青少年低中度近视患者配戴角膜塑形镜前后黄斑部脉络膜厚度的变化  

Changes in Macular Choroidal Thickness before and after Orthokeratology in Adolescents with Low and Moderate Myopia

作　　者：丁香英 鲁元媛 赵芳坤[1] 王宏娜 许军 DING Xiangying;LU Yuanyuan;ZHAO Fangkun;WANG Hongna;XU Jun(Department of Ophthalmology,The Fourth Affiliated Hospital,China Medical University,Eye Hospital of China Medical University,Lens Research Key Laboratory of Liaoning Province,Shenyang 110005,China;Department of Ophthalmolgy,The Aier Excellence Eye Hospital,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第四医院眼科,中国医科大学眼科医院,辽宁省晶状体学重点实验室,沈阳110005 [2]沈阳爱尔卓越眼科医院眼科,沈阳110001

出　　处：《中国医科大学学报》2019年第9期822-827,共6页Journal of China Medical University

基　　金：沈阳市科技计划(18-014-4-46)

摘　　要：目的应用频域光学相干断层扫描的增强深部成像技术(EDI-SD OCT)对配戴角膜塑形镜的低度和中度近视青少年患者的黄斑部脉络膜进行扫描,观察配戴角膜塑形镜前后黄斑部脉络膜厚度的变化。方法选择2016年11月至2017年8月就诊于中国医科大学附属第四医院眼科的近视青少年患者64例(123只眼),根据初诊时近视程度分为2组,A组为低度近视,共37例(70只眼),等效球镜度≤-3.00 D;B组为中度近视,共27例(53只眼),等效球镜度>-3.00D^-6.00D。于戴镜前及戴镜后1周、1个月、3个月、6个月、1年时,采用海德堡EDI-SD OCT分别对对黄斑中心凹下及距中心凹1、2、3 mm处的鼻侧、颞侧、上方、下方4个方向共13个位点的脉络膜厚度进行测量,对比观察配戴角膜塑形镜前后各位点脉络膜厚度的变化。结果2组患者配戴角膜塑形镜后各个位点的脉络膜厚度均较戴镜前增加(P<0.05)。2组戴镜前后中心凹下方脉络膜厚度的变化值存在统计学差异(P<0.05),A组变化更大,颞侧脉络膜厚度变化最大,鼻侧变化最小。黄斑中心凹下脉络膜厚度与等效球镜度的绝对值之间无明显相关性(P>0.05)。结论低度近视和中度近视青少年患者配戴角膜塑形镜后黄斑部脉络膜厚度均有增加,鼻侧增加最少,且黄斑部脉络膜厚度呈区域性差异分布。Objective To analyze macular choroidal thickness(CT)before and after orthokeratology in adolescents with low and moder-ate myopia using enhanced depth imaging spectral-domain optical coherence tomography(EDI-OCT).Methods Totally,64 adolescents with myopia(123 eyes)were recruited and divided into two groups:group A(low myopia:0 D to-3.00 D,70 eyes)and group B(mod-erate myopia:>-3.00 D to-6.00 D,53 eyes).CT was measured using EDI-OCT in both groups before and 1 week,1 month,3 months,6 months,and 1 year after orthokeratology.CT at the subfoveal region and at 1 mm,2 mm,and 3 mm to the nasal,temporal,superior,and inferior regions to the fovea were recorded.The difference in CT at the same position and various periods between the two groups was ana-lyzed.Results CT after orthokeratology in both groups increased significantly in all regions(P<0.05).A significant difference was found in the region inferior to the fovea between the two groups after orthokeratology(P<0.05).CT increased the most in the temporal region and increased the least in the nasal side.There was no significant correlation between the CT in the subfoveal region and equivalent spherical degree(P>0.05).Conclusion CT increases after orthokeratology in adolescents with low and moderate myopia.It increases the least in the nasal side of the fovea.

关 键 词：脉络膜厚度 角膜塑形镜 低中度近视 

分 类 号：R778.3[医药卫生—眼科]