机构地区:[1]天津医科大学眼科医院、眼视光学院、眼科研究所国家眼耳鼻喉疾病临床医学研究中心天津市分中心、天津市视网膜功能与疾病重点实验室,天津300384
出 处:《中华眼底病杂志》2023年第8期634-640,共7页Chinese Journal of Ocular Fundus Diseases
基 金:天津市卫生健康科技项目(TJWJ2022MS014);国家留学基金委项目(202006945002);教育部“春晖计划”合作科研项目(HZKY20220587);天津市教委心理健康教育重点课题(2022ZDGX20)。
摘 要:目的调查并分析天津医科大学不同屈光状态大学生豹纹状眼底(TF)特征及其危险因素方法横断面调查研究。2019年9~12月单纯随机抽取天津医科大学学生346名纳入研究。行裂隙灯显微镜、非散瞳电脑验光、主觉验光、最佳矫正视力、眼生物参数测量和非散瞳眼底照相检查。对比观察黄斑区是否有TF的受检者基本特征、眼生物学参数差异。根据等效球镜度(SE),将受检者分为无近视组(SE>-0.50D)、近视组(SE≤-0.50D)。近视组再分为低度近视组(-3.00D<SE≤-0.50D)、中度近视组(-6.00D<SE≤-3.00D)、高度近视组(SE≤-6.00D)。根据眼轴长度(AL),将受检者分为AL<24mm组、24~26mm组、>26 mm组。采用logistic回归分析影响TF的危险因素。对独立危险因素与TF进行趋势性检验。结果346名受检者中,近视组324名(93.6%,324/346),其中低度近视组、中度近视组、高度近视组分别为73(21.1%,73/346)、167(48.3%,167/346)、84(24.3%,84/346)名;无近视组22名(6.4%,22/346)。黄斑区有TF者294名(85.0%,294/346),其中无近视组、低度近视组、中度近视组、高度近视组分别为9(40.91%,9/22)、58(79.45%,58/73)、145(86.83%,145/167)、82(97.62%,82/84)名;无TF者52名(15.0%,52/346)。黄斑区有、无TF者性别构成比(χ^(2)=4.47)、SE(t=6.29)、AL(=-8.29)、前房深度(Z=-2.62)、晶状体厚度(Z=-2.23)、平均角膜曲率半径(Z=-3.58)比较,差异有统计学意义(P<0.05)。SE、AL是影响TF及其严重程度的独立危险因素(P≤0.001)。随近视程度、AL增加,TF发生风险增加(P趋势<0.001)。结论天津医科大学学生TF总检出率为85.0%。无近视、轻度近视、中度近视、高度近视者眼底均检出TF;近视程度越高,AL越长,TF可能性越高,程度越严重。Objective To investigate the prevalence and risk factors of tessellation fundus(TF)among Tianjin Medical University students with different refractive statuses.Methods A cross-sectional study.From September to December 2019,346 students from Tianjin Medical University were randomly selected and underwent slit-lamp examination,non-cycloplegic auto-refraction,subjective refraction,best-corrected visual acuity,ocular biometric measurement,and non-dilation fundus photography.The dfferences in the prevalence of TF in basic characteristics and ocular biometric parameters were compared.Based on the equivalent spherical(SE),refractive status was divided into the non-myopia group(SE>-0.50 D)and the myopia group(SE≤-0.50 D).The myopia group was further divided into mild myopia group(-3.00 D<SE≤-0.50 D),moderate myopia group(-6.00 D<SE≤-3.00 D),and high myopia group(SE≤-6.00 D).According to the axis length(AL),the subjects were divided into AL<24 mm group,24-26 mm group,and>26 mm group.The logistic regression was used to analyze the risk factors affecting TF.Trend tests were performed for each risk factor and TF.Results Of the 346 subjects,324(93.6%,324/346)were myopia,of whom 73(21.1%,73/346),167(48.3%,167/346),and 84(24.3%,84/346)were mild myopia,moderate myopia,and high myopia,respectively;22(6.4%,22/346)were non-myopia.There were 294(85.0%,294/346)students with TF in the macula,including 9(40.91%,9/22),58(79.45%,58/73),145(86.83%,145/167),and 82(97.62%,82/84)in nonmyopia,low myopia,moderate myopia,and high myopia group,respectively;52(15.0%,52/346)students were without TF in the macula.There were statistically significant gender differences(χ^(2)=4.47),SE(t=6.29),AL(t=-8.29),anterior chamber depth(Z=-2.62),lens thickness(Z=-2.23),and average corneal radius(Z=-3.58)between students with and without TF in the macula(P<0.05).Spherical equivalent and axial length were independent risk factors for TF and its severity(P≤0.001).With an increasing degree of myopia,and increasing axial length,the risk of TF increased(
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