不同年龄的高度近视眼压变化对眼轴和眼底改变的影响探讨  

The influence of intraocular pressure to the changes of myopic fundus and ocular axial length in high myopia natural course

作　　者：单武强 刘耀梅[2] 石一宁[3] 陈研明[4] 王云[5] 

机构地区：[1]陕西省宝鸡市人民医院,721000 [2]西安市中心医院 [3]陕西省人民医院 [4]西安交通大学医学院 [5]安徽省淮南市第一人民医院眼科

出　　处：《临床眼科杂志》2012年第6期489-495,共7页Journal of Clinical Ophthalmology

基　　金：陕西省科技厅科技研究发展项目(编号2009K17-02);安徽省科技厅科技研究发展项目(编号2008B086);西安市科技局社会发展基金资助项目(编号GG2006156)

摘　　要：目的研究眼压在近视自然病程中的变化规律,以及对近视性眼底改变和眼轴的影响。方法门诊就诊近视患者489例(976只眼),进行眼底照相、A/B超、眼压、验光、矫正视力、角膜曲率等相关眼科检查,记录并归纳整理。结果 (1)在20岁前高度近视的眼压呈现2个高水平,以豹纹状改变阶段的6～15岁之间形成第一个高眼压高峰,和以出现病理改变的10～15岁之间第二个高眼压高峰,眼压的高水平维持至20岁,这一阶段的眼球尚未扩张、眼轴相对短;(2)以后各年龄组高度近视伴随眼轴的增长、眼底呈现病理性改变,并不呈现高眼压状态。结论 (1)在20岁前近视形成发展过程中,眼压具有眼球扩张的内动力作用。(2)青春期后已经扩张的眼球,控制眼压在正常平均值16 mm Hg以下1至2个标准差,即13 mm Hg以下,对终生维持-7 D、27 mm眼轴和监测豹纹状眼底改变、预防病理性改变的发生具有积极意义。Objective To observe the intraocular pressure （IOP） changes in high myopia＇ s natural course and the influence to myopic fundus and ocular axial length. Methods The enrolled included clinical 489 patients 976 eyes of 5 to 85 years old, their refraction error were over -6 D （ -4 D below 10-year-old）, and the eyeball axis were over 25 mm （24 mm below 10-year-old）. They were divided 14 groups with the internal 5 year-old. The fundus appearances were divid- ed into 4 groups, negative, tessellation, focal lesions, and pathologic changes, according to the KOWA fundus camera and Heidelberg HRA2 lluoreceine/indocraine angiophotography. At the meantime, myopic severity was checked with cyclople- gic objective refraction by NIKON SPEEDY-K automatic optometry and retinescopy, ocular axis and shape of eye ball were measured and recorded by BVI A/B-scan. Their IOPs were measured by auto-applanation tonometry of Topeon C＇T60. The collected data were analyzed statistically by SPSS12.0. Results （ 1 ） There were 2 high levels IOP under 20 year-old ages, the first peak of IOP appeared with tessellation fundus changes of 6 to 15 years old, and the second one appeared with path- dogie fundus changes of 10 - 15 years old. The high level IOP maintained till to 20 year-old with less expanded axial length. （2 } The other groups older than 20 showed average IOP of 16 mm Hg, even with the pathologic changes keeping de- teriorated and the axial length increasing. Conclusion （ 1 ） The IOP has the inner motive power in the ocular expansion during the myopic development under 20 years old. （2）In the adolescence when the ocular expansion had developed, it is clinical significance to have lOP maintained lower 1 standard error （ of 3 mm Hg） than average （ 16 nun Hg） to keep the degree of myopia stable at - 7 D, ocular axis 27 ram. In this way, we may have tessellation appearance not to evolve to pathologic one.

关 键 词：高度近视 眼压 眼轴 豹纹状眼底 病理性近视 

分 类 号：R778.11[医药卫生—眼科]