成年高度近视患者脉络膜厚度及其相关影响因素分析  

Change of choridal thickness and its influence factors in adult high myopic patients

作　　者：戚沆[1] 陈长征[1] 翁铭[1] 易佐慧于 许芳[1] 

机构地区：[1]武汉大学人民医院眼科, 430060

出　　处：《中华实验眼科杂志》2014年第5期439-442,共4页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景 高度近视的多种眼底并发症均与眼轴增长引起的眼球壁厚度改变有关,但成年人高度近视眼脉络膜厚度与眼轴长度的量化分析研究较少见. 目的 观察成年高度近视患者脉络膜厚度的改变,并分析脉络膜厚度与眼轴长度、年龄及屈光度的关系.方法 采用前瞻性队列研究方法,纳入2012年12月至2013年5月在武汉大学人民医院就诊的成年高度近视患者75例75眼作为高度近视组,纳入同期年龄和性别相匹配的健康志愿者70例70眼作为正常对照组.采用频域光学相干断层扫描（SD-OCT）的加强深度扫描（EDI）技术,以6 mm的扫描线对黄斑部进行0±176;扫描,测量黄斑中心凹下及由中心凹向鼻侧和颞侧2 500 μm的脉络膜厚度值,共测量11个子午线,每个子午线间隔500 μm,比较两个组间脉络膜厚度和眼轴长度的差异,分析脉络膜厚度与眼轴长度、年龄及屈光度的关系.结果 高度近视组受检眼中心凹下脉络膜厚度值和平均黄斑部脉络膜厚度值分别为（146±177;52） μm和（142±177;63） μm,正常对照组分别为（306±177;60） μm和（271 ±177;71） μm,两个组间差异均有统计学意义（t=-17.130,P=0.000;t=-15.890,P=0.000）.高度近视组颞侧脉络膜最厚,中心凹下厚度次之,鼻侧最薄,而正常对照组以中心凹旁脉络膜最厚,其次为颞侧,鼻侧最薄.高度近视组受检眼各检测点脉络膜均薄于正常对照组.高度近视组患者脉络膜厚度值与眼轴长度呈明显负相关（r=-0.580,P=0.000）,眼轴长度每增加l mm,脉络膜厚度值平均减少17.943 μm. 结论 SD-OCT检测显示,成年高度近视患者脉络膜厚度较健康人明显变薄,且与眼轴长度的变化关系密切,提示脉络膜的病理改变可能在高度近视眼并发症的发生过程中发挥作用.Background Aheration of eyeball wall caused by ocular axial extension is associated with multiple complications of high myopia.However,the study on quantitative analysis of choroidal thickness and axial length in adult high myopic patients is less.Objective This study was to investigate the choroidal thickness in high myopic eyes of adult patients and estimate the correlation of choroidal thickness with axial length,age,and spherical equivalent（SE）.Methods A prospective cohort study was designed.Seventy-five eyes of 75 adult patients with high myopia were entrolled from December 2012 to May 2013,and 70 eyes of 70 age-and gendermatched healthy volunteers were included in Renmin Hospital of Wuhan University.Enhanced depth imaging （EDI）on Cirrus spectral-domain optical coherence tomography （SD-OCT） was used to measure the choroidal thickness from the outer border of the retinal pigment epithelium through the inner scleral boarder among the 11 meridians in a 500 μm intervals and range of 2 500 μm for each from fovea toward temporal and nasal lateral.The differences of choroidal thickness and axial length were compared between the high myopia group and normal control group,and the correlation of choroidal thickness with axial length,age,SE were analyzed.Results The subfoveal and mean choroidal thickness values were （146＆#177;52） μm and （142＆#177;63） μm in the high myopia group,and those in the normal control group were （306＆#177;60） μm and （271 ＆#177;71） μm,with significant differences between the two groups （t =-17.130,P=0.000; t=-15.890,P=0.000）.Choroid was thickest in the temporal and then was subfovea and nasal in the high myopia group,but in the normal control group,it was subfovea,temporal and nasal in turn,and the choroidal thicknesses in various areas were thinner in the high myopia group than those in the normal control group.A negative correlation was found between the choroidal thickness and axial length in high myopia group（r =-0.580,P =0.000）,and the regre

关 键 词：脉络膜厚度 眼轴长度 加强深度扫描 光学相干断层扫描 高度近视 成人 

分 类 号：R778.11[医药卫生—眼科]