屈光不正儿童青少年视网膜离焦与眼轴的相关性

Correlation between Retinal Defocus and Axial Length in Children and Adolescents with Refractive Error

目的:利用多光谱屈光地形图(MRT)量化远视、近视儿童青少年视网膜特定区域离焦量(RDV)及其特点,并探讨其与眼轴长度(AL)的相关性。方法:系列病例研究。连续纳入2021年12月至2022年5月就诊于石家庄爱尔眼科医院的屈光不正儿童青少年176例(176眼),年龄5~16(9.9±2.1)岁,根据等效球镜度(SE)分为近视组(-6.00~-0.50 D)90眼,远视组(+0.50~+6.00 D)86眼。MRT测量视网膜中心屈光度(CR)和特定区域RDV,包括总离焦差值(TRDV)、上侧(RDV-S)、下侧(RDV-I)、鼻侧(RDV-N)、颞侧(RDV-T)以及从黄斑中心凹到周边53°,每间隔15°的3个同心区域(RDV-15、RDV-30和RDV-45)的RDV。通过独立样本t检验分析近视组和远视组的各参数比较,Pearson相关性分析视网膜周边RDV、AL与SE之间的相关性。结果:近视组屈光度(-2.54±1.23)D,AL(24.72±0.83)mm,TRDV(+0.24±0.31)D,CR为(-2.47±1.20)D,RDV在4个方向为RDV-N>RDV-I>RDV-T>RDV-S(均P<0.05);远视组屈光度(+1.69±1.82)D,AL(22.29±1.33)mm,TRDV(-0.24±0.76)D,CR(1.90±3.15)D,4个方向RDV-N、RDV-S、RDV-I、RDV-T分别为(+0.25±1.07)(-0.30±1.34)(-0.32±1.06)(-0.68±0.91)D,远视组的CR与RDV-T呈负相关(r=-0.44,P<0.001)。2组RDV-S均呈近视性离焦,并且RDV-N远视性离焦值最大;AL与TRDV、RDV-30、RDV-45、RDV-I、RDV-T均存在相关性(r=0.19~0.53,均P<0.05)。结论:MRT可量化近视和远视儿童青少年视网膜特定区域离焦特征,周边离焦性质与AL增长相关。

Objective:Quantifying the amount of defocus in specific areas of the retina and its characteristics in hyperopic and myopic children and adolescents using multispectral refractive topography(MRT)and exploring its correlation with axial length(AL).Methods:This series of case study included 176(176 eyes)children and adolescents with refractive errors,aged 5 to 16(9.9±2.1)years,attending Shijiazhuang Aier Eye Hospital from December 2021 to May 2022.Based on spherical equivalent(SE),participants were divided into myopia group(-6.00 to-0.50 D,90 eyes)and hyperopia group(+0.50 to+6.00 D,86 eyes).MRT was used to measure central refraction(CR)and refraction difference value(RDV)in specific areas,including total refraction difference value(TRDV),RDV-superior(RDV-S),RDV-inferior(RDV-I),RDV-nasal(RDV-N),RDV-temporal(RDV-T),as well as three concentric regions at intervals of 15°from the fovea to 53°(RDV-15,RDV-30,and RDV-45).Independent samples t-tests were used to analyse parameters comparisons between two groups.And Pearson correlation analysis was used to examine the correlation between RDV,AL,and SE.Results:In the myopic group,the spherical refractive error was-2.54±1.23 D,AL was 24.72±0.83 mm,TRDV was+0.24±0.31 D,CR was-2.47±1.20 D,and RDV in four directions was RDV-N>RDV-I>RDV-T>RDV-S(all P<0.05).In the hyperopic group,the SE was+1.69±1.82 D,AL was 22.29±1.33 mm,TRDV was-0.24±0.76 D,CR was 1.90±3.15 D,and the defocus magnitude of RDV-N,RDV-S,RDV-I,RDV-T in four directions was+0.25±1.07 D,-0.30±1.34 D,-0.32±1.06 D,-0.68±0.91 D.Correlation between CR and RDV-T in the hyperopic group was statistically significant(r=-0.44,P<0.001).Both groups showed myopic defocus in RDV-S and RDV-N had the largest hyperopic defocus value.There was a correlation of TRDV,RDV-30,RDV-45,RDV-I,RDV-T with AL(r=0.19-0.53,all P<0.05).Conclusion:MRT can quantify the defocus characteristics in specific areas of the retina in myopic and hyperopic children and adolescents,and the peripheral defocus characteristics are related to AL.