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病理性近视脉络膜新生血管的眼部危险因素。

Ocular risk factors for choroidal neovascularization in pathologic myopia.

机构信息

Departments of Ophthalmology, Osaka University Medical School, Osaka, Japan.

出版信息

Invest Ophthalmol Vis Sci. 2010 Jul;51(7):3721-5. doi: 10.1167/iovs.09-3493. Epub 2010 Mar 5.

DOI:10.1167/iovs.09-3493
PMID:20207975
Abstract

UNLABELLED

PURPOSE. To identify the risk factors for development of myopic choroidal neovascularization (mCNV), a major cause of visual impairment. METHODS. Enrolled in the study were 23 consecutive patients with bilateral high myopia (axial length, > or =26.5 mm or refractive error, < or =8 D) and unilateral newly developed mCNV who presented to the Myopia Clinic, Osaka University Hospital. Spectral-domain optical coherence tomography (SD-OCT) showed that the fellow eyes had a normal macula. The parameters in the affected and fellow eyes were compared between the individual patients, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), refractive error, axial length, choroidal thickness (CT) (subfoveal, 1.5 mm superiorly and inferiorly), posterior staphyloma height 3 mm from the fovea, length of retinal pigment epithelium (RPE) curvature within 6 mm measured on SD-OCT images, and choroidal degeneration and lacquer crack formation, graded according to a published

METHOD

RESULTS. The IOP, axial length, refractive error, and chorioretinal degeneration did not differ significantly. Affected eyes had a significantly higher lacquer crack grade (P < 0.05). The superior CT was not significantly different; the subfoveal and inferior CTs were significantly lower in the affected eyes (P < 0.05 and P < 0.001, respectively). The absolute value of the nasal posterior staphyloma height from the fovea was significantly greater in the affected eyes (P < 0.05), and the affected eyes had a significantly (P < 0.05) longer RPE curvature. CONCLUSIONS. Choroidal thinning resulting from increased RPE/choroid curvature is a risk factor for unilateral mCNV.

摘要

目的

确定近视性脉络膜新生血管(mCNV)发生的危险因素,mCNV 是视力损害的主要原因。

方法

本研究纳入了 23 例双侧高度近视(眼轴长度≥26.5mm 或屈光不正<-8D)且单侧新发生 mCNV 的连续患者,这些患者均就诊于大阪大学医院的近视诊所。频域光学相干断层扫描(SD-OCT)显示对侧眼黄斑正常。对每位患者的患眼和对侧眼的参数进行了比较,包括最佳矫正视力(BCVA)、眼压(IOP)、屈光不正、眼轴长度、脉络膜厚度(CT)(黄斑中心凹下、上和下 1.5mm)、距黄斑 3mm 处后葡萄肿高度、SD-OCT 图像上测量的 6mm 内视网膜色素上皮(RPE)曲率长度,以及根据已发表的方法分级的脉络膜变性和漆裂纹形成。

结果

IOP、眼轴长度、屈光不正和脉络膜视网膜变性无显著差异。患眼的漆裂纹分级显著更高(P<0.05)。黄斑中心凹上 CT 无显著差异;黄斑中心凹下和下 CT 显著较低(P<0.05 和 P<0.001)。距黄斑 3mm 处的鼻侧后葡萄肿高度绝对值在患眼中显著更大(P<0.05),且患眼的 RPE 曲率显著更长(P<0.05)。

结论

RPE/脉络膜曲率增加导致脉络膜变薄是单侧 mCNV 的危险因素。

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