天津医科大学学生豹纹状眼底特征及危险因素分析

Prevalence and risk factors of tessellated fundus in Tianjin Medical University students

目的调查并分析天津医科大学不同屈光状态大学生豹纹状眼底(TF)特征及其危险因素方法横断面调查研究。2019年9~12月单纯随机抽取天津医科大学学生346名纳入研究。行裂隙灯显微镜、非散瞳电脑验光、主觉验光、最佳矫正视力、眼生物参数测量和非散瞳眼底照相检查。对比观察黄斑区是否有TF的受检者基本特征、眼生物学参数差异。根据等效球镜度(SE),将受检者分为无近视组(SE>-0.50D)、近视组(SE≤-0.50D)。近视组再分为低度近视组(-3.00D<SE≤-0.50D)、中度近视组(-6.00D<SE≤-3.00D)、高度近视组(SE≤-6.00D)。根据眼轴长度(AL),将受检者分为AL<24mm组、24~26mm组、>26 mm组。采用logistic回归分析影响TF的危险因素。对独立危险因素与TF进行趋势性检验。结果346名受检者中,近视组324名(93.6%,324/346),其中低度近视组、中度近视组、高度近视组分别为73(21.1%,73/346)、167(48.3%,167/346)、84(24.3%,84/346)名;无近视组22名(6.4%,22/346)。黄斑区有TF者294名(85.0%,294/346),其中无近视组、低度近视组、中度近视组、高度近视组分别为9(40.91%,9/22)、58(79.45%,58/73)、145(86.83%,145/167)、82(97.62%,82/84)名;无TF者52名(15.0%,52/346)。黄斑区有、无TF者性别构成比(χ^(2)=4.47)、SE(t=6.29)、AL(=-8.29)、前房深度(Z=-2.62)、晶状体厚度(Z=-2.23)、平均角膜曲率半径(Z=-3.58)比较,差异有统计学意义(P<0.05)。SE、AL是影响TF及其严重程度的独立危险因素(P≤0.001)。随近视程度、AL增加,TF发生风险增加(P趋势<0.001)。结论天津医科大学学生TF总检出率为85.0%。无近视、轻度近视、中度近视、高度近视者眼底均检出TF;近视程度越高,AL越长,TF可能性越高,程度越严重。

Objective To investigate the prevalence and risk factors of tessellation fundus(TF)among Tianjin Medical University students with different refractive statuses.Methods A cross-sectional study.From September to December 2019,346 students from Tianjin Medical University were randomly selected and underwent slit-lamp examination,non-cycloplegic auto-refraction,subjective refraction,best-corrected visual acuity,ocular biometric measurement,and non-dilation fundus photography.The dfferences in the prevalence of TF in basic characteristics and ocular biometric parameters were compared.Based on the equivalent spherical(SE),refractive status was divided into the non-myopia group(SE>-0.50 D)and the myopia group(SE≤-0.50 D).The myopia group was further divided into mild myopia group(-3.00 D<SE≤-0.50 D),moderate myopia group(-6.00 D<SE≤-3.00 D),and high myopia group(SE≤-6.00 D).According to the axis length(AL),the subjects were divided into AL<24 mm group,24-26 mm group,and>26 mm group.The logistic regression was used to analyze the risk factors affecting TF.Trend tests were performed for each risk factor and TF.Results Of the 346 subjects,324(93.6%,324/346)were myopia,of whom 73(21.1%,73/346),167(48.3%,167/346),and 84(24.3%,84/346)were mild myopia,moderate myopia,and high myopia,respectively;22(6.4%,22/346)were non-myopia.There were 294(85.0%,294/346)students with TF in the macula,including 9(40.91%,9/22),58(79.45%,58/73),145(86.83%,145/167),and 82(97.62%,82/84)in nonmyopia,low myopia,moderate myopia,and high myopia group,respectively;52(15.0%,52/346)students were without TF in the macula.There were statistically significant gender differences(χ^(2)=4.47),SE(t=6.29),AL(t=-8.29),anterior chamber depth(Z=-2.62),lens thickness(Z=-2.23),and average corneal radius(Z=-3.58)between students with and without TF in the macula(P<0.05).Spherical equivalent and axial length were independent risk factors for TF and its severity(P≤0.001).With an increasing degree of myopia,and increasing axial length,the risk of TF increased(P for trend<0.001).Conclusions The prevalence of TF is 85.0%among Tianjin Medical University students.TF is detected in the fundus of no myopia,mild myopia,moderate myopia and high myopia.The degree of myopia is higher,the AL is longer,the possibility of TF is higher.