高度近视眼OCT检查评估和预后预测  

The evaluation and examination of optical coherence tomography in high myopia

作　　者：周华[1] 袁援生[1] 蔡斌[1] 张波涌[1] 周铎[1] 苏宇[1] 

机构地区：[1]昆明医学院第一附属医院眼科,650032

出　　处：《中国斜视与小儿眼科杂志》2007年第1期9-12,F0003,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的对高度近视眼黄斑部进行光学相干断层扫描(Optical Coherence Tomography,OCT)检查评估。方法观察分析60例114眼OCT图象特征,测量黄斑区视网膜神经纤维层厚度,比较其与眼轴长度和矫正视力的关系。结果黄斑区视网膜神经纤维层厚度131μm～169μm,平均145μm±14μm。眼轴≤25mm时,Ⅲ组的眼数多于Ⅰ组(P<0.01);眼轴25～27mm,Ⅱ组眼数多于Ⅰ组(P<0.01);眼轴≥27mm时,Ⅰ组的眼数多于Ⅱ组(P<0.01)。视网膜神经纤维层厚度≤140μm,眼轴≥27mm的眼数多于≤25mm组(P<0.01);厚度141μm～150μm,眼轴25～27mm的眼数明显多于其它两眼轴组(均P<0.01);厚度>150μm,眼轴≤25mm的眼数多于≥27mm组(P<0.01)。厚度≤140μm,则矫正视力≤0.3的眼数多于0.4～0.5组(P<0.05);厚度141μm～150μm,0.4～0.5组的眼数多于≥0.6组(P<0.01);厚度>150μm,≥0.6组的眼数明显多于≤0.3组(P<0.01)。后巩膜葡萄肿发生率为91.23%(104眼),其中有27.88%(29眼)出现视网膜劈裂。结论OCT是高度近视眼的良好检测手段,可以观察到高度近视眼易发生的后巩膜葡萄肿和视网膜劈裂。随屈光度的增高,眼轴的增长,视网膜神经纤维层厚度逐渐变薄,矫正视力越差。Objective The evaluation and examination of optical coherence tomography （OCT） in high myopia. Methods The characteristics were analysed and thickness of neurosenory retina was measured in macular region in 114 eyes of 60 patients with high myopia by OCT. To find the relations between thickness in macular region and oecular axial length and correcting vision accuity （CVA）. Results The average thickness in macular region with high myopia was 145μm±14μm. The number of eye in group Ⅲ was more than that of group Ⅰ, group Ⅱ was more than that of group Ⅰ , group Ⅰ was more than that of group Ⅱ （all P〈0.01）, respectively, whence axial length was ≤25mm, 25-27mm and ≥ 27 ram. There were significant difference in statistics between group with axial≥27mm and ≤25mm, group with axial 25-27mm and other two groups with ≤25mm and ≥27mm （all, P〈0.01）, respectively, whence thickness of neurosenory retina in macular region was ≤ 140μm, 141μm -150μm and 〉150μm. There were significant difference in statistics between group with CVA ≤0.3 and 04-0.5 （P〈0.05）, group with CVA≥0.6 and ≤0.3, 0.4-0.5 and 〉/0.6, （P〈0.01）, respectively, whence thickness of neurosenory retina in macular region was ≤ 140μm, 141μm -150μm and 〉150μm. 104 （91.23%） of 114 eyes show posterior seleral staphyloma（PSS）. 29 （27.88%） of them displayed retinosehisis. Conclusions OCT can display posterior seleral staphyloma and retinosehisis, It is good examine method in high myopia. Thickness of neurosenory retina in macular region will get thin and correcting vision accuity will go bad gradually with the growth of diopter and axial length in high myopia.

关 键 词：高度近视眼 黄斑区 光学相干断层扫描 

分 类 号：R778.11[医药卫生—眼科]