近视患者视网膜及脉络膜厚度分析

Analysis of the retinal and choroidal thickness in myopia patients with different diopters

目的测量不同屈光度的近视患者的视网膜及脉络膜厚度,分析其变化规律及其与屈光度的关系。方法选取2015年10月—2016年6月在四川大学华西医院眼科就诊并诊断为近视性屈光不正患者161例(322只眼)及正常志愿者53例(106只眼)。全部受试者均采用德国卡尔蔡司公司Cirrus HD-OCT 5000进行Macular cube 512×128及EDI HD-OCT模式的光学相干断层成像检查,测量受试者黄斑中心凹处及中心凹上方、下方、鼻侧、颞侧3、6 mm处视网膜及脉络膜厚度并取平均值。根据屈光度的不同将受试者分为正视组53例(106只眼)、低度近视组(等效屈光度–0.25~–3.00)64例(128只眼)、中度近视组(等效屈光度–3.25~–6.00)47例(94只眼)、高度近视组(等效屈光度<–6.00)50例(100只眼)。所有受试者的最佳矫正视力均≥0.8。分析不同屈光度受试者视网膜及脉络膜厚度的变化。结果正视组、低度近视组、中度近视组、高度近视组视网膜厚度分别为(242.50±29.86)、(238.46±23.85)、(224.52±26.01)、(211.91±23.07)μm,脉络膜厚度分别为(220.16±66.00)、(252.39±79.56)、(191.09±103.03)、(121.83±92.54)μm。除中度近视组与高度近视组间视网膜厚度差异无统计学意义(P>0.05)外,其余各组之间视网膜厚度的差异均有统计学意义(P<0.05);除正视组与中度近视组间脉络膜厚度差异无统计学意义(P>0.05)外,其余各组间脉络膜厚度的差异均有统计学意义(P<0.05)。结论近视性屈光不正患者视网膜及脉络膜厚度均随屈光不正度数的增加而大体呈变薄的趋势,这可能与近视的形成过程有关。

Objective To explore the retinal and choroidal thickness of myopic patients with different diopters, and analyze the change rule and its relation with the diopter. Methods From October 2015 to June 2016, a total of 161 patients （322 eyes） with myopia and 53 normal volunteers （106 eyes） were selected from Department of Ophthalmology, West China Hospital of Sichuan University. Optical coherence tomography （OCT） examination was performed in all the subjects with Macular cube 512× 128 and EDI HD-OCT model in Cirrus HD-OCT 5000 of Carl Zeiss Company from Germany, measuring the retinal and choroidal thickness in macular central fovea, and 3 and 6 mm above, below, on the nose side, and on the temporal side of macular central fovea; the data were averaged. According to the different diopters, the subjects were divided into four groups, including emmetropia group with 53 patients （106 eyes）, low myopia group （equivalent diopter from -0.25 to -3.00） with 64 patients （128 eyes）, moderate myopia group （equivalent diopter from -3.25 to -6.00） with 47 patients （94 eyes）, and high myopia group （equivalent diopter 〈-6.00） with 50 patients （100 eyes）. All the subjects＇ best corrected visual acuities were t〉 0.8. The changes of retinal and choroidal thickness in myopia patients with different diopters were compared and analyzed. Results The average retinal thickness of the patients in the emmetropia group, the low myopia group, the moderate myopia group, and the high myopia group was （242.50±29.86）, （238.46±23.85）, （224.52±26.01）, （211.91±23.07）μm, respectively; the average choroidal thickness of the patients in the emmetropia group, the low myopia group, the moderate myopia group, and the high myopia group was （220.16±66.00）, （252.39±79,56）, （191.09± 103.03）, （121.83±92.54）μm, respectively. There was no significant difference in retinal thickness between the moderate myopia group and the high myopia group （P〉0.05）, while the differences in retinal thicknessbetween the remaining groups were statistically significant （P〈O.05）; there was no statistically significant difference between the emmetropia group and moderate myopia group （P〉O.05）, while the differences in choroid thickness between the remaining groups were statistically significant （P〈0.05）. Conclusion In general, there are decreasing trends of the retinal thickness and choroid thickness with the increase of the diopter, which may be associated with the formation process of myopia.