高度近视患者黄斑区视网膜劈裂分型与脉络膜特征分析

doi:10.6040/j.issn.1673-3770.0.2022.528

摘要/Abstract

摘要： 目的探讨不同类型高度近视视网膜劈裂患者脉络膜特征及临床意义。方法采用横断面研究。2019年1月至2022年3月于首都医科大学附属北京友谊医院眼科就诊的患者中,选取根据黄斑病变萎缩-牵拉-新生血管(atrophic, tractional, neovascular components, ATN)分型符合T0~T3级高度近视患者74例74只眼纳入研究。其中,男性20例20只眼、女性54例54只眼;平均年龄(64.3±11.2)岁;眼轴长度(axial length, AL)(29.2±2.78)mm。患者均行加强深度成像模式光学相干断层扫描。依据ATN分型将患者按照病变程度分为T0~T3级,分别为20、23、18、13只眼。获取黄斑中心凹多个部位脉络膜厚度数据,采用MATLAB软件计算该区域的脉络膜容积(macular choroidal volume, MCV)。参数间行相关性分析。组间差异比较采用单因素分析和多因素分析。结果 T0~T3组患者MCV分别为(4.6±2.3)mm³、(3.1±1.2)mm³、(2.9±1.3)mm³、(2.1±1.1)mm³,差异有统计学意义(P=0.006)。与T0组患者相比,T1~T3组患者最佳矫正视力明显下降,AL和等效球镜绝对值明显增加,黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness, SFCT)明显下降,差异均有统计学意义(P<0.05)。T1与T3组间及T2与T3组间等效球镜的差异,以及T1与T2组间及T1与T3组间SFCT和MCV的差异依赖AL和年龄,T2和T3组间SFCT和MCV的差异不依赖AL和年龄。结论高度近视患者随着视网膜劈裂程度加重,MCV逐步下降,MCV的变化受到AL、年龄等多种因素影响。

关键词: 高度近视, 视网膜劈裂, 脉络膜容积, 萎缩-牵拉-新生血管分型, 光学相干断层扫描

Abstract: Objective This study aimed to evaluate the characteristics and clinical significance of macular choroidal parameters according to the different severity classifications of retinoschisis in patients with high myopia. Methods This cross-sectional study included 74 patients(74 eyes)diagnosed with high myopia of grades T0~T3, according to the atrophy-traction-neovascularization(ATN)classification, from January 2019 to March 2022 at the Ophthalmology Department of the Beijing Friendship Hospital, which is affiliated with the Capital Medical University. Of these patients, there were 20 male(20 eyes)and 54 female(54 eyes)patients with a mean age of(64.3±11.2)years and axial length(AL)of 29.2±2.78 mm. All patients underwent enhanced depth imaging optical coherence tomography. They were then classified as having T0, T1, T2, or T3 grades(n=20, 23, 18, and 13 eyes, respectively)according to the severity of their lesions based on the ATN classification. The choroidal thickness of multiple parts of the fovea was measured, and the macular choroidal volume(MCV)was calculated using the MATLAB software. Correlation analysis of the different parameters was performed. Differences between the groups were compared using univariate and multivariate analyses. Results The mean MCV of the patients in the T0, T1, T2, and T3 groups was(4.6±2.3)mm³,(3.1±1.2)mm³,(2.9±1.3)mm³, and(2.1±1.1)mm³, respectively, and the differences between these groups were statistically significant(P=0.006). The best corrected visual acuity of patients in the T1-T3 groups was significantly lower than that of patients in the T0 group. The AL and absolute value of the spherical equivalent were significantly higher(P<0.05), while the subfoveal choroidal thickness(SFCT)was significantly lower(P<0.05)than those in the T0 group. Differences in the value of the spherical equivalent between the T1 and T3 groups and between the T2 and T3 groups and in SFCT and MCV between the T1 and T2 groups and between the T1 and T3 groups were AL- and age-dependent. Meanwhile, differences in SFCT and MCV between the T2 and T3 groups were independent of AL and age. Conclusion The study revealed a gradual decrease in MCV associated with the increasing severity of retinoschisis in patients with high myopia. The change in MCV was affected by AL, age, and other factors.

Key words: High myopia, Retinoschisis, Macular choroidal volume, Atrophy-traction-neovascularization classification, Optical coherence tomography

中图分类号:

R774.5

尤冉,郭笑霄,王薇,陈曦,王艳玲. 高度近视患者黄斑区视网膜劈裂分型与脉络膜特征分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 83-87.

YOU Ran, GUO Xiaoxiao, WANG Wei, CHEN Xi, WANG Yanling. Association of macular retinoschisis severity with choroidal parameters in patients with high myopia[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 83-87.

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