病理性近视眼黄斑区微视野分析

The macular function assessment in pathological myopia eyes by microperimetry

目的利用微视野计分析病理性近视眼黄斑区无特殊病理改变时光敏感度的变化和固视情况。方法临床病例对照研究。选择2013年11月至2014年4月在天津市眼科科医院就诊的病理性近视黄斑区无特殊病变的患者35例44只眼（A组），同时以年龄相匹配的中低度近视眼15例27只（B组）作为对照。所有患者均行最佳矫正视力、屈光度、眼轴长度测量，采用MAIA微视野计检测黄斑100总体平均光敏感度（meansensitivity，MS总）、2°、4°固视率（P1、P2）、固视稳定率。并将黄斑中心10°分5区，记录各区平均光敏感度（MS上、MS颞、MS鼻、MS下、MS中）。结果A组与B组相比，除下方（MS下）（t=-1．400，P=0．166）外，黄斑中心10°平均光敏感度（MS总），各分区平均光敏感度（MS上、MS颞、MS鼻、MS中）均下降，差异有统计学意义（t=-2．413、-2．689、-2．063、-2．731、-2．018，P=0．019、0．009、0．043、0．008、0．048）；两组2°、4°固视率、固视稳定率比较，差异无统计学意义（t=-1．740、-1．947，P=0．086、0．056，r=1．042，P〉0．05）。结论病理性近视眼无黄斑病变时黄斑区整体平均光敏感度下降且改变呈区域性，固视可基本保持稳定。

Objective To assess the macular light sensitivity, fixation situation of pathological myopia eyes without maculopathy using MAIA microperimetry. Methods Thirty-five pathologic myo- pia patients （44 eyes） without aay maculopathy （group A） and 15 low to moderate myopia patients （27 eyes） whose ages were matched as controls （group B） were included in this retrospective study. All patients took examinations of best corrected visual acuity （BCVA）, refraction, axial length （AL）. Then the mean light sensitivity （MStot） and fixation stability in the central 10°, fixation stability rate were recorded among all myopia eyes by using MAIA microperimetry. Then the macular central 10°re- gions were divided into 5 parts. The mean light sensitivity of each part （MSsup, MStem, MSnas, MSinf, MSmed） were also determined. Results Compared with group B, the MS of central 10° and each part of central macular region was lower in group A （t =-2.413, -2.689, -2.063, -2.731, -2.018, P =0.019, 0.009, 0.043, 0.008, 0.048）, except the inferior part （t =-1.400, P =0.166）, the differences were statistically significant. The differences of 2° and 4° fixation rate, fixation stability rate were all not statistically significant （t =-1.740, -1.947, P =0.086, 0.056, x^2=1.042, P 〉0.05）. Conclusions Pathological myopia patients have decreased mean light sensitivity in the macular region, although without any maculopathy. The alteration of macular light sensitivity has regional differences. The fixa- tion stability maintains normal when pathological myopia hasn＇t induces maculopathy.