真性小眼球眼球生物学参数测量及其与眼轴长度的关系

Measurement of biological parameters of nanophthalmos and its correlation with axial length

目的测量真性小眼球眼球生物学结构参数并分析其与眼轴长度(AL)的相关性。方法对2012年9月至2018年8月在中山大学中山眼科中心确诊为真性小眼球43例71眼的临床资料进行回顾性分析。行常规眼科检查、眼压测定、自然瞳验光、视野检查、A型超声生物测定、超声生物显微镜、频域光相干断层扫描及免扩瞳眼底照相检查。获取真性小眼球眼球生物学结构参数,采用Pearson相关分析法分析AL与眼球生物学结构参数的相关性。结果入组患者年龄为(46.00±12.75)岁,眼压为(24.97±14.87)mmHg(1 mmHg=0.133 kPa),AL为(17.13±1.57)mm,最佳矫正视力(LogMAR)为1.14±0.79,屈光度为(11.61±4.09)D,中央角膜厚度(CCT)为(550±60)μm,中央前房深度(ACD)为(1.64±0.37)mm,前房宽度(ACW)为(11.17±0.61)mm,晶状体厚度(LT)为(5.01±0.51)mm,玻璃体腔长度(VCL)为(10.10±1.80)mm,平均视网膜神经纤维层厚度(mRNFLT)为(98.51±40.93)μm,黄斑中心凹视网膜厚度(FRT)为(294.46±116.83)μm,黄斑中心凹下脉络膜厚度(SFCT)为(488.72±133.06)μm,杯盘比为0.52±0.29。ACD与AL比值为9.6%,LT与AL比值为29.4%,VCL与AL比值为59.3%。相关分析结果显示,AL与ACW和VCL均呈明显正相关(r=0.432、0.978,均P<0.001);AL与LT和FRT均呈明显负相关(r=-0.272,P=0.027;r=-0.679,P<0.001);AL与CCT、中央ACD、mRNFLT和SFCT无明显相关性(r=0.153、-0.053、-0.322、0.063,均P>0.05)。结论真性小眼球患者眼前后段结构狭窄。LT与AL比值增加,VCL与AL比值减小。AL与ACW和VCL均呈正相关,与LT和FRT均呈负相关.

Objective To quantitatively measure biological parameters of nanophthalmos and analyze the correlation between axial length(AL)and the other biological parameters.Methods The clinical data of 71 eyes of 43 patients identified with nanophthalmos(AL≤20 mm)from September 2012 to August 2018 in Zhongshan Ophthalmic Center were retrospectively analyzed.All enrolled patients underwent ophthalmological examinations including best-corrected visual acuity,refraction,slit-lamp biomicroscopy,fundus examination,Goldmann applanation tonometry,A-scan ultrasound examinations,ultrasound biomicroscopy,spectral domain optical coherence tomography(SD-OCT)and nonmydriatic fundus photography.Pearson correlation analysis was used to analyze the relationship between AL and all biological parameters.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Zhongshan Ophthalmic Center(NO.2017KYPJ092).All patients signed informed consent.Results Of the 43 patients,the average age was(46.00±12.75)years,the mean intraocular pressure was(24.97±14.87)mmHg(1 mmHg=0.133 kPa).The mean best corrected visual acuity was 1.14±0.79,the mean refraction was(11.61±4.09)D.The mean AL,central corneal thickness(CCT),central anterior chamber depth(ACD),anterior chamber width(ACW),len thickness(LT)and vitreous cavity length(VCL)was(17.13±1.57)mm,(550±60)μm,(1.64±0.37)mm,(11.17±0.61)mm,(5.01±0.51)mm and(10.10±1.80)mm,respectively.The average retinal nerve fiber layer thickness(mRNFLT),macular foveal retinal thickness(FRT)and subfoveal choroidal thickness(SFCT)was(98.51±40.93),(294.46±116.83)and(488.72±133.06)μm,respectively.The ratio of ACD to AL,LT to AL,and VCL to AL was 9.6%,29.4%and 59.3%,respectively.The ACW and VCL were positively correlated with AL(r=0.432,0.978;both at P<0.001);whereas,LT and FRT were negatively correlated with AL(r=-0.272,P=0.027;r=-0.679,P<0.001).There was no correlation between CCT,central ACD,mRNFLT,SFCT and AL(r=0.153,-0.053,-0.322,0.063;all at P>0.05).Conclusions Nanophthalmos has the characteristics of narrow anterior and posterior segment structure.The ratio of LT to AL is increased and the ratio of VCL to AL is decreased.The AL is positively correlated with ACW and VCL,negatively correlated with LT and FRT.