限定地区人群为基础的视盘旁萎缩弧形态学研究

The morphological characters of parapapillary atrophy in Beijing defined-population study

目的评估限定地区人群为基础的视盘旁萎缩弧情况。设计限定地区人群为基础的横断面研究。人群5324个参与者中4439个人入选到本研究中,应答率为83.4%。最低年龄在40岁以上。其中农村人群为1973人(44.4%),城市人群为2466人(55.6%)。方法应用佳能彩色眼底照相机对眼底视盘拍照后,进行视盘形态学的评估。眼底照相机的放大倍数通过计算视盘的面积得到矫正。结果4163张清晰的眼底照片入选到本研究中,其中2955人(70.98%)有α区,平均面积为(0.729±0.629)mm2(0.053～13.719mm2)。α区的大小和年龄相关(r=0.194,p=0.000<0.001)。同时和近视的程度相关(r=-0.094,p=0.000<0.001)。男性和女性之间萎缩弧α区大小无明显统计学差异(p=0.045,95%CI:0.706,0.752)。而872人有β区(20.95%),平均值为(1.985±2.223)mm2(0.102～14.999)mm2。β区的大小和年龄相关(r=0.144,p=0.000<0.001)。和近视的程度相关(r=-0.556,p=0.000<0.001)。男性和女性之间的β区大小无明显差异(p=0.096,95%CI:-0.548,0.045)。α区和β区面积大小与人群的裸眼视力,最佳矫正视力有关。两种萎缩弧均易发于视盘的颞侧,其次为颞下、颞上,最少发生在视盘鼻侧。结论α区和β区各自在人群中的发生率为70.98%和20.95%。由于β区多发于青光眼人群,β区的正常人群研究资料可能对青光眼的早期发现有重要意义。

Objective To evaluate morphological characters of parapapillary atrophy in Beijing defined-population. Population-based, cross-sectional cohort study. 4439 subjects out of 5324 subjects with an age of 40＋ years were asked to participate in the study （response rate 83.4%）. It was divided into a rural part [1973 （44. 4%） subjects] and an urban part [2466 （55.6%） subjects]. Mean age was 56.2 （ 10.6 years （range： 40～101 years）. Methods Color optic disc photographs （30°）were morphometrically examined. The magnification of the fundus camera was assessed by comparing optic disc photographs with confocal laser scanning tomographic images. Results 4163 （93.8%） subjects with clear photos were available. Alpha zone was present in 2955 （70. 98%） eyes. It measured （0.729 ±0.629）mm2 （range： 0.053～13.719mm^2）. Size of alpha zone was statistically correlated with age （r = 0.194, p = 0.000 〈 0.001）. It increased significantly with refractive error （correlation coefficient： r = -0.094, p = 0.000 〈 0.001）. It did not vary significantly between females and males [（0.708±0. 581 mm^2 versus （0.755±0.684） mm^2; p = 0.045, 95%CI： 0.706, 0.752）]. Beta zone present in 872 （20.95%） eyes measured （1.985 ±2.223）mm^2 （range： 0.102 ～14.999mm^2）. Size of beta zone was statistically correlated with age （p = 0.000）. It increased significantly with refractive error （correlation coefficient： r = -0.556, p = 0.000 〈 0.001）. It did not vary significantly between females and males [（2.722 ±0.205 mm^2 versus （2.246±0.146） mm^2; p=0. 096, 95%CI： -0.548, 0.045）]. Size of alpha zone and beta zone were statistically associated with uncorrected and best corrected visual acuity. Conclusions Alpha zone and beta zone of parapapillary atrophy, respectively, occur in more than 70.98% and in more than 20.95% in this group. Beta zone of parapapillary atrophy is associated with glaucomatous optic neuropathy, and may be helpful for glaucoma detection.