高度近视眼视网膜各分层厚度改变及其相关因素的临床研究  

The retinal thickness changes and their associated factors in highly myopic eyes

作　　者：马张芳[1] 宋薇[1] 王亚星[1] Zhangfang Ma;Wei Song;Yaxing Wang(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Ophthalmology and Visual Sciences Key Laboratory,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、眼科学与视觉科学北京市重点实验室,100730

出　　处：《中华眼科医学杂志（电子版）》2024年第1期26-33,共8页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：国家自然科学基金项目(82271086)。

摘　　要：目的探讨高度近视眼患者视网膜各分层厚度改变及其相关因素。方法收集2023年2月至2023年7月就诊于首都医科大学附属北京同仁医院眼科中心的高度近视眼患者128例(128只眼)进行研究。其中,男性46例(46只眼),女性82例(82只眼),年龄21~69岁,平均(35.9±7.9)岁。分别按眼轴长度(AL)、年龄及性别进行分组。记录患者的血压、近视初始年龄、眼压、身高及体重并计算身高体重指数(BMI)。应用相干光断层扫描仪(OCT)测量视网膜各层厚度及中心凹下脉络膜厚度(SFCT)。视网膜各层厚度的测量数据经Kolmogorov-Smirnova正态性检验符合正态分布,以±s进行描述。不同AL组间和不同年龄组间患者视网膜各层厚度的比较采用方差分析;当差异具有统计学意义时,采用Bonferroni法进一步两两比较。不同性别组间患者视网膜各层厚度的比较采用独立样本t检验。采用单因素线性回归筛选视网膜各层厚度的相关因素。然后,将各层视网膜厚度分别作为因变量,将单因素分析中P≤0.10的因素作为自变量,并参照既往的研究结果将年龄和AL亦作为自变量进行多元线性回归分析其相关性。结果本研究检测患者视网膜全层、视网膜神经纤维层(RNFL)、节细胞层(GCL)、内丛状层(IPL)、内核层(INL)、外丛状层(OPL)、外核层(ONL)、视网膜色素上皮层(RPE)、视网膜内层(IRL)及视网膜外层(ORL)的厚度,AL<26.5 mm组分别为(258.9±20.0)μm、(10.1±2.9)μm、(13.1±5.0)μm、(18.5±4.0)μm、(15.4±4.4)μm、(24.8±5.5)μm、(87.6±9.4)μm、(17.2±1.7)μm、(169.2±20.1)μm及(89.7±3.5)μm;26.5 mm≤AL<27.5 mm组分别为(266.6±26.1)μm、(10.8±2.9)μm、(15.2±8.6)μm、(19.6±5.3)μm、(17.7±5.4)μm、(26.2±6.8)μm、(87.5±12.2)μm、(17.1±2.4)μm、(176.5±27.6)μm及(90.1±4.5)μm;AL≥27.5 mm组分别为(271.0±24.1)μm、(11.6±2.8)μm、(17.3±7.6)μm、(21.3±5.1)μm、(18.9±5.8)μm、(28.4±7.3)μm、(86.5±9.3)μm、(16.7±Objective To explore the changes in retinal layer thickness and related factors in high myopia eyes.Methods A total of 128 highly myopic patients(128 eyes)who visited the Beijing Tongren Eye Center of Beijing Tongren Hospital affiliated with Capital Medical University from February 2023 to July 2023.Among them,there were 46 males(46 eyes)and 82 females(82 eyes)with an average age of(35.9±7.9)years(ranging from 21 to 69 years).According to axial length(AL),age,and gender,they were divided.The patient′s blood pressure,initial age of myopia,intraocular pressure,height and weight were recorded,and the height and body mass index(BMI)was calculated.The thickness of each layer of the retina and the thickness of the central fovea choroid was measured using coherent light tomography(OCT).The measurement data of the thickness of each layer of the retina conformed to a normal distribution through Kolmogorov-Smirnova normality test,and was described as±s,and compared by analysis of variance in retinal thickness between different AL and age groups and used for further pairwise by Bonferroni if there was a statistically significant difference.The retinal thickness between different gender groups was compared by independent sample t test.Single factor linear regression was used to screen for factors related to the thickness of each layer of the retina.Then,the thickness of each layer of the retina was used as the dependent variable,and the factor with P≤0.10 in the univariate analysis was used as the independent variable.Referring to previous results,age and AL were also used as independent variables for multiple linear regression analysis of their correlation.Results The thickness of the entire retina,retinal nerve fiber layer(RNFL),ganglion cell layer(GCL),inner plexiform layer(IPL),inner nuclear layer(INL),outer plexiform layer(OPL),outer nuclear layer(ONL),retinal pigment epithelium layer(RPE),inner retinal layer(IRL),and outer retinal layer(ORL)in patients were measured.The AL<26.5 mm group was(258.9±20.0)μm,(10.1�

关 键 词：高度近视 相干光断层扫描 视网膜厚度 

分 类 号：R778.11[医药卫生—眼科]