轴性高度近视眼黄斑OCT图像特征及与眼轴的关系

Characteristics of Macular OCT Images in Axial High Myopia and Their Relationship with Ocular Axis

目的观察轴性高度近视患者黄斑OCT图像特点并分析眼轴长度与眼底黄斑病变的关系,为早期发现高度近视微小病变、确定病变类型、指导治疗及预测预后积累经验。方法选择屈光度>-6.0D及IOL-master测量眼轴>26mm的高度近视患者77例137眼,年龄20～50岁,根据IOL-master测量的眼轴结果,将患者分为A组(26mm<L≤28mm)、B组(28mm<L≤30mm)和C组(L>30mm)。3组患者均采用频域OCT对黄斑区扫描,记录OCT图像特征。结果 3组间性别比较差异无统计学意义(P>0.05),年龄、屈光度比较差异有统计学意义(均P<0.05)。OCT的图像特征:1)大致正常,A组10眼,B组0眼,C组0眼,差异有统计学意义(P<0.01)。2)椭圆体带反射异常,A组22眼,B组43眼,C组60眼,差异有统计学意义(P<0.01)。3)黄斑劈裂,A组10眼,B组25眼,C组52眼,差异有统计学意义(P<0.01)。4)单纯性黄斑出血,A组2眼,B组4眼,C组4眼,差异无统计学意义(P>0.05)。5)脉络膜新生血管,A组3眼,B组5眼,C组5眼,差异无统计学意义(P>0.05)。6)黄斑裂孔,A组1眼,B组1眼,C组5眼,差异无统计学意义(P>0.05)。7)视网膜脱离,A组0眼,B组2眼,C组2眼,差异无统计学意义(P>0.05)。8)黄斑前膜,A组1眼,B组3眼,C组1眼,差异无统计学意义(P>0.05)。9)黄斑萎缩,A组2眼,B组5眼,C组22眼,差异有统计学意义(P<0.01)。结论轴性高度近视患者眼轴越长,眼底黄斑区发生椭圆体带反射异常、黄斑劈裂及黄斑萎缩的概率越高。

Objective To observe the characteristics of macular OCT images and the relationship between axial length and macular lesion in patients with axial high myopia,and to accumulate experience for early detection of minimal lesions,determination of lesion types,guidance of therapy and prediction of prognosis.Methods Totally 77 patients(137 eyes)with refractive index>-6.0 D and ocular axial length>26 mm(20-50 years old)were divided into three groups according to the ocular axial length measured by IOL-master:group A(26 mm<AL≤28 mm),group B(28 mm<AL≤30 mm)and group C(AL>30 mm).Each eye was scanned with OCT for macular area,and the characteristics of OCT images were recorded.Results There were significant differences among the three groups in the age and diopter(P<0.05),but not in the gender(P>0.05).The characteristics of OCT images included:1)normal(10 in group A,0 in group B and 0 in group C;P<0.01).2)ellipsoid reflex anomaly(22 in group A,43 in group B and 60 in group C;P<0.01).3)macular splitting(10 in group A,25 in group B and 52 in group C;P<0.01).4)simple macular hemorrhage(2 in group A,4 in group B and 4 in group C;P>0.05).5)choroidal neovascularization(3 in group A,5 in group B and 5 in group C;P>0.05).6)macular hole(1 in group A,1 in group B and 5 in group C;P>0.05).7)retinal detachment(0 in group A,2 in group B and 2 in group C;P>0.05).8)macular epiretinal membrane(1 in group A,3 in group B and 1 in group C;P>0.05).9)macular atrophy(2 in group A,5 in group B and 22 in group C;P<0.01).Conclusion The longer axial length of axial myopia,the higher probability of ellipsoid reflex abnormal,macular splitting and macular atrophy in macular area.