高度近视眼底形态学与视力关系的研究

Relationship between visual function and morphological changes of the high myopia fundus

目的:探讨高度近视眼视功能与近视弧和视网膜厚度形态改变的关系。方法:回顾性分析等效球镜-6^-27D的高度近视55例104眼,按最佳矫正视力分为A,B,C组,对视盘面积、近视弧面积、最大水平视盘长度、最大水平近视弧长度、脉络膜萎缩弧面积、6mm平均中央视网膜厚度、视网膜中央厚度、6mm视网膜体积进行分析,采用SPSS 13.0单因素方差分析进行统计。结果:A,B,C三组近视弧面积分别是8.29±4.82,4.31±3.05,2.49±2.60mm2;近视弧宽度分别是1.88±0.83,1.31±0.66,0.86±0.61mm,三组比较差异均有统计学意义(P<0.01)。A,B,C三组脉络膜萎缩弧面积分别是4.26±4.27,1.23±1.74,0.62±1.53mm2,差异有统计学意义(F=19.58,P<0.01);A,B,C三组视盘面积、视盘水平长度比较差异无统计学意义(F=1.1,P=0.33;F=0.44,P=0.64)。A组6mm平均视网膜度、6mm视网膜体积较B,C组薄,差异有统计学意义(F=4.28,P=0.01;F=3.35,P=0.03),但B,C组之间差异无统计学意义。A,B,C三组视网膜中心厚度之间差异无统计学意义。结论:脉络膜萎缩弧、6mm平均视网膜厚度、6mm视网膜体积可以帮助评估高度近视视功能的改变,近视弧扩大提示高度近视进展。

AIM：To evaluate the morphological changes of peripapillary atrophy（PPA） and retinal thickness（RT） in high myopia under different best corrected visual acuity（BCVA）.METHODS：A retrospective review of medical records in55 high myopia patients（104 eyes） was carried out,whose spherical equivalent（SE） refractive errors ranged from- 6 -- 27 D.Groups A,B and C were divided according to different BCVA.The parameters including optic disc（OD） size,PPA size,the biggest width of OD along the horizontal axis,the biggest width of PPA along the horizontal axis,the size of the peripapillary chorioretinal atrophy（PCA）,the average 6mm center retinal thickness（ACRT）,the center retinal thickness（CRT）,the total 6mm center retinal volume（TCRV） were evaluated.All the data were analyzed respectively by one-way ANOVA with edition SPSS 13.0.RESULTS：There were significant differences among three groups on PPA size（8.29 ±4.82,4.31 ±3.05,2.49 ±2.60mm^2 in groups A,B and C,respectively）,PPA width（1.88±0.83,1.31 ±0.66,0.86 ±0.61 mm in groups A,B and C,respectively）（all P 〈0.01）.The PCA size was increased significantly in group A（4.26 ±4.27mm^2） than other groups（group B：1.23±1.74mm^2,group C：0.62±1.53mm^2）（F= 19.58,P〈0.01）.The OD size and width had no significant differences among three groups（F =1.1,P = 0.33;F = 0.44,P = 0.64）.ACRT and TCRV reduced significantly in group A（ACRT：211.34 ±118.32μm;TCRV：6.09 ±3.65mm^3） than in other groups（F=4.28,P=0.01;F=3.35,P = 0.03）,but no significant difference between groups B and C.CRT was not changed in three groups（F=2.23,P = 0.11）.CONCLUSION：PCA increase,ACRT and TCRV decrease assist to evaluate visual function in high myopia.PPA increase indicates the myopia progress.