应用三维磁共振成像技术探究病理性近视眼眼底病变与眼球形态的关系  

Using 3D-MRI to study the relationship between pathological myopia fundus lesion and ocular shape

作　　者：刘向红 张月玲[2] 杨娜[2] 王莉菲 张建军[4] Liu Xianghong;Zhang Yueling;Yang na;Wang Lili;Zhang Jianjun(Graduate School of Chengde Medical University,Chengde 067000,China;Department of Ophthalmology,Baoding NO.1 Central Hospital,Baoding 071000,China;Department of Fundus Surgery,Hebei Eye Hospital,Xingtai 054000,China;Department of Medical Imaging,Baoding No.1 Central Hospital,Baoding 071000,China)

机构地区：[1]承德医学院研究生院,级研究生0670002016 [2]保定市第一中心医院东院眼二科,071000 [3]河北省眼科医院眼底外科,邢台054000 [4]保定市第一中心医院医学影像科,071000

出　　处：《中华眼科医学杂志（电子版）》2019年第1期38-44,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：河北省科技计划项目(152777102D)

摘　　要：目的探究病理性近视眼眼球形态在三维磁共振成像中的分型,不同类型的病理性近视眼眼底病变中各眼球形态分布,以及眼球形态与年龄、眼轴长度、屈光度及眼底病变类型的关系。方法本研究为观察性研究,将病理性近视患者58例(104只眼)按年龄分为<60岁组和≥60岁组;按眼轴长度分为<29 mm组和≥29 mm组;按屈光度分为-6. 00～-12. 00 D组、-12. 25～-18. 00 D组及≥-18. 25 D组;按眼底病变分为脉络膜新生血管组、黄斑劈裂组、黄斑裂孔性视网膜脱离组及单纯脉络膜视网膜萎缩组。所有患者均接受屈光度、散瞳检查眼底、眼底照相、光学相干断层扫描血管成像及磁共振眼眶扫描检查。观察各组别中不同眼球形态的发生率及差异。结果根据临床经验和三维磁共振成像结果,将病理性近视眼球形态分为椭圆形10例(14只眼)、锥形22例(26只眼)、扭曲形24例(36只眼)、桶形20例(28只眼)。在病理性近视眼脉络膜新生血管患者10例(10只眼)中,锥形和扭曲形各4例(4只眼),占40. 0%(4/10);椭圆形2例(2只眼),占20. 0%(2/10)。黄斑劈裂患者8例(8只眼)中,扭曲形4例(4只眼),占50. 0%(4/8);桶形4例(4只眼),占50. 0%(4/8)。黄斑裂孔性视网膜脱离患者6例(6只眼)中,桶形4例(4只眼),占66. 7%(4/6);扭曲形2例(2只眼),占33. 3%(2/6)。单纯脉络膜视网膜萎缩患者54例(80只眼)中,扭曲形18例(26只眼),占32. 5%(26/80);锥形18例(22只眼),占27. 5%(22/80);桶形10例(20只眼),占25. 0%(20/80);椭圆形8例(12只眼),占15. 0%(12/80)。4种眼球类型的分布差异在不同年龄组、不同眼轴组及不同屈光度组中均有统计学意义(χ~2=10. 43,44. 13,48. 93; P <0. 05),在不同病理性近视眼眼底病变组中无统计学意义(χ~2=15. 59,P> 0. 05)。结论三维磁共振成像技术能全面直观地反映眼球的具体形态,病理性近视眼眼球形态与年龄、眼轴长度及屈光度相关,病理性近视眼脉络膜新生血�Objective The aim of this study was to implore the classification of pathological myopia ocular shape in 3 dimensions magnetic resonance imaging(3 D-MRI),the incidence rate of ocular morphology classification in different pathological myopia fundus lesion,and the relationship between ocular shape and age,axis oculi length,diopter,and fundus lesion types.Methods This observational study was divided 58 pathological myopia patients(104 eyes)into groups by age(<60 years and≥60 years),axis oculi length(<29 mm and≥29 mm),diopter(-6.00 to-12.00 D,-12.25 to-18.00 D,and≥-18.25 D),and fundus lesions(pathological myopia choroidal neovascularization,foveoschisis,macular hole retinal detachment,and chorioretinal atrophy).All the patients were examined for diopter,dilated pupil for fundus examination,fundus photography,optical coherence tomography angiography,magnetic resonance orbital scanning.The incidence rate of various ocular shape and compare the differences between different age groups,axis oculi length groups,diopter groups,and fundus lesion groups was observed.Results Pathological myopia ocular shape was divided into ellipsoidal shape(10 cases,14 eyes),conical shape(22 cases,26 eyes),distorted shape(24 cases,36 eyes),and barrel shape(20 cases,28 eyes)according to clinical experiences and 3 D-MRI results.Ten cases(10 eyes)for pathological myopia choroidal neovascularization contained 4 cases(4 eyes,accounting for 40.0%of the 10 eyes)for conical shape and distorted shape,respectively,and 2 cases(2 eyes,20.0%)for ellipsoidal shape.Eight cases(8 eyes)for pathological myopia foveoschisis contained 4 cases(4 eyes,accounting for 50.0%of the 8 eyes)for distorted shape,and 4 cases(4 eyes,50.0%)for barrel shape.Six cases(6 eyes)for pathological myopia macular hole retinal detachment contained 4 cases(4 eyes,66.7%)for barrel shape,and 2 cases(2 eyes,33.3%)for distorted shape.Fifty-four cases(80 eyes)for pathological myopia chorioretinal atrophy contained 18 cases(26 eyes,32.5%)for distorted shape,18 cases(22 eyes,27.5%)for

关 键 词：病理性近视眼 眼球形态 眼底病变 三维磁共振成像 

分 类 号：R778.11[医药卫生—眼科] R445.2[医药卫生—临床医学]