应用布里渊光学扫描系统探究近视眼晶状体生物力学特性及其在睫状肌麻痹前后变化的研究  

Application of the Brillouin optical scanning system to investigate the biomechanical properties of the myopic lens and their changes before and after cycloplegia

作　　者：宋芬 王雁[1] 常乐 曲诗佳 吴雅楠[1] 徐路路[1] 张蕊蕊 王静[1] 谢睿思 Song Fen;Wang Yan;Chang Le;Qu Shijia;Wu Yanan;Xu Lulu;Zhang Ruirui;Wang Jing;Xie Ruisi(Clinical College of Ophthalmology of Tianjin Medical University,Tianjin Eye Hospital,Tianjin Key Laboratory of Ophthalmology and Visual Science,Nankai University Affiliated Eye Hospital,Nankai University Eye Institute,Tianjin 300020,China)

机构地区：[1]天津医科大学眼科临床学院,天津市眼科医院,天津市眼科学与视觉科学重点实验室南开大学附属眼科医院,南开大学眼科学研究院,天津300020

出　　处：《中华眼科杂志》2025年第4期251-259,共9页Chinese Journal of Ophthalmology

基　　金：国家重点研发计划项目(2022YFC2404502);国家自然科学基金面上项目(82271118);天津市科技计划项目(21JCZDJC01190);天津市卫生健康科技项目(TJWJ2022XK036);天津市医学重点学科(专科)建设项目(TJYXZDXK-016A)。

摘　　要：目的探讨近视眼人群晶状体生物力学特性及其在睫状肌麻痹前后的改变和可能的影响因素分析。方法横断面研究。连续收集2023年11月至2024年5月于天津市眼科医院接受布里渊光学扫描系统检查的近视眼患者159例(159只右眼)。其中男性82例,女性77例;年龄21(18,24)岁。根据等效球镜度数将患者分为低、中、高度近视3个组。通过布里渊光学扫描系统、光学生物测量仪及眼前节相干光层析成像仪获取晶状体生物力学参数及眼部屈光和形态学参数,包括顶部平台宽度、底部平台宽度、晶状体核纵向弹性模量(LMN)、晶状体皮质纵向弹性模量(LMC)、眼轴长度、晶状体厚度、前曲率半径、后曲率半径和晶状体光密度等。比较睫状肌麻痹前后各参数的差异,并通过单因素和多因素线性回归分析来评估睫状肌麻痹前后与LMN相关的因素。结果低、中、高度近视组分别有患者46、59、54例,年龄和性别分布的差异均无统计学意义(均P>0.05)。低、中、高度近视3个组的LMN分别为3.383(3.361,3.411)、3.401(3.378,3.416)和3.415(3.395,3.422)GPa,高度近视组LMN更高;3个组的LMN差异有统计学意义(P<0.001)。LMC在低、中、高度近视3个组之间的差异无统计学意义(P>0.05)。睫状肌麻痹后,LMN比麻痹前略下降[3.395(3.371,3.414)和3.405(3.379,3.417)GPa,P<0.05]。多因素线性回归分析结果显示,睫状肌麻痹前后LMN均与屈光度数成正比,近视度数越高,LMN越大(均P<0.05)。晶状体光密度越大,LMN越小(均P<0.05);性别也与LMN有关(均P<0.05)。结论年轻近视眼患者的LMN随近视程度的加深而增大,高度近视眼患者LMN更高,表明近视眼晶状体生物力学特性可能发生改变。同时,睫状肌麻痹前后LMN存在差异,表明调节可能影响晶状体的生物力学特性。性别与晶状体光密度也是影响LMN的相关因素。Objective To investigate the biomechanical properties of the lens and the changes before and after cycloplegia in the myopic population in China,and to analyze the possible influencing factors.Methods This is a cross-sectional study.Consecutively,159 myopic patients(159 right eyes)who underwent the Brillouin Optical Scanning System examination from November 2023 to May 2024 at Tianjin Eye Hospital were recruited.Among them,82 were male and 77 were female,with an age of 21(18,24)years.The patients were classified into low,intermediate,and high myopia groups according to the equivalent spherical lens power.The lens biomechanical parameters,as well as ocular refractive and morphological parameters,were measured,including the width of top plateau,the width of bottom plateau,the longitudinal modulus of nucleus(LMN),the longitudinal modulus of cortex(LMC),the axial length of the eye,lens thickness,anterior radius of curvature,posterior radius of curvature,and lens density.The differences in lens parameters before and after cycloplegia were compared.Univariate and multivariate linear regression analyses were utilized to assess the factors associated with the LMN before and after cycloplegia.Results There were 46,59,and 54 patients in the low,intermediate,and high myopia groups respectively.There were no statistically significant differences in age or gender distribution among the three groups(all P>0.05).The LMN of the three groups of low,intermediate,and high myopia were 3.383(3.361,3.411),3.401(3.378,3.416),and 3.415(3.395,3.422)GPa,respectively,and the LMN was higher in the high myopia group;the difference in the LMN among the three groups was statistically significant(P<0.001).The difference in the LMC of the lens cortex was not statistically significant among the 3 groups of low,intermediate,and high myopia(P>0.05).After ciliary muscle paralysis,the LMN decreased slightly compared with that before paralysis[3.395(3.371,3.414)and 3.405(3.379,3.417)GPa,P<0.05].The results of multifactorial linear regression analysis

关 键 词：近视 晶体 生物力学 睫状肌麻痹 布里渊光学扫描系统 

分 类 号：R778.1[医药卫生—眼科]