摘要
目的:观察近视屈光参差儿童的周边视网膜相对离焦量(RPRE),探索与近视发展相关的离焦区。方法:系列病例对照研究。连续纳入2022年7—8月于成都爱迪眼科医院就诊的近视屈光参差儿童83例(166眼)。所有儿童在小瞳下使用生物测量仪测量双眼眼轴长度(AL)。在1%环喷脱脂滴眼液睫状肌麻痹后使用自动验光仪测量并计算双眼等效球镜度(SE)。使用屈光地形图(MRT)测量视网膜上、下、鼻、颞(RPRE-S、RPRE-I、RPRE-N、RPRE-T)共4个象限以及偏心0~15°、15°~30°、30°~45°、45°~53°共4个区域(相连区域的分界线数据归后一组)的相对屈光度。使用配对t检验比较左右双眼间不同象限、不同区域的RPRE差异,并使用Spearman分析中心屈光度、AL与视网膜离焦状态的相关性。结果:双眼RPRE在4个象限以及偏心15°~30°、30°~45°、45°~53°区域内差异均有统计学意义(t=3.09~8.04,均P<0.05),在偏心0~15°区域内差异无统计学意义(t=0.76,P=0.448)。双眼间的RPRE差值(D-RPRE)在4个象限间差异无统计学意义(F=1.84,P=0.140),在偏心15°~30°、30°~45°、45°~53°区域间差异有统计学意义(F=14.49,P<0.001),事后比较发现偏心15°~30°与偏心30°~45°和偏心45°~53°差异均有统计学意义(P=0.020,P<0.001),偏心30°~45°与偏心45°~53°差异无统计学意义(P=0.270)。双眼间的SE差值(D-SE)分别与偏心30°~45°、45°~53°区域的D-RPRE呈负相关(r=-0.26,P=0.016;r=-0.32,P=0.003),与偏心15°~30°区域的D-RPRE无相关性(r=-0.15,P=0.162)。双眼间的AL差值分别与偏心30°~45°、45°~53°区域的D-RPRE呈正相关(r=0.38,P<0.001;r=0.45,P<0.001),而与偏心15°~30°区域的D-RPRE无相关性(r=0.19,P=0.090)。结论:近视屈光参差儿童的近视发展与周边视网膜离焦状态有关,偏心30°~53°的双眼间离焦量差异可能是其近视不平衡发展的促进因素之一。
Objective:This study investigated the regions of defocus related to myopia progression by examining relative peripheral refractive error(RPRE)in children with myopic anisometropia.Methods:Serial cases study.This study enrolled 83 children with myopic anisometropia(166 eyes)from July to August 2022 at Chengdu Aidi Eye Hospital.The axial length(AL)of all children was measured using an optical biometer under non-mydriatic conditions.After cycloplegia,the autorefractor was used to measure and calculate the spherical equivalent(SE)of both eyes.Multispectral refraction topography(MRT)was used to measure the retina relative refractive errors of four quadrants(RPRE-S,RPRE-I,RPRE-N,RPRE-T)in upper,lower,nose,and temporal and four regions with eccentricity 0-15°,15°-30°,30°-45°,and 45°-53°(the dividing line data of connected regions were returned to the latter group).Data from interconnected areas were categorized into the latter group for analysis.The differences in RPRE in various quadrants and regions between the two eyes were compared using Paired t-test.The correlations between central refractive error and AL with retinal defocus were analyzed utilizing Spearman's correlation.Results:Statistical differences were noted in RPRE in different quadrants and at eccentricities of 15°-30°,30°-45°,and 45°-53°between the two eyes(t=3.09-8.04,all P<0.05).The difference in RPRE(D-RPRE)in four quadrants showed no significant difference between the two eyes(F=1.84,P=0.140).However,statistical differences were detected in D-RPRE between eccentricities of 15°-30°and 30°-45°,as well as 45°-53°(F=14.49,P<0.001).Posterior comparisons revealed statistically significant differences between the eccentricities of 15°-30°and 30°-45°and between 15°-30°and 45°-53°(P=0.020,P<0.001).However,there was no difference between the eccentricity of 30°-45°and 45°-53°(P=0.270).The difference in SE(D-SE)between the two eyes was negatively correlated with the D-RPRE at eccentricities of 30°-45°and 45°-53°(r=-0.26,P=0.016;r=-0.32,P=0.003),but not statistically correlated with the D-RPRE at eccentricities between 15°-30°(r=-0.15,P=0.162).The difference in AL(D-AL)between the two eyes was positively correlated with D-RPRE at eccentricities of 30°-45°and 45°-53°(r=0.38,P<0.001;r=0.45,P<0.001),respectively.However,the D-RPRE at eccentricities between 15°-30°showed no correlations with D-AL(r=0.19,P=0.090).Conclusions:The development of myopia in children with myopic anisometropia is related to peripheral retinal defocus.The difference in the amount of defocus between the two eyes at an eccentricity of 30°-53°may be one of the contributing factors to the unbalanced development of myopia.
作者
廖俊
屈雪梅
张春芳
熊燕
何光华
Jun Liao;Xuemei Qu;Chunfang Zhang;Yan Xiong;Guanghua He(Chengdu Aidi Eye Hospital,Chengdu 610000,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
北大核心
2024年第6期416-422,共7页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
成都市卫健委医学科研项目(2022183)
关键词
近视
屈光参差
周边视网膜离焦
屈光地形图
myopia
anisometropia
peripheral retinal defocus
multispectral refraction topography
作者简介
通信作者:廖俊,Email:ljyyykx@163.com
