单纯高度近视和病理性近视患者眼后段结构的形态学改变  

Morphology changes in posterior eye segment of patients with the pure high myopia and the pathological myopia

作　　者：刘维锋[1] 徐月圆[1] 袁雪芳[1] 石浔[1] LIU Wei-Feng;XU Yue-Yuan;YUAN Xue-Fang;SHI Xun(Eye Hospital of 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》2018年第12期1153-1156,1160,共5页Recent Advances in Ophthalmology

基　　金：江西省科技厅重点研发项目(编号:20171BBG70100)~~

摘　　要：目的对比单纯高度近视和病理性近视患者视盘区域、眼球壁等形态学改变,探讨用于评价高度近视眼的可测量指标。方法收集18～45岁高度近视患者29例52眼,采用深度扫频光学相干断层扫描仪DRI-OCT Atlantis等影像设备检测相关数据,将患眼分成单纯高度近视组和病理性近视组。对比两组视盘、近视弧、脉络膜萎缩弧形态;不同区域的视网膜、神经纤维层、脉络膜、巩膜的厚度等形态特征。结果本研究中单纯高度近视组27眼,病理性近视组25眼。两组患者年龄比较差异无统计学意义(P=0. 08),病理性近视组比单纯高度近视组的屈光度更大、眼轴更长、最佳矫正视力更差,差异均有统计学意义(均为P <0. 01)。单纯高度近视组、病理性近视组患者的视盘水平长度分别为(1440±419)μm和(1228±331)μm;垂直长度分别为(1906±430)μm和(2085±304)μm;两组比较差异均无统计学意义(均为P> 0. 05)。视盘椭圆指数分别为0. 78±0. 16、0. 63±0. 16,两组比较差异有统计学意义(P <0. 01)。按照视盘椭圆指数0. 8以上为正常分类(8眼因视盘界限难以确定未纳入该项分析),单纯高度近视组中视盘正常形态13眼、异常12眼,病理性近视组视盘正常形态3眼、异常16眼,两组差异有统计学意义(P=0. 01)。两组单侧弧和环形弧分布差异无统计学意义(P=0. 84)。两组单纯近视弧和色素上皮脉络膜萎缩区分布差异有统计学意义(P <0. 01)。视网膜厚度:单纯高度近视组和病理性近视组患者视网膜厚度中心区域差异无统计学意义(P> 0. 05);病理性近视组患者的其余各区域视网膜厚度均比单纯高度近视组薄,差异均有统计学意义(均为P <0. 05)。神经纤维厚度:两组颞侧区域神经纤维厚度差异无统计学意义(P> 0. 05);病理性近视组的其余各区域神经纤维厚度均比单纯高度近视组薄,差异均有统计学意义(均为P <0. 01)。病理性近视组患者各区Objective To compare morphological changes in the area of optic nerve head (ONH) and wall of eyeball in order to discuss the measurable parameters for high myopia (HM). Methods Medical records from 52 eyes of 29 patients aged from 18 to 40 diagnosed with HM were included in this study. Individual eyes were evaluated from Deep Range Imaging Optical Coherent Tomography (DRI-OCT) Atlantis. All eyes grouped for pure HM and PM groups. ONH,perpapillary atrophy (PPA),peripapillary chorioretinal atrophy (PCA),the thickness of retina (RT),the thickness of retinal nerve fiber layer (RNFL),the thickness of choroid (CT) and the thickness of sclera (ST) were analysised. Results Total 27 eyes were divided in the group pure HM and 25 eyes for the group PM.There was no differences in age (P = 0. 08) between two groups and there were statistically significant differences in higher SE,longer AL and worse BCVA of the group PM compare to the group pure HM (all P < 0. 01). Horizontal length of ONH of the pure HM and PM groups were (1440 ± 419) μm and (1228 ± 331) μm and Vertical length of ONH were (1906 ± 430) μm and (2085 ± 304) μm,respectively. There was no difference between two groups (all P > 0. 05). Ovlity index (OI) of ONH were 0. 78 ± 0. 16,0. 63 ±0. 16,respectively. There were statistically significant differences in OI (P < 0. 01).There were statistically significant differences in distribution of morphology of ONH according to OI over 0. 8 was as normal and the other was abnormal (P = 0. 01). Normal 13 eyes and abnormal 12 eyes in group pure HM; Normal 3 eyes and abnormal 16 eyes in group PM. There was no statistically significant differences in distribution of the pure PPA and the ring PPA (P = 0. 84) and differences in distribution of PPA and PCA between two groups (P < 0. 01). RT: There was no statistically significant differences in the centre of RT between two groups (P > 0. 05). And there were statistically significant differences in thinner RT in other area of the group PM compare to the group pure HM (all

关 键 词：高度近视 病理性近视 近视弧 视网膜厚度 脉络膜厚度 眼轴 

分 类 号：R778[医药卫生—眼科]