北京市50岁以上人群高度近视眼合并视网膜劈裂的患病率调查及其相关危险因素分析  

Prevalence survey and analysis of related risk factors of high myopia with retinoschisis among people aged 50 years old or above in Beijing

作　　者：游启生[1] 徐亮[1] 彭晓燕[1] 陈长喜[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所北京市眼科学与视觉科学重点实验室,100005

出　　处：《中华眼科医学杂志（电子版）》2016年第5期201-207,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：国家自然科学基金(81400422);北京优秀青年拔尖人才项目(2015000021223ZK22)

摘　　要：目的调查北京市50岁以上人群高度近视眼合并视网膜劈裂的患病率,并探讨其相关危险因素。方法以人群为基础进行横断面研究。整群抽取2011年北京市海淀区3个社区和大兴区4个自然村的50岁以上人群3468例为研究对象,进行详细的问卷调查、全身检查及眼科检查。以频域光学相干断层扫描(SD-OCT)的检查结果为依据,诊断高度近视眼患者是否出现视网膜劈裂,并计算高度近视眼合并视网膜劈裂的患病率。人群的平均年龄、平均眼轴长度、平均屈光度及最佳矫正视力(BCVA)均以均数±标准差(x珋±s)表示。对高度近视眼合并视网膜劈裂患者和无劈裂患者的BCVA、平均年龄、平均近视屈光度数、平均眼轴长度、中心凹下脉络膜的平均厚度及后巩膜葡萄肿等进行单因素分析,并采用t检验的方法进行比较;进一步以是否发生视网膜劈裂为因变量,以单因素分析筛选出来的有意义的因素作为自变量,进行多因素Logistic回归分析,寻找视网膜劈裂的相关危险因素。结果在3468例参与者中,共获得了3278例(6530只眼)参与者的清晰可评估的SD-OCT图像。其中,有101例(164只眼)为高度近视眼患者。高度近视眼患者中有54只眼出现视网膜劈裂,包括视网膜血管旁劈裂37只眼(22.56%),黄斑中心凹劈裂6只眼(3.66%)及黄斑中心凹劈裂合并血管旁劈裂11只眼(6.71%)。高度近视眼合并视网膜劈裂的患眼数占高度近视眼的32.92%。北京市50岁以上的自然人群高度近视眼合并视网膜劈裂的患病率为0.83%。高度近视眼合并视网膜劈裂患者的BCVA(0.5±0.7)低于无劈裂者的(0.3±0.4),差异有统计学意义(t=2.32,P<0.05)。单因素分析结果显示,与视网膜劈裂相关的系统性因素包括高龄(t=2.56,P<0.05)、近视眼屈光度较大(t=2.11,P<0.05)、眼轴较长(t=2.84,P<0.05)、黄斑中心凹下脉络膜厚度较薄(t=2.35,P<0.05)及后巩膜葡萄肿(t=6.21,P<0.05)等。而多Objective To investigate the prevalence of high myopia with retinoschisis among people aged 50 years old or above in Beijing and analyze the related risk factors. Methods A cross-sectional study was conducted on population. In 2011, a cluster sample of 3468 participants from 3 communities in Haidian District and 4 villages in Daxing District, Beijing was surveyed. A detailed questionnaire, general examination and ophthalmic examination were carried out to them. Based on the examination results of spectral domain optical coherence tomography （SD-OCT）, patients with high myopia and retinoschisis were diagnosed and the prevalence of them was calculated. Average age, average length of axial length, mean refraction and mean MAR Log visual acuity were presented as mean ＋ standard deviation （x±s ）. The bestcorrected visual acuity （BCVA）, average age, average myopia diopter, mean axial length, average thickness of choroids under central fossa and posterior scleral staphyloma of patients with high myopia and retinoschisis were analyzed by single factor analysis and compared by t-test. After that, multiple factor logistic regression model were conducted by taking retinoschisis as the dependent variable and meaningful factors that were selected by single factor analysis as independent variables. Results 3278 participants＇ （6530 eyes） clear and appreciable SD-OCT image were obtained from the total 3468 participants.There were 101 patients （164 eyes） with high myopia. Among them, there were 54 eyes with high myopia and retinoschisis, including 37 eyes （22.56%） with foveoschisis, 6 eyes （3.66%） with para-vessel retina schisis and 11 eyes （6.71%） with both of them. The eyes with high myopia and retinoschisis accounted for 32.92% of eyes with high myopia. The prevalence rate of high myopia with retinoschisis in natural population aged 50 years old or above in Beijing was 0.83%. BCVA of patients with high myopia and retinoschisis （0.5＋0.7） was lower than that of patients with high myopia

关 键 词：高度近视眼 视网膜劈裂 光学相干断层扫描 

分 类 号：R778.11[医药卫生—眼科]