State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Ophthalmic Physiol Opt. 2012 Jan;32(1):60-7. doi: 10.1111/j.1475-1313.2011.00861.x. Epub 2011 Jul 18.
To describe the severity and morphological features of high myopic maculopathy in Chinese patients and to evaluate their association with age, refractive error and visual acuity.
Six hundred and four eyes of 337 patients (ages 8-88 years) with high myopia (refractive error ≤ -6.0 D) presenting to the Zhongshan Ophthalmic Center were studied retrospectively. All patients underwent an ophthalmological examination including digital colour fundus photography. Fundus fluorescein angiography was performed in 251 patients (443 eyes) and indocyanine green angiography was performed in 35 patients (63 eyes). The type and severity of myopic degeneration were categorized in each eye. Risk factors associated with high myopic maculopathy were evaluated using General Estimating Equation models.
Two hundred and fifty-one patients (443 eyes) presented with maculopathy in this study. The most common subtype of high myopic maculopathy was lacquer cracks (prevalence 29.1%). The most commonly observed degree was M(3) (choroidal pallor and tessellation, with posterior staphyloma and lacquer cracks). Older age was significantly associated with diffuse chorioretinal atrophy (p = 0.024), patchy chorioretinal atrophy (p < 0.001), choroidal neovascularisation (CNV, p < 0.001) and macular atrophy (p = 0.002). Younger age was associated with lacquer cracks (p < 0.001). A higher degree of myopia was a risk factor for almost all kinds of maculopathy: tessellated fundus (p = 0.001), lacquer cracks (p < 0.001), diffuse chorioretinal atrophy (p < 0.001), patchy chorioretinal atrophy (p = 0.025) and macular atrophy p < 0.001), whereas a lower degree of myopia was associated with CNV (p = 0.001). A worse visual acuity was associated with lacquer cracks (p = 0.001), macular atrophy (p < 0.001) and CNV p < 0.001), while better visual acuity was associated with tessellated fundus (p < 0.001) and diffuse atrophy (p = 0.002). Older age (p < 0.001), more myopic refractive error (p < 0.001) and worse visual acuity (p < 0.001) were significantly associated with a greater severity of maculopathy. There was no gender difference in the type and severity of myopic maculopathy.
Age and refractive error are important risk factors playing different roles in the development of distinct subtypes and varying severities of high myopic maculopathy. Visual acuity is significantly associated with various subtypes and the severity of high myopic maculopathy.
描述中国高度近视患者的黄斑病变的严重程度和形态特征，并评估其与年龄、屈光不正和视力的关系。
回顾性分析 337 例（8-88 岁）高度近视（屈光不正≤-6.0D）患者的 604 只眼。所有患者均接受眼科检查，包括数字眼底彩色照相。251 例（443 只眼）行眼底荧光素血管造影，35 例（63 只眼）行吲哚青绿血管造影。对每只眼的近视性退行性病变的类型和严重程度进行分类。使用一般估计方程模型评估与高度近视性黄斑病变相关的危险因素。
本研究 251 例（443 只眼）患者出现黄斑病变。最常见的高度近视性黄斑病变亚型是漆裂纹（患病率 29.1%）。最常见的观察程度为 M(3)（脉络膜苍白和镶嵌，伴有后葡萄肿和漆裂纹）。年龄较大与弥漫性脉络膜视网膜萎缩（p=0.024）、斑片状脉络膜视网膜萎缩（p<0.001）、脉络膜新生血管（CNV，p<0.001）和黄斑萎缩（p=0.002）显著相关。年龄较小与漆裂纹（p<0.001）相关。高度近视是几乎所有黄斑病变的危险因素：镶嵌眼底（p=0.001）、漆裂纹（p<0.001）、弥漫性脉络膜视网膜萎缩（p<0.001）、斑片状脉络膜视网膜萎缩（p=0.025）和黄斑萎缩（p<0.001），而低度近视与 CNV 相关（p=0.001）。视力越差与漆裂纹（p=0.001）、黄斑萎缩（p<0.001）和 CNV（p<0.001）相关，而视力越好与镶嵌眼底（p<0.001）和弥漫性萎缩（p=0.002）相关。年龄较大（p<0.001）、近视屈光不正较大（p<0.001）和视力较差（p<0.001）与黄斑病变的严重程度显著相关。近视性黄斑病变的类型和严重程度在性别上无差异。
年龄和屈光不正都是高度近视性黄斑病变发展过程中不同类型和严重程度的重要危险因素。视力与高度近视性黄斑病变的各种亚型和严重程度显著相关。
