近视性屈光不正HRT-Ⅱ视盘参数结果分析

Analysis of HRT-Ⅱ parameters in myopic refractive error eyes

目的 探讨近视性屈光不正HRT Ⅱ视盘参数结果的特点。 方法 对 61例健康近视者进行随机非对照研究。验光和HRT Ⅱ检查后,每例患者随机选择 1眼纳入研究,屈光度数-0 25 ^-14 75D。用鼻颞侧视盘边缘在坐标系Z轴方向的高度差代表视盘旋转变形程度,分析鼻颞侧高度差异与屈光度数的关系、视盘参数结果与屈光度数的关系、某些视盘参数结果与鼻颞侧高度差异的关系。对后两项有相关性者行一元线性回归分析。 结果 鼻颞侧高度差异与屈光度数之间有相关性。14项视盘参数当中,盘沿容积、轮廓线高度变异、平均RNFL厚度、RNFL截面面积、参考高度的参数结果与屈光度数有相关性,且与鼻颞侧高度差异有更密切的相关性。以上皆为正相关。 结论 近视因导致了视盘的旋转变形而对HRT Ⅱ某些重要参数结果产生影响,这种影响随屈光度数增大而更加显著,当合并青光眼时可能干扰后者的诊断。

Objective To evaluate characteristics of optic disc parameters in myopia with Heidelberg retina tomography. Methods The refraction and Confocal Scanning Laser Ophthalmoscopy(HRT Ⅱ,software:version 1 6) were taken in 61 subjects with the diopter of -0 25 to -14 75D,and one eye of each subject was selected for a randomly non controlled investigation.The height variation in Z axis between nasal and temporal margins (HVNT) was measured by coordinate system to predict the rotation of optic disc around Y axis(i.e.disc shape changing).The correlations between HVNT and refraction values,14 disc parameters and refraction values,certain parameters and HVNT were analyzed,and simple linear regression analysis were performed for linearly correlated parameters. Results HVNT was correlated with myopic refractive error( r =0 46, P <0 01). Among 14 optic disc parameters,rim volume,height variation contour,mean RNFL thickness,RNFL cross sectional area and reference height were positively correlated with myopic refractive error( r =0 341-0 388, P <0 01)and showed better correlations with HVNT( r =0 412-0 830, P <0 01).Mean RNFL thickness increased by 0 012mm and 0 049mm respectively when myopia increased 1 diopter or HVNT increased 0 1mm. Conclusion Optic disc rotation caused by myopic refractive error can affect some parameters obtained using HRT Ⅱ.The disturbances are more severe in higher myopia,and it would hinder clinicians from detecting,if any,a glaucomatous disc damage in myopic patients.