中低度近视青少年患者视盘参数特征:基于SD-OCT研究

The characteristics of optic disc parameters in juveniles with moderate and low myopia based on the spectral domain optical coherence tomography

目的观察并分析12~18岁中低度近视青少年患者视盘参数特征。方法应用频域光学相干断层扫描(SD-OCT)对2019年7月至12月就诊于新疆医科大学第五附属医院眼科的157例157眼12~18岁中低度近视青少年患者行视盘检测。根据等效球镜(SE)分为对照组(52眼)和低度近视组(60眼)、中度近视组(45眼)。对SD-OCT测量的视网膜神经纤维层(RNFL)厚度进行光学放大效应校正。采用单因素方差分析比较三组患者间参数差异,组间两两比较采用LSD-t检验;采用Pearson线性相关分析及偏相关分析视盘参数同眼轴长度(AL)及SE的相关性。结果校正后盘沿面积中度近视组患者较对照组及低度近视组均偏大(P=0.003、0.033)。校正后视杯容积中度近视组患者较低度近视组偏小(P=0.010)。垂直杯盘比(VCDR)及杯盘面积比(ACDR)中度近视组较对照组及低度近视组均偏小(均为P<0.01);校正后RNFL厚度低度近视组及中度近视组较对照组均偏厚(P=0.047、0.010)。患者AL与校正后盘沿面积、校正后视盘面积均呈正相关(P<0.001、P=0.002)。患者AL与RNFL厚度呈负相关(P=0.001),但经光学放大效应校正后两者呈弱的正相关(P=0.021)。患者SE与VCDR及ACDR均呈正相关(P<0.001、P=0.001)。患者RNFL厚度与盘沿面积呈正相关(P<0.001),与VCDR、ACDR均呈负相关(均为P<0.05)。患者校正后的RNFL厚度与校正后视盘面积无相关性(P=0.071)。结论中低度青少年患者近视眼,随着眼轴增长及近视度数加深,视盘面积扩大,盘沿面积增大,VCDR减小,视杯容积变小。青少年眼球仍处于塑形期,视盘参数结果判读有其特殊性,需考虑光学放大效应、AL及SE的影响。

Objective To investigate the characteristics of optic disc parameters in moderate and low myopic juveniles aged 12 to 18.Methods The spectral domain optical coherence tomography(SD-OCT)was used to analyze optic disc parameters of 157 juveniles(157 eyes)aged 12 to 18 diagnosed with low and moderate myopia from July to December 2019 in the Department of Ophthalmology,the Fifth Affiliated Hospital of Xinjiang Medical University.These juveniles were divided into three groups by spherical equivalent(SE)control group(52 eyes),low myopia group(60 eyes)and moderate myopia group(45 eyes).The retinal nerve fiber layer(RNFL)thickness measured by SD-OCT was corrected through optical amplification.The parameter differences in each group were analyzed by the one-way analysis of variance,while those in different groups were analyzed by the LSD-t test.The correlation between parameters and axial length(AL)or SE was evaluated with Pearson linear analysis.Results After correction,the rim area of the moderate myopia group was larger than that of the control group and low myopia group(P=0.003 and 0.033,respectively),the optic cup volume of the moderate myopia group was smaller than that of the control group(P=0.010),the vertical cup-to-disc ratio(VCDR)and cup/disk area ratio(ACDR)were smaller compared with those in other two groups(all P<0.01),and the RNFL thickness in the low myopia group and moderate myopia group was larger than that in the control group(P=0.047 and 0.010,respectively).AL showed positive correlation with the corrected rim area and disc area(P<0.001,P=0.002)and negative correlation with the RNFL thickness(P=0.001),but after the correction by the magnification effect,the said negative relation was reversed,that is,AL was weakly positively correlated with the RNFL thickness(P=0.021).SE showed positive correlation with VCDR and ACDR(P<0.001 and P=0.001,respectively).RNFL thickness showed positive correlation with the rim area(P<0.001)and negative correlation with VCDR and ACDR(both P<0.05).The corrected RNFL thickness was not significantly associated with the corrected disk area(P=0.071).Conclusion As the increase of the axial length and myopia degree,the disk area and rim area of juveniles with low and moderate myopia are elevated,while the VCDR and optic cup volume decline.Teenagers’eyeballs are still in the shaping stage.Therefore,when judging optic disc parameters in myopic juveniles,effects of optical magnification,AL and SE should be considered.