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隐匿性高度近视儿童黄斑区脉络膜厚度分析

Analysis of macular choroidal thickness in children with occult high myopia

摘要:

目的:观察分析隐匿性高度近视儿童黄斑区脉络膜厚度变化及其影响因素。方法:前瞻性非随机同期对照试验研究。2019年9月至2020年10月在承德医学院附属医院眼科门诊首次就诊且之前未进行过任何近视矫正训练的儿童56例110只眼纳入研究。其中,男性33例64只眼,女性23例46只眼;年龄6~12岁,平均年龄(8.62±1.87)岁。根据儿童近视的临床表现分为隐匿性高度近视组(27例52只眼)和对照组(29例58只眼)。隐匿性高度近视组52只眼中,等效球镜度数(SER)为-0.00~-1.00 D、>-1.00~-2.00 D、>-2.00~-3.00 D者分别为15、16、21只眼。对照组58只眼中,SER为-0.00~-1.00 D、>-1.00~-2.00 D、>-2.00~-3.00 D者分别为21、18、19只眼。将黄斑中心凹6 mm范围内划分为以黄斑中心凹为中心的3个同心圆,直径为1 mm的中心区、1~3 mm的内环区、3~6 mm的外环区,共9个区。内环、外环4区分别为上方、下方、鼻侧、颞侧。观察隐匿性高度近视组和对照组儿童黄斑各分区的脉络膜厚度变化。两组间黄斑各分区脉络膜厚度比较采用独立样本 t检验。隐匿性高度近视组黄斑中心凹平均脉络膜厚度与性别、年龄、眼压、眼轴、屈光度、角膜曲率的相关性采用Pearson相关性分析。 结果:隐匿性高度近视组儿童黄斑区脉络膜厚度以鼻侧最薄,颞侧最厚。与对照组比较,隐匿性高度近视组儿童黄斑9个分区平均脉络膜厚度均较对照组明显变薄,差异均有统计学意义( P<0.05 )。随着隐匿性高度近视儿童屈光度的增高,黄斑各分区的平均脉络膜厚度值均降低。与对照组相同屈光度的儿童比较,隐匿性高度近视组除-0.00~-1.00 D儿童黄斑中心凹内环上方、外环上方以及>-2.00~-3.00 D儿童黄斑中心凹内环颞侧、外环颞侧平均脉络膜厚度之间的差异无统计学意义外( P>0.05),其余各分区平均脉络膜厚度之间的差异均有统计学意义( P<0.05 )。Pearson相关分析结果显示,隐匿性高度近视儿童黄斑中心凹平均脉络膜厚度与年龄( r=-3.410, R 2=11.630, P=0.010 )、眼轴( r=-1.420, R 2=2.016, P=0.030 )、屈光度( r=-2.680, R 2=7.182, P=0.040)呈负相关,与性别( r=0.166, R 2=0.028, P=0.240 )、眼压( r=0.330 , R 2=0.109, P=0.800 )、角膜曲率( r=-0.260, R 2=0.068, P=0.850 )无显著相关性。 结论:隐匿性高度近视儿童的黄斑脉络膜厚度以中心凹鼻侧最薄,颞侧最厚,黄斑各分区平均脉络膜厚度较相同屈光度的普通近视儿童薄。隐匿性高度近视儿童黄斑中心凹平均脉络膜厚度与年龄、眼轴、屈光度呈负相关。

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abstracts:

Objective:To observe and analyze the changes of macular choroidal thickness in children with occult high myopia and its influencing factors.Methods:A prospective, non-randomized, contemporaneous controlled trial. From September 2019 to October 2020, 56 children (110 eyes) who first visited the ophthalmic clinic of the Affiliated Hospital of Chengde Medical College without any myopia correction training were enrolled in this study. There were 33 males (64 eyes) and 23 females (46 eyes), with the average age of 8.62±1.87 years old; the age ranged from 6 to 12 years old. According to the clinical manifestations of myopia in children, they were divided into occult high myopia group (27 cases, 52 eyes) and control group (29 cases, 58 eyes). In the 52 eyes of the occult high myopia group, the spherical equivalent refraction (SER) of -0.00 to -1.00 D, >-1.00 to -2.00 D, > -2.00 to -3.00 D were 15, 16 and 21 eyes. Among 58 eyes in the control group, the SER of -0.00 to -1.00 D, > -1.00 to -2.00 D, >-2.00 to -3.00 D were 21, 18 and 19 eyes, respectively. The macular fovea within 6 mm was divided into three concentric circles centered on the macular fovea, which included the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm, totally 9 areas. The inner ring and outer ring were divided into upper, lower, nasal and temporal areas. The changes of choroidal thickness in each macular area of children in occult high myopia group and control group were observed. The choroidal thickness in each macular area was compared between the two groups using independent sample t-test. Pearson correlation analysis was used to analyze the correlation between mean foveal choroidal thickness and gender, age, intraocular pressure, ocular axis, diopter and corneal curvature in occult high myopia group. Results:Choroidal thickness in macular area of children in occult high myopia group was thinnest in nasal side and thickest in temporal side. Compared with the control group, the mean choroidal thickness in the 9 macular zones of children in the occult high myopia group was significantly thinner than that in the control group, and the difference was statistically significant ( P<0.05). The mean choroidal thickness in each macular region decreased with the increase of diopter in children with occult high myopia. Compared with the control group with the same spherical equivalent, there was no significant difference in the area above the inner ring and the outer ring of the macular fovea in the occult high myopia group of -0.00 to -1.00 D and the temporal side of the inner ring and the outer ring of the macular fovea in the occult high myopia group of >-2.00 to -3.00 D ( P>0.05), but there were significant differences among the other regions ( P<0.05). Pearson correlation analysis results showed that the average choroidal thickness of the fovea in children with occult high myopia was negatively correlated with age ( r=-3.410, R 2=11.630, P=0.010), eye axis ( r=1.420, R 2=2.016, P=0.030) and diopter ( r=-2.680, R 2=7.182, P=0.040), but not significantly correlated with gender ( r=0.166, R 2=0.028, P=0.240), intraocular pressure ( r=0.330, R 2=0.109, P=0.800) and corneal curvature ( r=-0.260, R 2=0.068, P=0.850). Conclusions:The thickness of macular choroidal in children with occult high myopia is the thinnest on the nasal side of the macular fovea and the thickest on the temporal side of the macular fovea. The mean choroidal thickness in each region of the macular is thinner than that in the common myopia children with the same diopter. The mean choroidal thickness of fovea is negatively correlated with age, ocular axis and diopter.

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作者: 韩雅军 [1] 石晶 [1] 谭小波 [1] 杨洁 [1] 许雪妹 [1] 付笑笑 [1]
期刊: 《中华眼底病杂志》2020年36卷12期 922-928页 ISTICPKUCSCD
栏目名称: 高度近视研究
DOI: 10.3760/cma.j.cn511434-20201020-00496
发布时间: 2023-05-30
基金项目:
2016年政府资助省级临床医学优秀人才项目 2020年河北省自然科学基金精准医学专项 Provincial Excellent Clinical Medicine Talents Project Funded by the Government in 2016 Precision Medicine Project of Natural Science Foundation of Hebei Province in 2020
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