单眼发病的原发性开角型青光眼黄斑脉络膜厚度及影响因素初探  

Sub-foveal choroidal thickness in both eyes of patients with unilateral primary open-angle glaucoma and related influencing factors

作　　者：霍妍佼 郭彦 石砚 李蕾 王宁利 Huo Yanjiao;Guo Yan;Shi Yan;Li Lei;Wang Ningli(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing 100730,China)

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,100730

出　　处：《中华眼科杂志》2021年第3期194-200,共7页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金(11571031);北京市属医院科研培育计划(PX2020010)。

摘　　要：目的初步探讨原发性开角型青光眼(POAG)单眼发病患者黄斑中心凹下脉络膜厚度(SFCT)与其对侧眼和健康人的差异及其影响因素。方法横断面研究。收集2018年9月至2019年9月就诊于首都医科大学附属北京同仁医院青光眼门诊确诊为POAG的单眼发病、对侧眼正常的患者(POAG组)以及健康志愿者(健康对照组)。对所有参与者进行系统眼科检查,应用高分辨率频域的相干光层析成像术测量SFCT及距黄斑中心凹鼻侧和颞侧500、1000、2000μm共7个位置的脉络膜厚度。应用配对t检验比较脉络膜厚度在POAG组患眼与对侧眼的差异。应用协方差分析比较POAG组患眼与健康对照组之间脉络膜厚度的差异。应用多元线性回归分析年龄、性别、等效球镜度数、视野平均缺损值对POAG组患眼黄斑各个位置脉络膜厚度的影响。结果POAG组纳入75例患者(平均年龄46岁,男性48例,女性27例),健康对照组纳入61名(61只右眼)健康受试者(平均年龄44岁,男性34名,女性27名)。POAG组患眼SFCT为(244.41±83.18)μm,其对侧眼SFCT为(254.28±88.92)μm,二者差异无统计学意义(P>0.05)。健康对照组SFCT为(272.98±55.87)μm,校正年龄、性别和等效球镜度数后,POAG组患眼与健康对照组SFCT差异无统计学意义(P>0.05)。POAG组患眼在距离黄斑中心凹鼻侧2000μm处的脉络膜厚度为(167.84±70.44)μm,其对侧眼为(188.84±89.06)μm,二者差异有统计学意义(t=-3.55;P<0.01)。POAG组患眼与其对侧眼及健康对照组在距黄斑中心凹鼻侧和颞侧其他距离处的脉络膜厚度差异均无统计学意义(均P>0.05)。POAG患眼的SFCT变薄与视野平均缺损值下降(β=14.66,P<0.05)和近视屈光度数增高(β=14.95,P<0.01)有关,与年龄和性别无关(均P>0.05)。结论单眼发病的POAG患眼SFCT较对侧眼和健康人未见明显变薄,仅黄斑鼻侧2000μm的脉络膜薄于对侧眼。视野缺损的严重程度及近视屈光度数程度与SFCT变薄相�Objective To investigate and compare the sub-foveal choroidal thickness(SFCT)in both eyes of patients with unilateral primary open-angle glaucoma(POAG)and healthy controls.Methods Cross-sectional study.Patients with unilateral POAG and healthy controls were recruited from September 2018 to September 2019 in the Beijing Tongren Hospital.All subjects underwent enhanced depth imaging optical coherence tomography.The SFCT was measured at the fovea,and at 500μm,1000μm and 2000μm nasal and temporal to the fovea.Paired t test was conducted to compare the choroidal thickness between affected POAG eyes and unaffected fellow eyes.Analysis of covariance was conducted to compare the choroidal thicknesses between POAG eyes and controls.Multiple regression analysis determined the association between choroidal thickness and age,gender,spherical equivalent and mean deviation.Results Seventy-five patients with unilateral POAG(mean age,46 years;48 males,27 females)and 61 healthy controls(mean age,44 years;34 males,27 females)were included in this study.The SFCT of POAG eyes was(244.41±83.18)μm,which was not significantly different from their unaffected fellow eyes[(254.28±88.92)μm,P>0.05]and controls(right eyes)[(272.98±55.87)μm,P>0.05].Choroidal thickness at 2000μm nasal to the fovea was significantly decreased in the glaucomatous eyes compared with the unaffected fellow eyes[(167.84±70.44)vs.(188.84±89.06)μm,t=-3.55;P<0.01].There were no significant differences among the glaucomatous eyes,unaffected fellow eyes and healthy controls in choroidal thickness at 500μm and 1000μm nasal and temporal to the fovea,as well as at 2000μm temporal to the fovea(all P>0.05).The SFCT of POAG eyes was associated with mean deviation(β=14.66,P<0.05)and spherical equivalent(β=14.95,P<0.01)but not with age and gender(both P>0.05).Conclusions The SFCT of affected eyes in patients with unilateral POAG has no significant difference from unaffected fellow eyes and healthy controls.However,the choroidal thickness at 2000μm nasal to the

关 键 词：青光眼 开角型 视觉 单眼 黄斑 脉络膜 体层摄影术 光学相干 

分 类 号：R775.2[医药卫生—眼科]