摘要
目的观察青年近视人群视网膜血管旁异常临床表现及光相干断层扫描(OCT)图像特征。方法病例观察研究。2020年7~12月于河北医科大学第二医院眼科就诊的青年不同近视屈光度患者523例1046只眼纳入研究。其中,男性277例,女性246例;中位年龄19.0(5.0)岁。所有患眼均行最佳矫正视力、频域光相干断层扫描(OCT)检查以及眼轴长度(AL)测量。患眼中位近视屈光度为5.00(3.25)D。其中,低度、中度、高度近视分别为227、405、414只眼。患眼平均AL为(25.6±2.8)mm。采用频域OCT仪对视网膜颞上、颞下、鼻上、鼻下血管弓和黄斑中心凹进行放射状扫描。采集存在视网膜血管旁囊腔、微皱褶、板层裂孔的图像并存储。观察分析视网膜血管旁异常患病率、组成比例、分布规律及OCT影像特征。视网膜血管旁异常分布比较采用χ^(2)检验;不同血管旁异常表现者年龄、屈光度、AL比较采用K-W秩和检验。结果1046只眼中,检出视网膜血管旁异常40只眼,总患病率3.8%(40/1046)。其中,中度、高度近视者视网膜血管旁异常患病率分别为0.7%(3/405)、8.9%(37/414)。40只眼中,血管旁囊腔、微皱褶、板层裂孔分别为40(3.8%,40/1046)、28(2.7%,28/1046)、13(1.2%,13/1046)只眼。其中,血管旁囊腔最常见(100.0%,40/40),其次为血管旁微皱褶(70.0%,28/40),板层裂孔最少见(32.5%,13/40)。单纯囊腔12只眼(30.0%,12/40);囊腔伴微皱褶15只眼(37.5%,15/40);囊腔、微皱褶、板层裂孔共存13只眼(32.5%,13/40)。颞侧血管弓视网膜血管旁囊腔(χ^(2)=25.664)、微皱褶(χ^(2)=14.973)、板层裂孔(χ^(2)=13.499)明显多于鼻侧,差异有统计学意义(P<0.001)。结论青年近视人群视网膜血管旁异常总患病率为3.8%;中度、高度近视者均可发生。血管旁囊腔可能是视网膜血管旁异常最早期病变。3种血管旁异常多沿视网膜颞侧血管弓分布。
Objective To observe the abnormal clinical manifestations of retinal blood vessels and the characteristic image characteristics of optical coherence tomography(OCT)in young myopia.Methods A case observation study.From July to December 2020,523 young patients with different myopia refractive powers who were treated in Department of Ophthalmology of The Second Hospital of Hebei Medical University were included in the study.Among them,277 were males and 246 were females;the median age was 19.0(5.0)years.All the affected eyes underwent best corrected visual acuity(BCVA),frequency domain OCT(SD-OCT)examination and axial length(AL)measurement.The BCVA examination was performed using the Snellen eye chart.The median myopia refractive power of the affected eye was 5.00(3.25)D.Among them,low myopia,moderate myopia,and high myopia were 227,405,and 414 eyes,respectively.The average AL of the affected eye was 25.6±2.8 mm.The frequency domain OCT instrument was used to scan the temporal side of the retina,the upper and lower nasal vascular arches and the macular fovea radially.The images of retinal vascular cysts,microfolds,and lamellar hole were acquired and stored.The prevalence,composition ratio,distribution rule and OCT imaging characteristics of retinal paravascular abnormalities were observed and analyzed.The distribution of paravascular abnormalities in the retina was compared by theχ^(2) test;the age,refractive power,and AL of different paravascular abnormalities were compared by the K-W rank sum test.Results Of the 1046 different diopters of myopic eyes,there were 227 eyes in mild myopia,405 eyes in moderate myopia and 414 eyes in high myopia.Retinal paravascular abnormalities were detected by SD-OCT in 40 eyes(3.8%,40/1046).The prevalence of retinal paravascular abnormalities in moderate myopia was 0.7%(3/405)and high myopia was 8.9%(37/414).No retinal paravascular abnormalities were observed in mild myopia.Retinal paravascular cysts in 40 eyes(3.8%,40/1046),retinal paravascular microfolds in 28 eyes(2.7%,28/1046)and retinal paravascular lamellar holes in 13 eyes(1.2%,13/1046).Of 40 eyes with retinal paravascular abnormalities,retinal paravascular cysts in all 40 eyes(100.0%,40/40),retinal paravascular microfolds in 28 eyes(70.0%,28/40)and retinal paravascular lamellar holes in 13 eyes(32.5%,13/40).Twelve eyes with simple cyst cavity(30.0%,12/40);15 eyes were with cyst cavity with micro-wrinkles(37.5%,15/40);13 eyes were with cyst cavity,micro-wrinkles and lamellar holes(32.5%,13/40).The temporal vascular arch retinal paravascular cysts(χ^(2)=25.664),microfolds(χ^(2)=14.973),and lamellar holes(χ^(2)=13.499)were significantly more than those on the nasal side,and the difference was statistically significant(P<0.001).Conclusions The total prevalence of retinal paravascular abnormalities in young myopia is 3.8%;it can occur in both moderate and high myopia.The paravascular cyst may be the earliest pathology of paravascular abnormalities in the retina.The three paravascular abnormalities are mostly distributed along the temporal arch of the retina.
作者
宫月
郝玉华
沈宁
周娜磊
郭秀瑾
Gong Yue;Hao Yuhua;Shen Ning;Zhou Nalei;Guo Xiujin(Department of Ophthalmology,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第12期949-953,共5页
Chinese Journal of Ocular Fundus Diseases
关键词
青年人
近视
体层摄影术
光学相干
视网膜血管旁异常
Young adult
Myopia
Tomography,optical coherence
Retinal paravascular abnormalities
