学龄近视儿童黄斑中心凹下脉络膜分层分析

Analysis of different layers of Subfoveal choroidal thickness in school-aged myopia children

目的研究学龄近视儿童黄斑中心凹下脉络膜厚度(SFCT)及其分层厚度的变化,并分析其相关影响因素。方法回顾性横断面观察研究。招募2018年8月至2019年11月就诊于武汉爱尔眼科医院的学龄近视儿童71例(142只眼),并根据等效球镜度(SE)分为不同的屈光组,其中轻度近视组70只眼,中度近视组38只眼,高度近视组34只眼。应用扫频源相干光层析成像术(SS-OCT)测量SFCT及脉络膜分层厚度,比较3组间的脉络膜厚度变化情况,并对相关影响因素进行分析。结果SFCT轻度近视组为(222.74±37.35)μm,中度近视组为(211.41±54.14)μm,高度近视组为(200.11±46.84)μm,黄斑中心凹颞侧1 mm脉络膜厚度(TCT1)轻度近视组为(242.91±43.76)μm,中度近视组为(225.21±47.57)μm,高度近视组为(219.50±45.19)μm,脉络膜毛细血管层及中血管层厚度(MCVT)轻度近视组为(64.81±15.89)μm,中度近视组为(59.26±15.52)μm,高度近视组为(47.68±9.68)μm,随着近视度数越高,SFCT、TCT1及MCVT越薄,且3组间差异有统计学意义(F=3.274,3.894,15.875,均P<0.05),其余象限各组间差异均无统计学意义。学龄近视儿童SFCT与SE、眼轴长度(AL)有相关性(P<0.05)。结论学龄近视儿童黄斑中心凹下脉络膜厚度呈现不均匀分布,SFCT与SE、AL呈负相关,黄斑中心凹下脉络膜厚度及黄斑中心凹1 mm颞侧脉络膜厚度随着儿童近视程度的加深的变化较周边其余象限脉络膜厚度出现较早且差异显著,其中脉络膜分层分析显示这种变化又以毛细血管层及中血管层厚度变化较为明显。

Objective To study the changes in whole and different layers of subfoveal choroid thickness(SFCT)in school aged children with different degrees of myopia,and analyze the related factors.Methods In this cross sectional study.A total of 71 cases(142 eyes)of children aged 7-13 years old admitted to the Aier Eye Hospital from August 2018 to November 2019 were recruited and divided into different refraction groups according to the spherical equivalent(SE).The mild,moderate and high myopia groups consisted of 70,38 and 34 eyes,respectively.Swept-source optical coherence tomography(SS-OCT)was used to measure the posterior pole choroidal thickness and different layers of SFCT,and the changes of choroid thickness among the three groups were compared.Pearson correlation analysis was used to analyze the related risk factors.Results The SFCT of the mild,moderate and high myopia group was(222.74±37.35)μm,(211.41±54.14)μm and(200.11±46.84)μm,respectively.The choroidal thickness at 1 mm temporal to the fovea(TCT1)in the mild,moderate and high myopia group was(242.91±43.76)μm,(225.21±47.57)μm and(219.50±45.19)μm,respectively.The medium choroidal vessel thickness(MCVT)in the mild,moderate and high myopia group was(64.81±15.89)μm,(59.26±15.52)μm and(47.68±9.68)μm,respectively.With the increase of myopia severity,the SFCT,TCT1 and MCVT were thinner,and the differences among the three groups were statistically significant(F=3.274,3.894,15.875,all P<0.05).There was significant association between SFCT and SE,AL among school-aged myopic children(P<0.05).Conclusions SFCT was negatively correlated with SE and AL.As compared to peripheral choroidal thickness,the changes in SFCT and TCT1 developed earlier and the difference was more obvious.Among the different choroidal layers,the thickness changes in the capillary layer and middle vascular layer were more obvious.