健康孕妇和健康非孕女性脉络膜厚度的对比观察

Comparison of choroid thickness in healthy pregant women and non-pregant women

目的对比观察健康孕妇和健康非孕女性脉络膜厚度变化。方法前瞻性临床研究。2019年1~8月于诸暨市人民医院产科检查确诊的健康孕妇(孕妇组)以及同期年龄匹配的健康非孕女性(正常组)纳入研究。所有受检者均以右眼入组;并采用频域OCT的增强深度成像技术测量黄斑中心凹下以及距中心凹1000μm上方、下方、鼻侧、颞侧脉络膜厚度和中心凹视网膜厚度(CMT)。孕妇组与正常组脉络膜厚度、CMT比较采用t检验,正常组和不同孕期受检眼脉络膜厚度和CMT比较行单因素方差分析。结果孕妇组、正常组分别纳入161名161只眼和40名40只眼。根据孕周不同,将孕妇组分为孕早期组、孕中期组、孕晚期组,分别为47名47只眼、66名66只眼、48例48只眼。不同孕期组与正常组受检者年龄、眼轴长度、眼压、CMT比较,差异无统计学意义(F=1.433、1.558、0.416、2.288,P>0.05)。孕妇组、正常组受检眼中心凹下脉络膜厚度(SFCT)分别为(317.7±73.9)、(279.7±44.1)μm,差异有统计学意义(t=3.113,P=0.002)。与正常组比较,孕妇组距中心凹1000μm上方、下方、鼻侧、颞侧脉络膜均增厚;上方、鼻侧、颞侧差异有统计学意义(t=2.699、3.474、2.595,P<0.05)。孕早期组、孕中期组、孕晚期组受检眼SFCT分别为(305.8±72.3)、(327.7±69.8)、(315.8±80.5)μm;与正常组受检眼SFCT比较,差异有统计学意义(F=4.180,P=0.007)。组间两两比较,孕中期组与正常组差异有统计学意义(P=0.003);孕早期组、孕晚期组与其他组比较,差异均无统计学意义(P>0.05)。结论孕妇脉络膜厚度较正常人增厚,其中孕中期脉络膜厚度达最大值;而孕期黄斑CMT无显著变化。

Objective To compare and observe the changes in choroidal thickness between healthy pregnant women and healthy non-pregnant women.Methods A prospective clinical study.From January 2019 to August 2019,healthy pregnant women(pregnant women group)and healthy non-pregnant women agematched were enrolled during the same period(the normal group)in the obstetrics of Zhuji People's Hospital.All patients were enrolled with their right eyes.Frequency-domain OCT-enhanced depth imaging technology was used to measure the subfoveal macular and 1000μm above,below,nasal,and temporal choroidal thickness and foveal retinal thickness(CMT).The choroidal thickness and CMT of the pregnant women group and the normal group were compared by t test,and the choroidal thickness and CMT of the normal group and the eyes of different gestational weeks were compared by one-way analysis of variance.Results The pregnant women group and the normal group included 161 patients(161 eyes)and 40 patients(40 eyes).According to the different gestational weeks,the pregnant women were divided into the first trimester group,the second trimester group,and the third trimester group,with 47 patients(47 eyes),66 patients(66 eyes),and 48 patients(48 eyes)respectively.There was no significant difference in age,axial length,intraocular pressure,and CMT between the different gestational week groups and the normal group(F=1.433,1.558,0.416,2.288;P>0.05).The subfoveal choroidal thickness(SFCT)of the pregnant women group and normal group were 317.7±73.9μm and 279.7±44.1μm,respectively,and the difference was statistically significant(t=3.113,P=0.002).Compared with the normal group,the choroid at the upper,lower,nasal,and temporal sides of the pregnant group 1000μm from the fovea was thickened.The difference between the upper,nasal and temporal sides was statistically significant(t=2.699,3.474,2.595;P<0.05).The SFCT of the eyes in the first trimester group,the middle group,and the late group were 305.8±72.3,327.7±69.8,315.8±80.5μm,respectively.Compared with the normal group,the difference was statistically significant(F=4.180,P=0.007).Pairwise comparison between the two groups,the second trimester group was significantly different from the normal group(P=0.003).There was no significant difference among the first trimester group、the third trimester group and the other groups(P>0.05).Conclusion The choroidal thickness of pregnant women is thicker than normal,and the choroidal thickness in the second trimester reaches the maximum value;while the macular CMT during pregnancy has no significant change.