基于OCT观察正视眼及高度近视眼在调节过程中眼前节的形态学变化  

Morphologic Changes in Anterior Segment of the Eye during Accommodation in Emmetropia and High Myopia Based on OCT

作　　者：李子璇 邵一磊 沈梅晓 周煜恒 吴小天 万妮 陈昊 王一益 张日炎 吕帆 Zixuan Li;Yilei Shao;Meixiao Shen;Yuheng Zhou;Xiaotian Wu;Ni Wan;Hao Chen;Yiyi Wang;Riyan Zhang;Fan Lu(National Clinical Research Center for Ocular Diseases,Eye Hospital,Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属眼视光医院,国家眼耳鼻喉疾病(眼部疾病)临床医学研究中心,温州325027

出　　处：《中华眼视光学与视觉科学杂志》2024年第4期254-260,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：国家自然科学基金(82101177)

摘　　要：目的:利用扫频光源眼前节光学相干断层扫描(SS-ASOCT)研究硝酸毛果芸香碱滴眼液刺激睫状肌收缩前后小梁网和Schlemm管的形态变化。方法:横断面研究。连续性纳入2022年4月至2023年6月在温州医科大学附属眼视光医院招募的54名健康受检者,以等效球镜度数(SE)为-0.75~+0.50 D和SE≤-6.00 D为界分为正视组与高度近视组。在应用硝酸毛果芸香碱滴眼液刺激调节前后,利用SS-ASOCT拍摄受检者右眼颞侧小梁网、睫状肌及Schlemm管的图像,通过自行编写的软件分析获取睫状肌最大厚度及睫状肌前部长度、小梁网长度和厚度、Schlemm管面积及直径等参数。采用配对t检验、卡方检验、独立t检验、Pearson相关分析对相关数据进行分析。结果:在调节前后,2组受检者均发生睫状肌最大厚度增加、睫状肌前部长度减小、小梁网长度和宽度增加及Schlemm管面积和直径增大的改变(均P<0.05)。正视组和高度近视组的睫状肌最大厚度变化量(t=4.85,P<0.001)、小梁网长度变化量(t=5.08,P<0.001)、小梁网宽度变化量(t=2.72,P=0.009)、Schlemm管面积变化量(t=3.86,P<0.001)及Schlemm管直径变化量(t=2.02,P=0.049)比较差异均有统计学意义。小梁网长度和Schlemm管面积与睫状肌最大厚度在正视组中均存在相关性(r=0.48,P=0.011;r=0.54,P=0.004),但在高度近视眼中均无相关性。结论:硝酸毛果芸香碱滴眼液诱导的调节过程中,正视眼和高度近视眼均发生睫状肌收缩、小梁网和Schlemm管扩张的形态改变。睫状肌的收缩与小梁网和Schlemm管形态改变的相关性仅在正视眼中存在差异有统计学意义。Objective:We aim to evaluate the relationship between changes in morphological parameters of the ciliary muscle,trabecular meshwork and Schlemm’s canal during pilocarpine-induced accommodation using Swept-source anterior segment optical coherence tomography(SS-ASOCT).Methods:This was a cross-sectional study.Fifty-four healthy subjects were recruited continuously from April 2022 to June 2023 at the Eye Hospital of Wenzhou Medical University.And they were divided into two groups as emmetropia and high myopia groups based on spherical equivalent lens power(SE)of-0.75 to+0.50 D and SE≤-6.00 D respectively.SS-ASOCT images were analyzed to determine the following parameters:the maximum thickness and anterior length of ciliary muscle,the length and width of trabecular meshwork,and the area and diameter of Schlemm's canal.Paired t-test,chi-square test,independent t-test,and Pearson correlation analysis were used to analyze the relevant data.Results:An increase in the maximum thickness of ciliary muscle,the length and width of trabecular meshwork,and the area and diameter of Schlemm’s canal,as well as a decrease in the anterior length of ciliary muscle,were observed in both groups during accommodation(P<0.05).The change in the thickening of the maximum thickness of ciliary muscle was larger in emmetropia than in high myopia(t=4.85,P<0.001).Compared to emmetropic eyes,both the amplitude of changes in the length of trabecular meshwork and the width of trabecular meshwork were significantly smaller in highly myopic eyes(t=5.08,P<0.001;t=2.72,P=0.009),respectively.Besides,notable changes in the Schlemm’s canal area(t=3.86,P<0.001)and the diameter of the Schlemm's canal(t=2.02,P=0.049)were shown in emmetropic eyes than in highly myopic eyes,respectively.The change in the length of trabecular meshwork and the change in the Schlemm's canal area were related to the changes in the maximum thickness of the ciliary muscle(r=0.48,P=0.011;r=0.54,P=0.004)in emmetropia eyes.Neither the changes in the maximum thickness of the cil

关 键 词：睫状肌 小梁网 扫频光源眼前节光学相干断层扫描 调节 

分 类 号：R778.11[医药卫生—眼科]