山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (5): 107-114.doi: 10.6040/j.issn.1673-3770.0.2022.354
买尔哈巴·玉素甫1,克里木江·阿不拉2,丁琳2,秦艳莉2,陈雪艺1
YUSUFU·Maierhaba1, ABULA·Kelimujiang2, DING Lin2, QIN Yanli2, CHEN Xueyi1
摘要: 目的 探讨伴发于后巩膜葡萄肿的高度近视性白内障眼底病变特点。 方法 采用回顾性病例对照研究,选取2021年8月至12月白内障手术者68例(103眼),根据眼轴长度分为2组:高度近视组,眼轴≥26.5 mm;对照组,眼轴22.0~24.0 mm。高度近视组根据是否伴有后巩膜葡萄肿分为有葡萄肿者和无葡萄肿者2个亚组。采用Cirrus HD-OCT 5000测量黄斑中心凹、离中心凹1 000 μm、3 000 μm处视网膜厚度(retinal thickness, RT)、脉络膜厚度(choroidal thickness, CT),视神经纤维层厚度(retinal nerve fiber layer, RNFL),测量黄斑及视神经光学相干断层成像血管造影(optical coherence tomography angiography, OCTA)等。根据高度近视眼底病变ATN分级对所有眼底病变进行分级。 结果 对照组白内障术后视力恢复最佳,其次为高度近视无葡萄肿者,而高度近视有葡萄肿者最差。有葡萄肿者ATN分级明显高于无葡萄肿者,差异有统计学意义(P=0.007,0.015,0.001)。与对照组相比,高度近视组RT、CT 和RNFL更薄(P=0.004,0.004,0.001,0.001,0.018,0.001),黄斑无血管区(FAZ)面积更小(P=0.001,0.001),视神经OCTA 血流信号更低(P=0.025,0.001,0.001,0.001,0.026,0.001,0.001,0.001);但有、无葡萄肿者之间差异无统计学意义(P=0.871,0.964,0.888,0.911,0.765,0.999,0.999,0.806)。 结论 伴发于后巩膜葡萄肿的高度近视患者眼底病变更严重,影响白内障术后视力恢复,可能与RT、CT、RNFL、黄斑及视神经血流和FAZ发育等均有关。
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