近视眼眼球突出度及相关研究

Myopic proptosis and the associated changes in axial components of the eye

目的探讨眼球突出度、等效球镜度数、眼轴长度之间的相关性。方法近视患者及正视者189例，散瞳检影验光进行屈光度检查，采用Hertel眼球突出计测量眼球突出度，相干光生物测量仪（IOL—master）测量角膜曲率、眼轴长度。按眼轴长度不同分正视及轻度近视组、中度近视组、高度近视组。均取右眼进行各组之间眼球突出度比较，分析眼球突出度、等效球镜度数、眼轴长度三者之间关系。结果正视及轻度近视组眼轴〈25．00mm，平均（23．54±0．73）mm，等效球镜度数为（-0．76±1．29）D。中度近视组眼轴长度25．00～27．00mm，平均（25．77±0．53）mm，等效球镜度数为（-5．33±237）D。高度近视组眼轴≥27．00mm，平均（30.08±209）mm，等效球镜度数为（-15．92±5．12）D。正视及轻度近视组平均眼球突出度为10．50～19．50mm，平均（14．66±1．94）mm，中度近视组平均眼球突出度为13．00～19．50mm，平均（16．16±1．40）mm，高度近视组平均眼球突出度为14．00～23．00mm，平均（18．30±1．63）mm。高度近视组眼球突出度分别大于中度近视组、正视及轻度近视组（P〈0．01）。中度近视组眼球突出度大于正视及轻度近视组（P〈0．01）。眼球突出度、等效球镜度数、眼轴三者之间存在线性相关关系，一元线性回归方程分别为眼球突出度=0．616×AL（眼轴长度）（R^2=0．990，F=18450．30，P〈0．01）；眼球突出度=14．65—0．227×SE（等效球镜度数）（R^2=0．500，F=187．05，P〈0．01）；等效球镜度数=52．06—2．24×AL（眼轴长度）（R^2=0．892，F=1537．83，P〈0．01）。结论随着眼轴长度、等效球镜度数增加，近视眼眼球突出度随之线性增加。随着眼轴增长眼球向后扩张、眼球向前突出，眼球向前突出更为明显。（中华腰科杂志，2007，43：525-529）

Objective To investigate the correlation between proptosis and changes of axial components in myopic eyes. Methods One hundred and eighty-nine myopic and emmetropic eyes were included. There are one hundred and eighty-three right eyes and six left eyes. Based on axial length （AL）, subjects were divided into three groups： low-myopia ＆ emmetropia group, moderate myopia group, high myopia group. Refraction of the eye （SE, spherical equivalent） was measured by retinoscopy examination under mydriasis. Proptosis was measured by Exophthalmometers （K-0161 Hertel-Type）. Axial components including axial length and corneal curvature and were measured by partial coherence laser interferometry （IOL-master）. The correlation in results among proptosis, axial components, and refraction was evaluated. Results The proptosis in high myopia group was bigger than in the other groups （ P 〈 0. 01 ）. The proptosis in moderate myopia group was bigger than in low-myopia and emmetropia group （P 〈 0. 01 ）. The axial length was shorter than 25 mm in low-myopia and emmetropia group, from 25.00 to 27. 00 mm in moderate myopia group and equal or longer than 27 mm in high myopia group. There was an increasing trend in proptosis [ ranging from （ 14. 66 ± 1.94） mm, （ 16. 16 ± 1.40） mm to （ 18. 30 ± 1.63 ） mm ] and axial length [ ranging from （23.54 ± 0. 73 ） nun, （25. 77 ± 0. 53 ） nun to （30. 08 ± 2. 09） mm ] among the three groups, the order of groups in the rangking was from low-myopia and emmetropia group, moderate myopia group to high myopia group. There was a highly significant correlation between proptosis and AL （R2 =0. 990,F = 18 450. 30, P 〈 0. 01 ）. Refraction results in low-myopia and emmetropia group, moderate myopia group and high myopia group were （ -0.76 ± 1.29） diopters （D）, （ -5.33 ±2.37） diopters （D） and （ -15.92 ±5.12） diopters （D） respectively. There was a moderate correlation between proptosis and SE （R^2 = 0. 500,F = 187.05, P 〈 0. 01 ）. There was a highly significant correlation between axial length and refraction （R^2 =0. 892, F = 1537.83,P 〈 0. 01 ）. Conclusion Myopic proptosis increases with the increasing AL and SE of the eye. The eyeball tends to expand backward and proptosis forward with the increasing AL and the proptosforward appears to be more obvious. （Chin J Ophthalmol, 2007,43：525-529 ）