青少年近视对外层视网膜厚度和脉络膜厚度影响及相关性研究

Influence and correlation analysis of outer retinal thickness and choroidal thickness in adolescents with myopia

目的量化分析10~18岁青少年近视眼外层视网膜和脉络膜厚度,分析外层视网膜和脉络膜厚度与近视程度及眼轴相关性。方法横断面研究。共纳入120例(120只眼)。按屈光度分为正视组与低度、中度、高度近视组。频域相干光层析成像术(EDI-OCT)确定外层视网膜和脉络膜分布,ImagePro Plus软件测量各层厚度。采用单因素方差分析,Kruskal-Wallis秩和检验,Pearson相关,线性回归分析不同屈光度外层视网膜厚度与脉络膜厚度的关系。结果(1)黄斑中心凹与黄斑中心凹颞侧1.5 mm直径处,高度近视组光感受器外节到色素上皮层厚度比正视组薄,近视组脉络膜厚度,外层视网膜总厚度比正视组薄,近视组椭球体区厚度比正视组厚(P<0.05)。黄斑旁中心凹1.5 mm直径鼻侧处,近视组光感受器外节到色素上皮层厚度,脉络膜厚度,外层视网膜总厚度比正视组薄,椭球体层厚度比正视组厚(P<0.05)。(2)黄斑中心凹与黄斑中心凹1.5 mm直径鼻侧及颞侧处,脉络膜厚度与屈光度呈正相关(r=0.715,r=0.718,r=0.745,P<0.001),眼轴呈负相关(r=-0.647,r=-0.658,r=-0.639,P<0.001)。椭球体区厚度与屈光度呈负相关(r=-0.645,r=-0.827,r=-0.694,P<0.001)眼轴呈正相关(r=0.406,r=0.447,r=0.675,P<0.001)。外层视网膜总厚度与眼轴呈负相关(r=-0.240,r=-0.276,r=-0.325,P<0.001)。(3)椭球体区厚度和脉络膜厚度变化与近视屈光度相关。结论本研究得出10~18岁青少年的近视程度对外层视网膜厚度及脉络膜厚度有影响,外层视网膜厚度及脉络膜厚度与屈光度和眼轴相关。

Objective To quantitative the thickness of the outer retina and choroid between 10 and 18 years old with myopia and to analyze the thickness between diopter and axial length.Methods It was a cross-sectional study.A total of 120 eyes were included and divided into diopter group and low,moderate and high myopia group according to diopter.Enhanced depth imaging optical coherence tomography(EDI-OCT)determined the outer retina and choroid distribution,and Image-Pro Plus software measured the thickness of each layer.One-way analysis of variance,Kruskal-Wallis rank sum test,Pearson correlation and linear regression were used to analyze the relationship between the outer retinal thickness and choroidal thickness in different diopter.Results(1)In macula fovea and the diameter of 1.5 mm on temporal side,the thickness of outer photoreceptor,pigment epithelium layer of the high myopia group was thinner than emmetropia,the choroid and the total outer retina thickness of myopia group were thinner than emmetropia,and the thickness of ellipsoid layer was thicker than emmetropia(P<0.05).On the nasal side,the thickness from the outer segments of photoreceptor to the pigment epithelium layer,choroidal thickness and total outer thickness in myopic group were thinner than emmetropia,and the thickness of ellipsoid zone was thicker than emmetropia(P<0.05).(2)Macular fovea and macular fovea in 1.5 mm diameter on nasal and temporal side,the choroid thickness was positive correlated with diopter(r=0.715,r=0.718,r=0.745,P<0.001),and the axial axis was negative correlated with diopter(r=-0.647,r=-0.658,r=-0.639,P<0.001).The thickness of ellipsoid zone was negative correlated with diopter(r=-0.645,r=-0.827,r=-0.694,P<0.001),and positive correlated with axial length(r=0.406,r=0.447,r=0.675,P<0.001).The thickness of total outer retina was negative correlated with axial length(r=-0.240,r=-0.276,r=-0.325,P<0.001).(3)The thickness of ellipsoid zone and choroid thickness affected diopter.Conclusions The study showed that the degree of myopia in adolescents aged 10~18 has an effect on the outer retinal thickness and choroidal thickness,the outer retinal thickness and choroidal thickness were related to the diopter and the eye axis.