摘要
目的通过频域光学相干断层扫描仪（OCT）观察高度近视眼底后部血管弓旁视网膜的形态改变并探讨相关因素。方法横断面研究。177例双眼高度近视患者（屈光不正≥-8D或眼轴〉26．5mm），随机选择其中一只眼采用频域OCT观察后部血管弓旁视网膜形态。以高度近视伴血管弓旁视网膜改变为阳性组，高度近视不伴血管弓旁视网膜改变为阴性组，比较2组患者年龄、患眼屈光度以及眼轴长度的差异行独立样本t检验，2组患者后巩膜葡萄肿例数的差异行卡方检验。结果经频域OCT扫描证实，108例患者（61．0％）存在后部血管弓旁视网膜形态改变，平均年龄（59．3±6.2）岁。108只患眼等效球镜度（-13．55±3-43）D，眼轴长度（29．57±2．06）mm。阴性组69例（39．0％）患者平均年龄（34．8±13．1）岁，等效球镜度（-9．50±3．07）D，眼轴长度（27．02±1．02）mm。2组患者年龄（t=10．466，P〈0．05）、等效屈光度（t=7．454，P〈0．05）以及眼轴长度（t=10．979，P〈0．05）差异均有统计学意义。在阳性组中，108例患者（100．0％）伴有血管弓旁视网膜微囊肿和微皱褶，65例（60．2％）伴有视网膜板层裂隙或裂孔，53例（49．1％）伴有视网膜不同层次的劈裂，1例（0．9％）伴有牵引性视网膜脱离。所有视网膜形态改变集中分布于距离视盘2～3PD的后巩膜葡萄肿凹陷区内。阳性组101眼伴有后巩膜葡萄肿．阴性组48眼伴有后巩膜葡萄肿，2组差异具有统计学意义（X2=-16．999，P〈0．05）。结论高度近视眼后部血管弓旁视网膜常见一系列细微的形态改变，玻璃体皮质牵引和后巩膜葡萄肿的发展应是其形成的重要原因。
Objective To evaluate the morphologic characteristics around the blood vessels of the retinal vascular arcade with spectral-domain optical coherence tomography （SD-OCT） in eyes with high myopia. Methods One eye of 177 patients with binocular high myopia （refractive error ≥-8.00 diopters or axial length 〉26.5 mm） was randomly selected to undergo detailed SD-OCT scans along the entire posterior vascular arcade. High myopic eyes with paravascular retinal abnormalities were classified as the positive group and those eyes without paravascular retinal abnormalities were considered as the negative group. A independent t test was used to compare the age of patients, refractive error and the axial length of myopic eyes in these 2 groups. A chi-square test was used to compare the cases of staphyloma in 2 groups. Results Among 177 high myopia patients, paravascular retinal abnormalities were detected in 108 patients （61.0%） by SD-OCT. The mean age of patients in the positive group was 59.3±6.2 years, the mean refractive error of the 108 eyes was -13.55±3.43 D, and mean axial length was 29.57±2.06 mm. The mean age of the 69 patients in the negative group was 34.8±13.1 years, the mean refractive error was -9.50±3.07 D, and mean axial length was 27.02＋1.02 mm. The differences in the age of the patients （t=10.466）, refractive error （t=7.454） and axial length （t=10.979） of myopic eyes between these two groups were statistically significant （P〈0.05）. In the positive group, paravascular retinal cysts and microfolds were detected in all of the 108 eyes （100.0%）, paravascular lamellar holes in 65 eyes （60.2%）, paravascular retinoschisis in 53 eyes （49.1%）, and tractional detachment of the retina in 1 eye （0.9%）. All of the paravascular retinal abnormalities were located within staphyloma area of 2 to 3 PD from the optic disc. There were 101 eyes with staphyloma in the positive group and 48 eyes with staphyloma in the negative group. The difference between the 2 groups was sta
出处
《中华眼视光学与视觉科学杂志》
CAS
2013年第7期418-422,共5页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
上海市卫生局青年基金（2009y012）：上海市视觉损害与重建重点实验室资助项目（12DZ2260500）
