高度近视眼底改变与年龄和近视度数变化相关性分析

Analysis on the correlation between fundus change of high myopia with the aging and myopic severity

目的探讨高度近视眼的豹纹状眼底改变及其与近视度数和年龄相关因素的关系。方法对近10年354例不同年龄、不同近视度数的高度近视眼患者按年龄、近视度数、超声及眼底形态进行观察,并分组记录。结果①眼底变化:13.6%无眼底变化,8.8%局部改变,33.3%和44.4%分别为豹纹改变和弥漫性病理改变;不同年龄组分析,20岁组眼底无改变占44.8%,20～40岁组豹纹状眼底占46.1%,40岁以上的弥漫性病理改变超出50%;不同近视度数组分析,-6～-10D组眼底改变呈多样化,阴性改变占28.1%,弥漫性病理改变占33.3%,-10～-15D组眼底主要为豹纹状眼底39.1%和弥漫性病理改变48.3%,-15D以上组混合改变占70.8%。②从A超结果分析,眼轴在25mm时眼底无改变40.5%和豹纹状眼底18.9%,弥漫性病理改变27%,27mm时豹纹状眼底占51.9%,>27mm时弥漫性病理改变比例逐渐增加从53.4%到73.9%;从B超结果分析,阴性改变(61.10%)与25mm组基本相同,均匀扩张改变(58.90%)与25～27mm组对应,葡萄肿改变(70.20%)与27mm以上眼轴组对应。结论高度近视视网膜退行性病变早期(20岁后青春期、眼球扩张初期、豹纹状眼底改变)阶段介入医源性干预可能作为高度近视黄斑病变的预防策略。

OBJECTIVE To observe the fundus tessellation changes in the high myopia eyes in correlation with the aging and myopic severity. METHODS Three hundred and fiftyfour cases were divided into different groups and were observed and recorded according to their age,eye axis,myopia severity,and fundus appearances. RESULTS 1. Fundus changes：Of 354 cases,there were 13.6% cases with the non-pathologic appearance,and 8.8% with limited macular focus consisting 33.3% with tessellation and 44.4% diffused pathologic myopias were 44.4%. According to different age groups,the results were seen as 44.8% without change under the age of 20,46.1% tessel-lation change between the age 20 to 40,over 50% diffused pathologic change beyond the age of 40. Among the groups of myopic severity,multiple changes were shown in -6 to -10D mild myopia with 28.1% negative and 33.3% pathologic myopia changes ,while increased proportion of 39.1% tessellation and 48.3% pathologic changes in-10 to -15D severe myopia and mainly diffused change of 70.8% in myopia over.-15D. 2. Analysis of ultrasonography A/ B：From the results of ultrasonography A,with ocular axis of 25mm there was 40.5% no change,18.9% tessellation and 27% pathologic changes while 51.9% tessellation correspond to ocular axis of 27mm,meanwhile diffused pathologic change increased from 53.7% with 29mm ocular axis to 73.9% with over 27mm axis whereas from the results of ultrasonography B.There was 61.10% negative changes ,which was similar to ocular axis of 25mm ultrasonography A,and 58.9% even enlargement corresponded to 25～27mm,and 70.20% staphyloma corresponded to over 27mm. CONCLUSIONS The tessellation changes of high myopias deteriorated along with the increase of ageing and my-opia index.