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日本成年人高度近视眼中的眼轴长度变化及近视性黄斑并发症的影响

Axial length changes in highly myopic eyes and influence of myopic macular complications in Japanese adults.

作者信息

Ohsugi Hideharu, Ikuno Yasushi, Shoujou Tomohiro, Oshima Kanako, Ohsugi Eiko, Tabuchi Hitoshi

机构信息

Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan.

Ikuno Eye Center, Osaka, Japan.

出版信息

PLoS One. 2017 Jul 7;12(7):e0180851. doi: 10.1371/journal.pone.0180851. eCollection 2017.

Abstract

PURPOSE

To investigate changes of the axial length in normal eyes and highly myopic eyes and influence of myopic macular complications in Japanese adults.

STUDY DESIGN

Retrospective longitudinal case series.

METHODS

The changes in the axial length of 316 eyes from 316 patients (mean age, 63.8 ± 9.0 years; range, 34-82; 240 females) examined using IOLMaster with a follow-up period of at least 1 year were studied. This study included 85 non-highly myopic eyes (|refractive error| ≤ 5 diopters; 63 females; non-highly myopic group), 165 highly myopic eyes (refractive error ≤ -6 diopters or axial length ≥ 26 mm; 124 females) without macular complications (no complications group), 32 eyes (25 females) with myopic traction maculopathy (MTM group), and 34 eyes (28 females) with myopic choroidal neovascularization (CNV group).

RESULTS

All groups showed a significant increase in the axial length during the follow-up period (mean follow-up, 28.7 ± 16.8 months; range, 12-78) (P < 0.01). Changes in the axial length/year in the no complications group (0.041 ± 0.05 mm) were significantly greater than those in the non-highly myopic group (0.007 ± 0.02 mm) (P < 0.0001). Furthermore, changes in the CNV group (0.081 ± 0.04 mm) were significantly greater than those in the no complications (P < 0.0001) and MTM (0.040 ± 0.05 mm) (P = 0.0059) groups, whereas no significant difference was found between the changes in the MTM and no complications groups (P = 0.91). Multiple regression analyses indicated that CNV eyes (P < 0.0001) and female patients' eyes (P = 0.04) showed greater changes in the axial length/year.

CONCLUSIONS

All groups showed an increase in the axial length, which was greater for highly myopic eyes. In particular, CNV eyes showed greater increases, indicating that larger changes in the axial length may require careful follow-up.

摘要

目的

研究日本成年人正常眼和高度近视眼眼轴长度的变化以及近视性黄斑并发症的影响。

研究设计

回顾性纵向病例系列研究。

方法

对316例患者(平均年龄63.8±9.0岁;范围34 - 82岁;女性240例)的316只眼使用IOLMaster进行检查,随访期至少1年,研究眼轴长度的变化。本研究包括85只非高度近视眼(屈光不正绝对值≤5屈光度;女性63例;非高度近视组)、165只无黄斑并发症的高度近视眼(屈光不正≤ - 6屈光度或眼轴长度≥26mm;女性124例;无并发症组)、32只患有近视性牵引性黄斑病变的眼(MTM组;女性25例)以及34只患有近视性脉络膜新生血管的眼(CNV组;女性28例)。

结果

所有组在随访期内眼轴长度均显著增加(平均随访28.7±16.8个月;范围12 - 78个月)(P < 0.01)。无并发症组的眼轴长度/年变化(0.041±0.05mm)显著大于非高度近视组(0.007±0.02mm)(P < 0.0001)。此外,CNV组的变化(0.081±0.04mm)显著大于无并发症组(P < 0.0001)和MTM组(0.040±0.05mm)(P = 0.0059),而MTM组和无并发症组之间的变化无显著差异(P = 0.91)。多元回归分析表明,CNV眼(P < 0.0001)和女性患者的眼(P = 0.04)眼轴长度/年变化更大。

结论

所有组眼轴长度均增加,高度近视眼增加更明显。特别是CNV眼增加更显著,表明眼轴长度变化较大时可能需要密切随访。

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