中国成年人视乳头周围脉络膜厚度：北京眼病研究
Peripapillary Choroidal Thickness in Adult Chinese: The Beijing Eye Study.
作者信息
Jiang Ran, Wang Ya Xing, Wei Wen Bin, Xu Liang, Jonas Jost B
机构信息
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
出版信息
Invest Ophthalmol Vis Sci. 2015 Jun;56(6):4045-52. doi: 10.1167/iovs.15-16521.
PURPOSE
To measure peripapillary choroidal thickness (PPCT) and to assess its associations.
METHODS
The population-based cross-sectional Beijing Eye Study 2011 included 3468 participants. Detailed medical and ophthalmic examinations were performed. We measured PPCT by spectral-domain optical coherence tomography (SD-OCT) with a 3.4-mm scan circle centered on the optic nerve head.
RESULTS
Peripapillary choroidal thickness measurements were available for 3060 (88.2%) study participants with a mean age of 64.4 ± 9.6 years (range, 50-93 years). Mean global PPCT was 134 ± 53 μm (range, 35-348 μm). Peripapillary choroid was thickest in the superior region (155 ± 60 μm), followed by the temporal region (144 ± 75 μm; P < 0.001); nasal region (139 ± 55 μm; P < 0.001); and inferior region (110 ± 45 μm; P < 0.001). In multivariate analysis, thicker PPCT was associated with younger age (P < 0.001; standardized coefficient β: -0.33; correlation coefficient B: -1.95; 95% confidence interval (CI): -2.25, -1.65); shorter axial length (P < 0.001; β: -0.11; B: -5.39; 95% CI: -7.85, -2.93); smaller parapapillary α zone (P = 0.01; β: -0.06; B: -5.46; 95% CI: -9.73, -1.19); and smaller β zone (P < 0.001; β: -0.14; B: -8.29; 95% CI: -11.12, -5.46); better best corrected visual acuity (logMAR; P = 0.002; β: -0.05; B: -14.75; 95% CI: -28.59, -0.91), and higher prevalence of early age-related macular degeneration (P = 0.04; β: 0.05; B: 9.11; 95% CI: 0.42, 17.80) and intermediate age-related macular degeneration (P = 0.001; β: 0.08; B: 10.90; 95% CI: 4.46, 17.33). It was not significantly (all P > 0.05) associated with blood pressure, blood concentration of lipids, intraocular pressure and prevalence of glaucoma, diabetic retinopathy, and retinal vein occlusions. The decrease of PPCT with longer axial length occurred predominantly in the temporal region.
CONCLUSIONS
Peripapillary choroidal thickness is thickest superiorly and thinnest inferiorly. It decreases by 2 μm per year of life and by 5 μm per diopter of myopia. Thinner PPCT is correlated with larger parapapillary α and β zones. The association of thinner PPCT with lower best corrected visual acuity may warrant further study.
目的
测量视乳头周围脉络膜厚度（PPCT）并评估其相关性。
方法
基于人群的横断面2011年北京眼病研究纳入了3468名参与者。进行了详细的医学和眼科检查。我们使用以视乳头为中心的3.4毫米扫描环的光谱域光学相干断层扫描（SD - OCT）测量PPCT。
结果
3060名（88.2%）研究参与者可获得视乳头周围脉络膜厚度测量值，平均年龄为64.4±9.6岁（范围50 - 93岁）。平均整体PPCT为134±53μm（范围35 - 348μm）。视乳头周围脉络膜在上方区域最厚（155±60μm），其次是颞侧区域（144±75μm；P<0.001）；鼻侧区域（139±55μm；P<0.001）；下方区域（110±45μm；P<0.001）。在多变量分析中，较厚的PPCT与较年轻的年龄相关（P<0.001；标准化系数β：-0.33；相关系数B：-1.95；95%置信区间（CI）：-2.25，-1.65）；较短的眼轴长度（P<0.001；β：-0.11；B：-5.39；95%CI：-7.85，-2.93）；较小的视乳头旁α区（P = 0.01；β：-0.06；B：-5.46；95%CI：-9.73，-1.19）；以及较小的β区（P<0.001；β：-0.14；B：-8.29；95%CI：-11.12，-5.46）；更好的最佳矫正视力（logMAR；P = 0.002；β：-0.05；B：-1十四点七五；95%CI：-28.59，-0.91），以及早期年龄相关性黄斑变性的较高患病率（P = 0.04；β：0.05；B：9.11；95%CI：0.42，17.80）和中期年龄相关性黄斑变性（P = 0.001；β：0.08；B：10.90；95%CI：4.46，17.33）。它与血压、血脂浓度、眼压以及青光眼、糖尿病视网膜病变和视网膜静脉阻塞的患病率无显著相关性（所有P>0.05）。PPCT随眼轴长度增加而降低主要发生在颞侧区域。
结论
视乳头周围脉络膜厚度上方最厚，下方最薄。其厚度随年龄每年降低2μm，随近视每屈光度降低5μm。较薄的PPCT与较大的视乳头旁α和β区相关。较薄的PPCT与较低的最佳矫正视力之间的关联可能值得进一步研究。
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