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高度近视眼中视网膜和脉络膜厚度与视力的关系。

The relationship between retinal and choroidal thickness and visual acuity in highly myopic eyes.

机构信息

Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain.

出版信息

Br J Ophthalmol. 2013 Aug;97(8):1010-3. doi: 10.1136/bjophthalmol-2012-302836. Epub 2013 Jun 13.

Abstract

BACKGROUND/AIMS: To correlate visual acuity in highly myopic eyes without macular disease with retinal and choroidal thickness as measured by spectral-domain optical coherence tomography (OCT).

METHODS

60 eyes of 46 highly myopic patients (spherical equivalent ≥-6 D or axial length ≥26 mm) were studied in a clinical setting. Eyes with any clinical evidence of maculopathy or amblyopia were excluded. Eyes were imaged using the 3D-2000 OCT (Topcon Corporation, Tokyo, Japan). Two independent investigators manually measured: choroidal thickness at 500-μm intervals up to 2500-μm nasal and temporal to the fovea, subfoveal choroidal thickness, foveal thickness, outer nuclear layer and photoreceptors in addition to retinal pigment epithelium (RPE). Statistical analysis was performed.

RESULTS

Mean age was 45.9±17.9 years (range 18-99), mean best-corrected visual acuity (BCVA) LogMAR was 0.11±0.19 (range 0-1), mean axial length was 28.2±2.4 mm (range 26-35.3) and mean spherical equivalent was -12.05±5.02 D (range -6 to -26). Mean macular choroidal thickness was 157±84.6 μm (range 16.7-426.5), mean subfoveal choroidal thickness was 166±88.7 μm (range 13.5-486.5), mean foveal thickness was 221.1±30.3 μm (range 157.5-296), mean outer nuclear layer was 121.3±22.6 μm (range 74-191.5) and mean photoreceptors in addition to RPE was 99.5±10.8 μm (range 71.5-115.5). BCVA (LogMAR) negatively correlated with macular choroidal thickness (r=-0.371, p=0.003), subfoveal choroidal thickness (r=-0.358, p=0.004) and photoreceptors and RPE aggregate (r=-0.346, p=0.006).

CONCLUSIONS

Subfoveal choroidal thickness, mean macular choroidal thickness and outer retinal thickness are the most important predictive factors of visual acuity in highly myopic eyes without macular pathology. Outer nuclear layer and foveal thickness are not related to visual acuity.

摘要

背景/目的:通过频域光相干断层扫描(OCT)测量高度近视患者(等效球镜度≥-6D 或眼轴长度≥26mm)的视网膜和脉络膜厚度,分析其与无黄斑病变的视力之间的相关性。

方法

在临床环境中研究了 46 例高度近视患者(等效球镜度≥-6D 或眼轴长度≥26mm)的 60 只眼。排除任何有黄斑病变或弱视临床证据的眼。使用 3D-2000 OCT(Topcon 公司,东京,日本)对眼睛进行成像。两名独立的研究者手动测量:黄斑中心凹下脉络膜厚度、黄斑中心凹 500μm 处的脉络膜厚度、黄斑中心凹颞侧和鼻侧 2500μm 处的脉络膜厚度、视网膜色素上皮(RPE)以外的光感受器的外层核层和光感受器。进行了统计学分析。

结果

平均年龄为 45.9±17.9 岁(范围 18-99 岁),最佳矫正视力(BCVA)LogMAR 平均值为 0.11±0.19(范围 0-1),平均眼轴长度为 28.2±2.4mm(范围 26-35.3mm),平均等效球镜度数为-12.05±5.02D(范围-6 至-26)。平均黄斑脉络膜厚度为 157±84.6μm(范围 16.7-426.5μm),平均黄斑中心凹下脉络膜厚度为 166±88.7μm(范围 13.5-486.5μm),平均黄斑中心凹厚度为 221.1±30.3μm(范围 157.5-296μm),平均光感受器以外的外层核层厚度为 121.3±22.6μm(范围 74-191.5μm),平均 RPE 以外的光感受器厚度为 99.5±10.8μm(范围 71.5-115.5μm)。BCVA(LogMAR)与黄斑脉络膜厚度(r=-0.371,p=0.003)、黄斑中心凹下脉络膜厚度(r=-0.358,p=0.004)和光感受器和 RPE 总量(r=-0.346,p=0.006)呈负相关。

结论

黄斑中心凹下脉络膜厚度、平均黄斑脉络膜厚度和外层视网膜厚度是高度近视患者无黄斑病变视力的最重要预测因素。外层核层和黄斑中心凹厚度与视力无关。

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