Corvis ST评估高度近视患者角膜生物力学参数及其相关因素

Evaluation of Corneal Biomechanical Properties in High Myopia Using the Corivs ST and Its Correlation Factors

目的:利用Corvis ST评估高度近视患者角膜生物力学参数及其相关因素。方法:横断面研究。选取2017年6-10月就诊于温州医科大学附属眼视光医院的高度近视患者53例,其中男17例,女36例,年龄18~53(33.0±9.6)岁,均取右眼检测数据。应用Corvis ST测量角膜生物力学参数,包括第1次压平速率(A1V)、长度(A1L);第2次压平速率(A2V)、长度(A2L)以及最大凹陷位置的形变幅度(DA)、曲率半径(HCR)、顶点距离(PD)。比较高度近视患者(-6^-10D,23眼)和超高度近视患者(≤-10D,30眼)角膜生物力学参数的差异,并分析各参数与年龄、眼压、眼轴长度(AL)、中央角膜厚度(CCT)及视网膜神经纤维层(RNFL)厚度的相关性。数据采用独立样本t检验、Pearson相关进行分析。结果:高度近视组与超高度近视组之间的A2L差异具有统计学意义(t=1.95,P=0.043)。双变量相关分析结果显示眼压与A1V、PD、DA呈负相关(r=-0.56、-0.46、-0.63,P<0.001),与A2V呈正相关(r=0.37,P=0.005);PD与AL呈正相关(r=0.43,P=0.001)。A1L、A2L、A2V与CCT呈正相关(r=0.33,P=0.043;r=0.28,P=0.041;r=0.39,P=0.003);角膜压平范围与下方RNFL厚度呈负相关(r=-0.45,P=0.001)。所有参数与年龄不存在相关性。结论:高度近视患者的角膜生物力学与AL、CCT呈正相关,与眼压和RNFL厚度呈负相关,提示高度近视的角膜易发生变形,下方的RNFL受累较严重。

Objective:To evaluate the corneal biomechanical properties in high myopia using corneal visualization Scheimpflug technology(Corvis ST)and the correlation between corneal biomechanical parameters and intraocular pressure(IOP),axial length(AL),central corneal thickness(CCT),age,and retinal nerve fiber layer thickness.Methods:This was a cross-sectional study.From June to October 2017,53 patients with high myopia were recruited from Eye Hospital,Wenzhou Medical University.The right eyes of all patients were tested.There were 17 males and 36 females,with a mean age of 33.0±9.6 years(range 18-53 years).Corvis ST was used to obtain the corneal biomechanical parameters,including velocity at the first applanation(A1V),length at the first applanation(A1L),velocity at the second applanation(A2V),length at the second applanation(A2L),deformation amplitude at the highest concavity(DA),radius at the highest concavity(HCR),and peak distance at the highest concavity(PD).The differences in corneal biomechanical parameters were compared between high myopia(-6 D to-10 D,23 eyes)and extremely high myopia(≤-10 D,30 eyes).Data were analyzed using independent t test and Pearson correlation.Results:There was a significant difference in A2L(t=1.95,P=0.043)between the high myopia group and extremely high myopia group.There was a negative correlation between IOP and A1V,PD,DA(r=-0.56,-0.46,-0.63,P<0.001)and a positive correlation between IOP and A2V(r=0.37,P=0.005).There was a positive correlation between PD and AL(r=0.43,P=0.001).A1L,A2L,A2V were positively correlated with CCT(r=0.33,P=0.043;r=0.28,P=0.041;r=0.39,P=0.003).PD was negatively correlated with inferior RNFL thickness(r=-0.45,P=0.001).All parameters had no significant correlation with age.Conclusions:Corneal biomechanical parameters in high myopia are positively correlated with AL and CCT,and negatively correlated with IOP and RNFL thickness,suggesting that cornea of high myopia deformed easily,and the inferior RNFL is easily affected.