近视性屈光不正与眼底病变  

Myopic and Retinopathy

作　　者：郭立斌[1] 郑晓华[2] 王景文 王忠海[1] 耿爽[1] 陈辛元[1] 叶俊杰[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院眼科,北京100730 [2]北京崇文光明医院综合病房,北京100061 [3]中国航天科工集团731医院眼科,北京100074

出　　处：《中国医学科学院学报》2007年第4期538-542,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨近视性屈光不正眼底病变的发生率,以及与屈光度、年龄和性别等因素的关系。方法回顾性分析拟行激光角膜屈光手术的1449例近视性屈光不正患者(2879只眼)的眼底情况及其与屈光度、年龄及性别之间的临床关系。结果2879只眼中发生眼底病变的有413只眼(14.35%),其中后极部病变22只眼(0.76%),周边部眼底病变396只眼(13.75%)。轻度、中度、高度及超高度近视组周边部眼底病变的发生率分别为4.18%、8.72%、19.18%和37.44%,4组间周边部眼底病变发生率的差异具有显著性(χ2=178.594,P<0.001);不同年龄段的3个组周边部眼底病变的发生率分别为8.11%、15.34%和24.59%,3组间周边部眼底病变发生率的差异具有显著性(χ2=76.090,P<0.001)。近视患者周边部眼底病变的发生率与屈光度及年龄之间具有显著正相关性(P<0.01)。男性与女性的周边部眼底病变的发生率分别为9.32%和16.07%,二者比较差异具有显著性(χ2=24.886,P<0.001)。后极部眼底病变仅发生于Ⅱ、Ⅲ组及高度、超高度近视组。Ⅱ、Ⅲ组的后极部病变发生率分别为0.55%和3.55%,二者比较差异具有显著性(χ2=22.523,P<0.001);高度、超高度近视组的发生率分别为0.86%和6.67%,二者比较差异具有显著性(χ2=31.898,P<0.001)。结论近视性屈光不正患者的眼底病变发生率较高,并具有其临床特征。周边部眼底病变随年龄及屈光度的增加而增高,发生部位以颞侧为多。后极部病变多发生于年龄≥25岁及屈光度>-6.00D的患者。对于近视性屈光不正患者,详查眼底对早期发现眼底病变、及时给予治疗是必要的。Objective To investigate the incidence of myopic retinopathy and its risk factors. Methods The fundus of 1 449 patients （2 879 eyes） with myopia were retrospectively examined. The clinical relationship between myopic retinopathy and diopter, age, and sex was analyzed. Results Myopic retinopathy was detected in 413 eyes （ 14.35% ）. Posterior pole retinal lesions were detected in 22 eyes （0. 76% ）. Peripheral retinal lesions were found in 396 eyes （13.75%）. According to their diopters, the myopic patients were divided into four groups ： low, medium, high and super high myopia. The incidence of peripheral retinal lesions was 4. 18%, 8.72%, 19. 18%, and 37.44% in these four groups, which significantly different （X^2 =178. 594, P 〈0. 001 ）. By age these patients were divided into three groups： Ⅰ group, age 〈 25;Ⅱ group, age 25-34; Ⅲ group, age 〉 34. The incidences of peripheral retinal lesions in these three groups were 8.11% , 15.34% , and 24.59% , which were significantly different （X^2 = 76. 090, P 〈 0. 001 ）. The incidence of retinal lesion in male and female was 9.32 % and 16.07 % , respectively, which was significantly different （X^2 = 24. 886, P 〈 0. 001 ）. Posteriorpole retinal lesions were only detected in the highly or super highly myopic patients, all of them were more than 25 years. The incidence of posteriorpole retinal lesions in the highly and super highly myopia group was 0. 86% and 6.67% respectively, which was significantly different （X^2 =31. 898, P 〈0. 001）. The incidence of posteriorpole retinal lesions in group Ⅱ and group Ⅲ was 0.55 % and 3.55 % respectively, which was significantly different （X^2 = 22. 523, P 〈 0. 001 ）. Conclusions The prevalence of retinal lesions in myopic patients is higher than that of emmetropia. The incidence of peripheral retinal lesions increases in patients with deeper diopters. Posterior pole retinal lesions usually occur in the myopic patients whose age are more than 25 years and diopter more than - 6.0

关 键 词：近视性屈光不正 眼底病变 屈光度 年龄 

分 类 号：R778.11[医药卫生—眼科]