近视眼脉络膜厚度与近视程度的相关性分析

The correlations between choroidal thickness and degree of myopia in Chinese

目的评价中国近视人群黄斑区脉络膜厚度与近视程度的相关性。设计回顾性病例系列。研究对象北京同仁眼科中心拟行近视矫正手术者248例470眼。方法用RTVue OCT进行脉络膜视网膜扫描,手工测量中心凹处和距离中心凹500、1000、2000μm处上、下、鼻、颞侧13个点上的脉络膜厚度。视网膜厚度计算是设备测量软件自动生成的以距离黄斑中心凹1、3、6 mm的圆内选取8个测量值的平均值。近视程度分为轻(-0.50^-3.00 D)、中(-3.25^-6.00 D)、高(-6.25^-9.00 D)、超高(<-9.00 D)度近视四个组。主要指标脉络膜厚度、视网膜厚度、眼轴长度。结果在中心凹和其他测量点上脉络膜厚度在轻度、中度近视组间无显著差别,在轻度和高度、轻度和超高度、中度和高度、中度和超高度、高度和超高度近视眼组间均有显著性差别(P均<0.01)。中心凹处视网膜厚度在各组之间无显著差别(P均>0.05)。在超高度近视组和总样本内眼轴长度和等效球镜绝对值与黄斑区脉络膜厚度呈负相关。总样本内年龄和最佳矫正视力与黄斑区脉络膜厚度相关。黄斑区视网膜厚度与年龄、眼轴长度、等效球镜绝对值无显著相关,与黄斑区脉络膜厚度呈正相关。在轻度、中度近视组中心凹下脉络膜厚度比黄斑区脉络膜厚度更厚,而在高度和超高度近视组中心凹下脉络膜厚度比黄斑区脉络膜厚度更薄;这种差别在轻度和超高度近视组间有显著统计学意义(P<0.001)。在正常与异常最佳矫正视力的两组间黄斑区脉络膜厚度与中心凹下脉络膜厚度显著不同(P<0.05)。年龄(P=0.019)和黄斑区脉络膜厚度(P<0.01)与总样本的最佳矫正视力独立相关(P<0.05)。结论黄斑区的脉络膜厚度越薄,高度近视的可能越大,越容易出现影响最佳矫正视力的近视黄斑病变。

Objective To evaluate the correlations between choroidal thickness and degree of myopia in Chinese. Design Retrospective case series. Participants A total of 470 eyes（248 consecutive patients） were observed at the Tongren Eye Center. Method Choroidal and retinal biometry was measured using RTVue OCT [DL-Medsci1]. Choroidal thickness measurements were obtained manually at the point of fovea, and at 500, 1000, and 2000 μm apart from the fovea in the nasal, temporal, superior, and inferior directions.The mean retinal thickness was calculated by the software of the RTVue OCT. Main Outcome Measures Choroidal thickness, retinal thickness and axial length. Results There were no differences in the choroidal thickness at the fovea and each points between mild and moderate myopia（P〉0.05）, while there were differences between mild and high myopia, mild and super-high myopia, moderate and high myopia, moderate and super-high myopia, and high and super-high myopia（all P〈0.001）. There were no differences in the retinal thickness at the fovea（all P〉0.05）. Age（P=0.019） and macular choroidal thickness（P〈0.01） were independently related to best corrected visual acuity（P〈0.05）. Both macular choroidal thickness and subfovea choroidal thickness was significantly different between the two groups of patients with and without normal best-corrected visual acuity. Conclusions Macular choroidal thickness could be associated with the development of myopia. The macular choroidal thickness could be a good indicator of myopic maculopathy.