高度近视眼后巩膜形态、黄斑轮廓形态临床观察  

Shapes of posterior sclera and macular in high myopia

作　　者：刘维锋[1] 赵雁之 李春英 黄国富[1] 钟翔[1] LIU Wei Feng;ZHAO Yan Zhi;LI Chun Ying;HUANG Guo Fu;ZHONG Xiang(the Department of Ophthalmology,the Third Affiliated Hospital of Nanchang University,Nanchang 330000,Jiangxi Province,China)

机构地区：[1]南昌大学第三附属医院眼科医院,江西省南昌市330000

出　　处：《眼科新进展》2017年第12期1158-1161,共4页Recent Advances in Ophthalmology

基　　金：江西省科技厅重点研发项目(编号:20171BBG70100)~~

摘　　要：目的探讨高度近视眼后巩膜形态、黄斑轮廓形态类型,并比较其在单纯高度近视和病理性近视分布情况。方法收集南昌大学第三附属医院90例163高度近视眼,利用DRI-OCT Atlantis、眼底照相检测相关数据,分析后巩膜形态、黄斑轮廓形态类别和分布情况;按META-PM标准分成单纯高度近视眼组和病理性近视眼组,对比两组不同后巩膜形态、黄斑轮廓形态分布概况。结果 163眼高度近视眼,Ⅰ型后巩膜形态44眼(27.0%)、Ⅱ型后巩膜形态85眼(52.1%)、Ⅲ型后巩膜形态15眼(9.2%)、Ⅸ型后巩膜形态15眼(9.2%)、Ⅶ型4眼(2.5%)。黄斑水平轮廓形态153眼中Ⅰ型31眼(占20.3%)、Ⅱ型23眼(占15.0%)、Ⅲ型87眼(占56.9%)、Ⅳ型12眼(占7.8%);黄斑垂直轮廓形态149眼中Ⅰ型104眼(占69.8%)、Ⅲ型28眼(占18.8%)、Ⅳ型17眼(占11.4%)。综合水平和垂直分布160眼中:Ⅲ+Ⅰ型62眼(占38.8%);Ⅰ+Ⅰ型26眼(占16.3%);Ⅲ+Ⅲ型22眼(占13.8%);Ⅱ+Ⅰ型20眼(占12.5%);Ⅳ+Ⅳ型10眼(占6.3%);其余7种类型共20眼(占12.5%)。不同黄斑水平轮廓形态在单纯高度近视和病理性近视分布眼数,差异有统计学意义(χ2=12.67;P<0.01)。结论单纯高度近视主要以Ⅱ型、Ⅰ型后巩膜形态为主,黄斑水平轮廓形态主要以Ⅲ型为主,黄斑垂直轮廓形态主要以Ⅰ型为主,综合以水平Ⅲ型+垂直Ⅰ型为主。Ⅸ型后巩膜形态、Ⅳ型不规则型黄斑水平轮廓多见于病理性近视。ObjectiveTo observe the types of posterior sclera shape(PSS)and macular shape(MS)in high myopia(HM)and its distributions in the pure HM and pathologic myopia(PM).MethodsTogether90patients with high myopia(163eyes)in the Third Affiliated Hospital of Nanchang University were included in this study.The medical records from deep range imaging optical coherent tomography(DRI OCT)Atlantis and fundus photography examination were used to analyze the types and distributions of PSS and MS.Then all eyes were grouped into the pure HM group and MP group according to META PM classification standard for comparing and analyzing the types and distributions of PSS and MS.ResultsOf all90patients(163eyes),The typeⅠ,Ⅱ,Ⅲ,ⅨandⅦPSS was in44eyes(27.0%),85eyes(52.1%),15eyes(92%),15eyes(9.2%),4eyes(2.5%),respectively.The typeⅠ,Ⅱ,Ⅲ,Ⅳhorizontal MS was in31eyes(20.3%),23eyes(15.0%),87eyes(56.9%),12eyes(7.8%),respectively.The typeⅠ,Ⅲ,Ⅳvertical MS was in104eyes(69.8%),28eyes(18.8%)and17eyes(11.4%),respectively.As for horizontal MS combined with vertical MS,typeⅢ+Ⅰwas in62eyes(38.8%),typeⅠ+Ⅰin26eyes(16.3%),typeⅢ+Ⅲin22eyes(13.8%),typeⅡ+Ⅰin20eyes(12.5%),and typeⅣ+Ⅳin10eyes(6.3%);the others7types were in20eyes(12.5%).There were statistically significant differences in distribution of PPS and horizontal MS between the pure HM and MP group(χ2=12.67,47.60;P<0.01).ConclusionPatients with pure high myopia has mainly typeⅠ,ⅡPPS,and typeⅢhorizontal MS together with typeⅠvertical MS plus typeⅢ+Ⅰhorizontal combined with vertical MS,while typeⅨPSS and typeⅣhorizontal MS were commonly seen in PM.

关 键 词：高度近视 病理性近视 近视性黄斑病变 后巩膜形态 黄斑轮廓形态 

分 类 号：R778[医药卫生—眼科]