. Thus OCTA could be an important technique for studying the progression, retinal pathology, and complications of pterygium by providing scientific evidences on vascular density alteration.By using the OCTA technique in pterygium, our results showed that vascular densities decreased in the retinal superficial MIR,SR, IR, R, and retinal deep TMI, MIR, SR, IR, R in pterygium patients. The major decreased region was on the bitamporal side of macula. The annuli partition method showed that vascular density of the superficial annuli (SC)1, SC2, SC3 in the foveal and deep layer of C2, C2 regions, significantly decreased. Zhaoet al[25]found there was a significant increase in retinal vessel density, a decrease in the foveal avascular zone at the macular area after the cataract surgery. They also found that the retinal vessel density of the parafoveal and perifoveal regions increased significantly at 1wk, 1, and 3mo after the cataract surgery. At 3mo after surgery, there was a mean 6%±11% and 3%±10% increase in vessel density at the parafoveal and perifoveal regions, respectively compared with the baseline, which seems consistent with our data. It has been estimated that a cataract might block 18% to 40% of light at different wave-lengths. Zhaoet al[25]thought that the increase density in macular vasculature in cataract patients resulted from the increase of light exposure. Zhouet al[8]found macular vessel density to be significantly increased after cataract surgery. Postoperative inflammatory reactions have been considered as potential pathogenic factors for postoperative fundus change[26-27]. But inflammation by itself cannot explain why the increase persists for so long, they thought higher exposure lever of light may lead to angiogenesis by inducing retinal metabolic activation, which could be regarded as postoperative light toxicity, this might also explain the relatively high incidence of AMD found in those IOL eyes[28].Our data also supported the hypothesis. Pterygium blocked the light exposure from cornea, which may lead to a reduction in retinal activity and metabolic demands[29], leading to a decreased vascular density. Hardarsonet al[30]tried to address this question. However, their results were shown uncertain.Pterygium occurs on the nasal side, which blocks refraction and scattering of light from the refractive stroma in this region,therefore mainly affecting the retina on bitamporal side. On the other hand, the decreased light exposure may be associated with the metabolic changes and the unique vascular pattern of the central fovea. Light vision is accomplished by cone cells, which are also in the highest density in the central fovea.The decreased light exposure leads to a decreased activity of cone cells. Furthermore, the consistency of this location also supports the hypothesis that the decreased light exposure may lead to the decreased density in macular blood vessels.

    Our data also showed that in the pterygium group, SC2 and DC2 had the highest positive likelihood ratio, and SC1 and IR had the lowest negative likelihood ratio. And we found that the decreased vascular density was negatively correlated with the disease course, and the size of pterygium area.Pterygium is caused by dysfunction of limbal stem cells and a decrease in the number of stem cells, resulting in an active proliferation and remodeling of conjunctival fibroblasts and vascularization of connective tissue. The most significantly pathological alterations of pterygium is the proliferation and degeneration of elastic fibers and collagen fibers. But it is not a simple process of proliferation, but an ever-changing process[31]. This obviously pathological alterations indicated that the longer the disease course of the pterygium, the larger size of the pterygium area would develop, therefore blocking more external sunlight into the bitamporal retina. Aspiotiset al[5]reported that pterygium tissues presented with statistically significant higher density of average count of microvessel,when compared to normal conjunctivae, and the angiogenesisrelated factors were highly expressed in pterygium tissue.

    Decreased macular vascular density may also affect visual acuity. Hittonet al[32]reported that after cataract surgery, the increased vascular density in macula was beneficial to the eyes. Our results showed that the visual acuity decreased significantly in pterygium when compared to healthy control(Table 1). But pterygium can also cause corneal alteration[33],leading to a decreased visual acuity, although the posterior corneal surface has been shown to compensate for anterior corneal astigmatism[34]. Corneal astigmatism and ocular wavefront aberrations are also found to be related to the area size of the pterygium[35]. Large pterygium can invade the pupillary area and lead to a decrease in visual acuity. Since it is difficult to control these factors, it is not clear whether it is beneficial to the eyes. Surgical removal is still the main therapy for pterygium[36]. After pterygium excision, astigmatism and the wavefront aberration caused by the pterygium on the cornea will be greatly reduced[35]. Visual acuity will also be significantly improved. The decreased vascular density in macula will help to understand the pathophysiological mechanisms involved in the pterygium. This study has some limitations. We did not measure the vascular endothelial growth factor (VEGF). A significant increase of VEGF was reported to occur in pterygium patients[37]. VEGF is mainly produced by fibroblasts. A variety of factors including inflammation, hypoxia, toxic substances, and ultraviolet damage, can affect its expression[38]. The formation of pterygium is accompanied by the growth of activated fibroblasts, the excessive proliferation of extracellular matrix,and inflammation. Whether the production of VEGF will alter the vascular density, we have no answer since no VEGF was tested in the study due to the difficulty in biopsy availabilities.In addition, we also consider that pterygium may lead to low measurements of macular vascular density in healthy eyes, as this can lead to artifact generation, which needs further study.In summary, this study, by using the OCTA, a convenient and rapid technique to detect the microvessel alteration in the retina macular area in pterygium patients, we first discovered and reported a decreased vascular density in fundus of the pterygium patients. and we further found that the vascular density was negatively correlated to the disease course and the size of the pterygium area. Weather such changes might affect the fundus in long still needs to be verified,more studies are still needed to investigate whether the vascular density of the macula would recover after pterygium is removed by surgery. Pterygium blocked the light exposure from cornea,which may lead to a reduction in retinal activity and metabolic demands leading to a decreased vascular density. Detailed analysis according to non-invasive OCTA techniques could be beneficial towards better to characterize the underlying pathophysiological mechanisms involved in pterygium.

    ACKNOWLEDGEMENTS

    Foundations: Supported by National Natural Science Foundation of China (No.82160195); Central Government Guides Local Science and Technology Development Foundation (No.20211ZDG02003); Key Research Foundation of Jiangxi Province (No.20181BBG70004;No.20203BBG73059); Excellent Talents Development Project of Jiangxi Province (No.20192BCBL23020).

    Conflicts of Interest:Wang F, None; Ge QM, None; Shu HY, None; Liao XL, None; Liang RB, None; Li QY, None;Zhang LJ, None; Gao GP, None; Shao Y, None.

    亚洲国产精品成人久久小说| 高清不卡的av网站| 久久久久人妻精品一区果冻| 久久热在线av| 亚洲国产精品一区三区| 欧美日韩视频高清一区二区三区二| 日日爽夜夜爽网站| 国产精品嫩草影院av在线观看| 下体分泌物呈黄色| 水蜜桃什么品种好| 丝袜在线中文字幕| 悠悠久久av| 涩涩av久久男人的天堂| 国产野战对白在线观看| 天天影视国产精品| 欧美精品亚洲一区二区| 美国免费a级毛片| 人妻人人澡人人爽人人| 精品国产一区二区久久| av有码第一页| 另类亚洲欧美激情| tube8黄色片| 熟妇人妻不卡中文字幕| 一边摸一边抽搐一进一出视频| 2018国产大陆天天弄谢| 精品久久蜜臀av无| 亚洲精品视频女| 亚洲精品,欧美精品| 大香蕉久久成人网| 亚洲第一区二区三区不卡| 女人被躁到高潮嗷嗷叫费观| 丝袜美足系列| 欧美少妇被猛烈插入视频| 亚洲美女黄色视频免费看| 中文天堂在线官网| 欧美最新免费一区二区三区| 中文字幕人妻丝袜一区二区 | 欧美最新免费一区二区三区| 久久鲁丝午夜福利片| 久久久久久久久久久免费av| 制服诱惑二区| 国产日韩一区二区三区精品不卡| 亚洲熟女毛片儿| 国产av一区二区精品久久| 亚洲av欧美aⅴ国产| 午夜激情久久久久久久| a级毛片黄视频| 日本欧美视频一区| 久久精品国产亚洲av高清一级| 成人国语在线视频| 亚洲欧美清纯卡通| 日本欧美视频一区| 亚洲成人av在线免费| 成人国产麻豆网| 卡戴珊不雅视频在线播放| 天天躁夜夜躁狠狠躁躁| 国产男女超爽视频在线观看| 女人精品久久久久毛片| 一本大道久久a久久精品| 日本91视频免费播放| 大陆偷拍与自拍| 国产麻豆69| 精品少妇内射三级| 国产在线一区二区三区精| 国产免费现黄频在线看| 免费不卡黄色视频| 夜夜骑夜夜射夜夜干| av在线老鸭窝| 国产成人精品无人区| 国产亚洲欧美精品永久| www日本在线高清视频| 免费少妇av软件| 亚洲av日韩精品久久久久久密 | 人妻人人澡人人爽人人| 中国国产av一级| 精品一区二区免费观看| 少妇人妻久久综合中文| 国产极品天堂在线| 免费高清在线观看日韩| 欧美激情极品国产一区二区三区| 在线观看免费视频网站a站| 欧美黑人精品巨大| 91成人精品电影| 尾随美女入室| av在线观看视频网站免费| 搡老乐熟女国产| 啦啦啦啦在线视频资源| 岛国毛片在线播放| 亚洲av男天堂| 欧美国产精品va在线观看不卡| 美女中出高潮动态图| 国产精品久久久久久人妻精品电影 | 亚洲,一卡二卡三卡| bbb黄色大片| 久久久久视频综合| 久久午夜综合久久蜜桃| 在线观看www视频免费| 国产探花极品一区二区| bbb黄色大片| 91精品伊人久久大香线蕉| 午夜精品国产一区二区电影| 精品国产乱码久久久久久男人| 女人精品久久久久毛片| 国产精品久久久久久精品电影小说| avwww免费| 电影成人av| 中文字幕最新亚洲高清| 精品国产超薄肉色丝袜足j| 国产精品二区激情视频| 亚洲美女视频黄频| av电影中文网址| 久久久国产欧美日韩av| 天天操日日干夜夜撸| 久久久久精品国产欧美久久久 | av一本久久久久| 国产无遮挡羞羞视频在线观看| 日本黄色日本黄色录像| 国产精品秋霞免费鲁丝片| av国产久精品久网站免费入址| 国产成人系列免费观看| 天天操日日干夜夜撸| 久久影院123| 另类精品久久| 亚洲av电影在线进入| 亚洲成国产人片在线观看| 在现免费观看毛片| kizo精华| 欧美精品一区二区免费开放| 大片免费播放器 马上看| 午夜福利视频在线观看免费| 久久天躁狠狠躁夜夜2o2o | 国产1区2区3区精品| 女人被躁到高潮嗷嗷叫费观| 大陆偷拍与自拍| 一本色道久久久久久精品综合| 国产精品久久久久久精品电影小说| 人妻 亚洲 视频| 视频在线观看一区二区三区| 综合色丁香网| 亚洲伊人色综图| 久久99一区二区三区| 搡老乐熟女国产| 在线亚洲精品国产二区图片欧美| 亚洲av日韩精品久久久久久密 | 中文字幕最新亚洲高清| 国产爽快片一区二区三区| 叶爱在线成人免费视频播放| www.精华液| 亚洲av综合色区一区| 亚洲av电影在线进入| 中文精品一卡2卡3卡4更新| 97精品久久久久久久久久精品| 国产一区二区三区综合在线观看| 亚洲精品乱久久久久久| 欧美成人午夜精品| 亚洲人成77777在线视频| 日韩av免费高清视频| 国产精品一二三区在线看| 捣出白浆h1v1| 日本vs欧美在线观看视频| 一二三四中文在线观看免费高清| 欧美老熟妇乱子伦牲交| 人妻一区二区av| 考比视频在线观看| 精品酒店卫生间| 国产伦理片在线播放av一区| 精品少妇黑人巨大在线播放| 大话2 男鬼变身卡| 国产精品 国内视频| 精品久久久久久电影网| 亚洲欧洲日产国产| av国产精品久久久久影院| 天堂8中文在线网| 国产av国产精品国产| 免费黄色在线免费观看| 国产精品.久久久| 一区二区三区精品91| 9色porny在线观看| 国产野战对白在线观看| 婷婷色麻豆天堂久久| 国产免费视频播放在线视频| 久久精品熟女亚洲av麻豆精品| 街头女战士在线观看网站| 亚洲婷婷狠狠爱综合网| 国产精品久久久人人做人人爽| 99热国产这里只有精品6| 超碰成人久久| 不卡视频在线观看欧美| 777米奇影视久久| 亚洲精品在线美女| 国产av精品麻豆| 成人影院久久| 久久精品国产a三级三级三级| 色94色欧美一区二区| 美女大奶头黄色视频| av在线app专区| 国产精品国产av在线观看| 伊人亚洲综合成人网| √禁漫天堂资源中文www| 狠狠精品人妻久久久久久综合| 精品免费久久久久久久清纯 | 日本av手机在线免费观看| 久久久国产欧美日韩av| 如日韩欧美国产精品一区二区三区| 一本久久精品| 亚洲男人天堂网一区| 国产精品亚洲av一区麻豆 | 国产成人91sexporn| 日韩 亚洲 欧美在线| 黄色视频不卡| 欧美中文综合在线视频| 丝瓜视频免费看黄片| 一级片免费观看大全| 美女福利国产在线| 国产又色又爽无遮挡免| 亚洲成国产人片在线观看| 亚洲精品在线美女| 午夜福利网站1000一区二区三区| 久久精品久久精品一区二区三区| 日韩精品免费视频一区二区三区| 又大又黄又爽视频免费| 久热爱精品视频在线9| 免费高清在线观看日韩| 91老司机精品| 国产又爽黄色视频| 操出白浆在线播放| 九色亚洲精品在线播放| 色网站视频免费| 欧美精品av麻豆av| 一个人免费看片子| 久久精品久久久久久噜噜老黄| 美女国产高潮福利片在线看| 性高湖久久久久久久久免费观看| av一本久久久久| 男女午夜视频在线观看| 成人黄色视频免费在线看| 亚洲四区av| 精品酒店卫生间| 精品一区在线观看国产| 天天影视国产精品| 精品一区二区三区四区五区乱码 | 高清在线视频一区二区三区| 久久精品亚洲av国产电影网| 国产片特级美女逼逼视频| 九草在线视频观看| 国产亚洲最大av| 男女午夜视频在线观看| 99香蕉大伊视频| 国产精品99久久99久久久不卡 | 国产黄色视频一区二区在线观看| 美女脱内裤让男人舔精品视频| 日韩成人av中文字幕在线观看| 精品国产一区二区三区四区第35| 亚洲国产av影院在线观看| 国产精品国产三级国产专区5o| 精品国产乱码久久久久久男人| 亚洲精品久久午夜乱码| 国产又色又爽无遮挡免| 日韩中文字幕视频在线看片| 丝瓜视频免费看黄片| 久久精品亚洲av国产电影网| 日韩 亚洲 欧美在线| 久久亚洲国产成人精品v| 大陆偷拍与自拍| 搡老岳熟女国产| 搡老岳熟女国产| 国产免费现黄频在线看| 日本色播在线视频| 成人漫画全彩无遮挡| 久久99一区二区三区| 一本—道久久a久久精品蜜桃钙片| 久久人人爽人人片av| av.在线天堂| 国精品久久久久久国模美| 少妇被粗大的猛进出69影院| 亚洲精品乱久久久久久| 久久人人97超碰香蕉20202| 又大又爽又粗| 老司机影院成人| 99re6热这里在线精品视频| 国产男女内射视频| 一个人免费看片子| 国产成人91sexporn| 飞空精品影院首页| 青草久久国产| 一级a爱视频在线免费观看| 免费观看人在逋| 国产1区2区3区精品| 尾随美女入室| 伦理电影免费视频| 男女无遮挡免费网站观看| e午夜精品久久久久久久| 女的被弄到高潮叫床怎么办| 这个男人来自地球电影免费观看 | 国产av码专区亚洲av| 最近中文字幕高清免费大全6| 热99久久久久精品小说推荐| √禁漫天堂资源中文www| 国产成人系列免费观看| 一级毛片 在线播放| 激情视频va一区二区三区| 日韩熟女老妇一区二区性免费视频| 亚洲国产av新网站| 欧美日韩视频高清一区二区三区二| 国产黄色视频一区二区在线观看| 婷婷成人精品国产| 1024香蕉在线观看| 欧美xxⅹ黑人| 少妇的丰满在线观看| 久久韩国三级中文字幕| 黄色 视频免费看| 蜜桃在线观看..| 一区在线观看完整版| 丰满乱子伦码专区| 国产在视频线精品| 亚洲av在线观看美女高潮| 欧美日韩一区二区视频在线观看视频在线| 9色porny在线观看| 18禁国产床啪视频网站| 伦理电影免费视频| 国产成人午夜福利电影在线观看| 又粗又硬又长又爽又黄的视频| 久久久国产欧美日韩av| 国产97色在线日韩免费| 男女午夜视频在线观看| 七月丁香在线播放| 精品亚洲乱码少妇综合久久| 精品一区二区免费观看| 亚洲精品一区蜜桃| 日本wwww免费看| 在线亚洲精品国产二区图片欧美| 99香蕉大伊视频| 国产无遮挡羞羞视频在线观看| 欧美亚洲 丝袜 人妻 在线| 久久久久精品性色| 人成视频在线观看免费观看| 下体分泌物呈黄色| a级毛片在线看网站| 9热在线视频观看99| 久久精品国产亚洲av高清一级| 最近手机中文字幕大全| 大陆偷拍与自拍| 好男人视频免费观看在线| videosex国产| 精品卡一卡二卡四卡免费| 国产探花极品一区二区| 国产97色在线日韩免费| 亚洲欧洲精品一区二区精品久久久 | 精品一品国产午夜福利视频| 亚洲国产av新网站| 极品少妇高潮喷水抽搐| 一本—道久久a久久精品蜜桃钙片| 老熟女久久久| 精品国产一区二区久久| 精品亚洲乱码少妇综合久久| 色吧在线观看| 国产成人系列免费观看| 啦啦啦在线观看免费高清www| 新久久久久国产一级毛片| 性少妇av在线| 国产日韩欧美亚洲二区| 成年女人毛片免费观看观看9 | 一本一本久久a久久精品综合妖精| av一本久久久久| 国产午夜精品一二区理论片| 国产人伦9x9x在线观看| 欧美黑人欧美精品刺激| 看免费av毛片| 久久久国产精品麻豆| 中文字幕高清在线视频| 国产高清不卡午夜福利| 我要看黄色一级片免费的| 免费观看av网站的网址| 中文乱码字字幕精品一区二区三区| 国产福利在线免费观看视频| 国产精品99久久99久久久不卡 | 成年av动漫网址| 欧美日韩福利视频一区二区| 成年av动漫网址| 一区二区av电影网| 女人高潮潮喷娇喘18禁视频| 各种免费的搞黄视频| 无遮挡黄片免费观看| 一本色道久久久久久精品综合| 天天躁狠狠躁夜夜躁狠狠躁| 中文字幕色久视频| 国产精品久久久av美女十八| 国产亚洲欧美精品永久| 亚洲视频免费观看视频| 日本av手机在线免费观看| 日韩,欧美,国产一区二区三区| xxxhd国产人妻xxx| 波野结衣二区三区在线| av不卡在线播放| 永久免费av网站大全| 777久久人妻少妇嫩草av网站| 一级,二级,三级黄色视频| 一边摸一边做爽爽视频免费| 香蕉国产在线看| 国产精品蜜桃在线观看| 亚洲伊人久久精品综合| 欧美精品高潮呻吟av久久| 午夜激情久久久久久久| 精品人妻在线不人妻| 久久久精品94久久精品| 精品少妇黑人巨大在线播放| 好男人视频免费观看在线| 丝袜美腿诱惑在线| 国产老妇伦熟女老妇高清| 日韩人妻精品一区2区三区| 精品少妇一区二区三区视频日本电影 | 日本爱情动作片www.在线观看| 国产探花极品一区二区| av国产久精品久网站免费入址| av.在线天堂| 亚洲国产精品成人久久小说| 亚洲精品久久久久久婷婷小说| 免费看av在线观看网站| 国产欧美日韩综合在线一区二区| 精品亚洲成国产av| 欧美日韩亚洲国产一区二区在线观看 | 免费看av在线观看网站| 如日韩欧美国产精品一区二区三区| 亚洲欧美一区二区三区国产| 成年美女黄网站色视频大全免费| 男男h啪啪无遮挡| 欧美老熟妇乱子伦牲交| 极品人妻少妇av视频| 97精品久久久久久久久久精品| 亚洲人成77777在线视频| 黑人欧美特级aaaaaa片| 国产亚洲精品第一综合不卡| 日本av免费视频播放| 国产精品嫩草影院av在线观看| 午夜福利在线免费观看网站| 欧美日韩视频高清一区二区三区二| 久久久精品国产亚洲av高清涩受| 老司机在亚洲福利影院| 黑丝袜美女国产一区| 久久综合国产亚洲精品| 久久婷婷青草| 亚洲美女视频黄频| 性色av一级| 日韩人妻精品一区2区三区| 一级毛片我不卡| 亚洲成色77777| 久久青草综合色| 亚洲,欧美精品.| 男女国产视频网站| 男人添女人高潮全过程视频| av片东京热男人的天堂| 蜜桃国产av成人99| 色精品久久人妻99蜜桃| 国产在视频线精品| 亚洲中文av在线| 久久久久人妻精品一区果冻| 精品人妻在线不人妻| 一级毛片 在线播放| 三上悠亚av全集在线观看| 久久av网站| 亚洲精品国产色婷婷电影| 欧美97在线视频| 精品久久蜜臀av无| av在线app专区| 日韩一卡2卡3卡4卡2021年| 九九爱精品视频在线观看| 久久精品亚洲av国产电影网| 狂野欧美激情性bbbbbb| 美女大奶头黄色视频| 啦啦啦啦在线视频资源| 亚洲av男天堂| 久久久欧美国产精品| 亚洲精品久久午夜乱码| 中文字幕人妻丝袜制服| 亚洲熟女毛片儿| 日韩不卡一区二区三区视频在线| 巨乳人妻的诱惑在线观看| 中文字幕最新亚洲高清| 人人妻人人澡人人爽人人夜夜| 女性被躁到高潮视频| 汤姆久久久久久久影院中文字幕| 麻豆乱淫一区二区| 久久久亚洲精品成人影院| 国产片特级美女逼逼视频| 国产成人精品久久久久久| 婷婷色综合www| 叶爱在线成人免费视频播放| 天天躁日日躁夜夜躁夜夜| 久久女婷五月综合色啪小说| 亚洲,一卡二卡三卡| 国产精品av久久久久免费| 最近2019中文字幕mv第一页| 久久精品久久久久久噜噜老黄| 天天影视国产精品| 国产成人av激情在线播放| 99精国产麻豆久久婷婷| 秋霞在线观看毛片| 国产精品成人在线| 丝袜在线中文字幕| 少妇被粗大猛烈的视频| 天天躁夜夜躁狠狠躁躁| 国产麻豆69| 免费少妇av软件| 国产男女内射视频| 亚洲人成网站在线观看播放| 亚洲欧洲精品一区二区精品久久久 | 18禁动态无遮挡网站| 汤姆久久久久久久影院中文字幕| 国产亚洲av高清不卡| 18在线观看网站| 国产亚洲av高清不卡| 黄片无遮挡物在线观看| 日日啪夜夜爽| 久久久久人妻精品一区果冻| 大陆偷拍与自拍| 亚洲五月色婷婷综合| 欧美精品一区二区免费开放| 欧美 日韩 精品 国产| 日本wwww免费看| 亚洲少妇的诱惑av| av片东京热男人的天堂| 午夜福利视频在线观看免费| 18禁裸乳无遮挡动漫免费视频| 久久久国产欧美日韩av| 亚洲精品乱久久久久久| 在线观看一区二区三区激情| 狂野欧美激情性xxxx| 国产日韩欧美在线精品| 久久久国产一区二区| 久热这里只有精品99| 丰满乱子伦码专区| 亚洲国产精品999| 看免费av毛片| kizo精华| 国产成人av激情在线播放| 老汉色av国产亚洲站长工具| 啦啦啦在线免费观看视频4| 一级毛片黄色毛片免费观看视频| 日韩免费高清中文字幕av| 亚洲七黄色美女视频| 水蜜桃什么品种好| 最新的欧美精品一区二区| 日韩中文字幕欧美一区二区 | 精品一区二区三区av网在线观看 | 日韩熟女老妇一区二区性免费视频| 好男人视频免费观看在线| 国产熟女欧美一区二区| av女优亚洲男人天堂| 亚洲激情五月婷婷啪啪| 在线观看www视频免费| 看非洲黑人一级黄片| 丝瓜视频免费看黄片| 少妇人妻久久综合中文| tube8黄色片| 午夜免费鲁丝| 久久国产精品大桥未久av| 热99国产精品久久久久久7| 美女大奶头黄色视频| 国产乱来视频区| 亚洲天堂av无毛| 中文字幕亚洲精品专区| 亚洲伊人久久精品综合| 国产日韩欧美在线精品| www.精华液| 欧美激情 高清一区二区三区| 亚洲色图综合在线观看| 黑丝袜美女国产一区| 一本大道久久a久久精品| 精品福利永久在线观看| 亚洲精品国产av蜜桃| 少妇人妻久久综合中文| 日韩 欧美 亚洲 中文字幕| 久久久久精品国产欧美久久久 | 国产男女内射视频| 岛国毛片在线播放| 2021少妇久久久久久久久久久| 男女边摸边吃奶| 精品国产超薄肉色丝袜足j| 国产精品无大码| 男人舔女人的私密视频| 免费在线观看黄色视频的| 丝袜喷水一区| 最近中文字幕高清免费大全6| 欧美精品人与动牲交sv欧美| 亚洲熟女毛片儿| 视频区图区小说| 国产亚洲av片在线观看秒播厂| 又粗又硬又长又爽又黄的视频| 亚洲视频免费观看视频| 热re99久久国产66热| 只有这里有精品99| 日韩 欧美 亚洲 中文字幕| 日日摸夜夜添夜夜爱| 一级毛片黄色毛片免费观看视频| 亚洲欧美中文字幕日韩二区| 18在线观看网站| a级毛片黄视频| 国产黄频视频在线观看| 男人舔女人的私密视频| 国产一区亚洲一区在线观看| 人妻 亚洲 视频| netflix在线观看网站| 香蕉国产在线看| 久热这里只有精品99| 亚洲精品国产av成人精品| 少妇被粗大猛烈的视频| 国产一卡二卡三卡精品 | av有码第一页| 黄网站色视频无遮挡免费观看| 中文精品一卡2卡3卡4更新| 女人久久www免费人成看片| 国产乱来视频区| 2018国产大陆天天弄谢| 99精国产麻豆久久婷婷| 女的被弄到高潮叫床怎么办|