高度近视病因多元分析及其最佳矫正视力与近视屈光度、眼底病变特征的相关性分析  

Multivariate analysis of the causes of high myopia and the correlation between best corrected visual acuity and myopic diopter and fundus lesions

作　　者：钱蕾 余亚波 陈彦 王武 Qian Lei;Yu Yabo;Chen Yan;Wang Wu(Department of Ophthalmology,Yuyao Hospital of Traditional Chinese Medicine,Yuyao 315400,Zhejiang Province,China;Department of Ophthalmology,Mingzhou Hospital,Ningbo 315199,Zhejiang Province,China;Department of Ophthalmology,Yangming Hospital,Yuyao 315400,Zhejiang Province,China;Department of Ophthalmology,Shengshan Health Center,Cixi 315323,Zhejiang Province,China)

机构地区：[1]余姚市中医医院眼科,浙江省315400 [2]宁波明州医院眼科,315199 [3]余姚市阳明医院眼科,浙江省315400 [4]慈溪市胜山镇卫生院眼科,浙江省315323

出　　处：《中国基层医药》2021年第3期435-440,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨高度近视病因多元分析及其最佳矫正视力(BCVA)与近视屈光度、眼底病变特征的相关性分析。方法回顾性分析余姚市中医医院2018年12月至2019年12月确诊为高度近视的患者112例(198眼)的临床资料,分析患病影响因素。观察患者近视屈光度、眼底病变种类、严重程度以及BCVA情况,并分析各观察指标间相关性。结果高度近视的发生与晶状体部分浑浊、眼底畸变、角膜薄翳、家族遗传有关;经非条件多因素logistic回归分析显示,父母存在近视[73例(83.91%)比39例(57.34%)]、每周户外活动<4.17 h[47例(89.36%)比24例(61.54%)、26例(68.42%)、20例(64.52%)]是患者高度近视的危险多因素(χ^(2)=13.427、10.300,P<0.05或P<0.01);经Pearson线性相关分析结果显示,近视屈光度与BCVA呈负相关(r=-0.729,P<0.001);豹纹状眼底、倾斜视盘、视盘旁β区萎缩弧、后极部视网膜脉络膜萎缩的病变与BCVA呈正相关(r=0.461、0.732、0.528、0.825,P<0.05或P<0.001);患眼病变程度与BCVA呈负相关(r=-0.673,P<0.001)。结论高度近视患者近视屈光度、眼底病变特征与BCVA最佳矫正视力有紧密联系,可用于评估患者病情变化,为其预防与治疗提供了方向。Objective To investigate the etiology of high myopia and the correlation between best corrected visual acuity and myopic diopter and fundus lesions.Methods The clinical data of 112 patients(198 eyes)with high myopia diagnosed in Yuyao Hospital of Traditional Chinese Medicine from December 2018 to December 2019 were retrospectively analyzed.The factors that influence high myopia were analyzed.Myopic diopter,the type and severity of fundus lesions,and best corrected visual acuity were evaluated.The correlation between observation indexes was analyzed.Results The occurrence of high myopia was related to partial lens opacity,fundus aberrations,corneal pannus and heredity.Unconditional multivariable logistic regression revealed that parental myopia[73(83.91%)vs.39(57.34%)],outdoor activities<4.17 h[47(89.36%)vs.24(61.54%),26(68.42%),20(65.42%)]are the risk factors of high myopia(χ^(2)=13.427,10.300,P<0.05 or P<0.01).Pearson linear correlation analysis showed that myopia diopter was negatively correlated with best corrected visual acuity(r=-0.729,P<0.001).Tigroid fundus,tilted optic disc,β-zone parapapillary atrophy and posterior polar annular choroidal dystrophy were positively correlated with best corrected visual acuity(r=0.461,0.732,0.528,0.825,P<0.05 or P<0.001).The severity of lesion was negatively correlated with best corrected visual acuity(r=-0.673,P<0.001).Conclusion The myopia diopter and fundus lesion characteristics in patients with high myopia are closely related to best corrected visual acuity,which can be used to evaluate patient's condition and provide guidance for prevention and treatment of high myopia.

关 键 词：眼 近视 视力 眼睛 屈光不正 眼底 矫正 危险因素 多元分析 

分 类 号：R778.11[医药卫生—眼科]