Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany.
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Retina. 2018 Sep;38(9):1839-1847. doi: 10.1097/IAE.0000000000001786.
Axial myopia is associated with elongation of the posterior ocular segment. The authors measured posterior fundus landmarks and assessed their associations with axial length.
Using fundus photographs, the authors measured the vertical distance between the temporal superior and temporal inferior arterial arcade (VDA) and the angle kappa between the temporal arterial arcades among other morphometric variables.
The study included 456 eyes with a mean age of 61.2 ± 14.2 years (range: 13-88 years) and mean axial length of 29.4 ± 2.1 mm (range: 23.2-35.3 mm). Mean angle kappa was 91.3 ± 17.2° (range: 39-161°), and mean VDA was 7.93 ± 1.71 mm (range: 2.72-12.85 mm). In multivariate regression analysis, wider angle kappa was associated (regression coefficient r: 0.47) with shorter axial length (P = 0.002; beta: -0.17; B: -1.37; 95% confidence interval [CI]:-2.23 to -0.51), longer VDA (P < 0.001; beta: 0.27; B: 2.70; 95% CI: 1.85-3.54), shorter disk-foveola distance (P < 0.001; beta: -0.22; B: -4.76; 95% CI: -7.05 to -2.46), shorter vertical optic disk diameter (P = 0.002; beta: -0.14; B: -6.83; 95% CI: -11.1 to -2.56), lower number of any chorioretinal lesions (P = 0.007; beta: -0.13; B: -2.11; 95% CI: -3.63 to -0.58), and longer maximal vertical chorioretinal lesion diameter (P = 0.05; beta: 0.09; B: 0.92; 95% CI: -0.02 to 1.86). A longer VDA was associated (r: 0.31) with longer axial length (P < 0.001; beta: 0.22; B: 0.18; 95% CI: 0.10-0.25), wider angle kappa (P < 0.001; beta: 0.28; B: 0.03; 95% CI: 0.02-0.04) and higher number of chorioretinal lesions (P = 0.03; beta: 0.10; B: 0.16; 95% CI: 0.02-0.31). If eyes with chorioretinal lesions were excluded, the association between longer VDA and longer axial length was no longer statistically significant (P > 0.10).
Axial elongation was correlated with decreasing angle kappa, caused by an elongation of the disk-foveola distance because of an enlargement of the gamma zone, whereas VDA remained constant. By contrast, horizontal length of macular Bruch membrane and vertical length of macular Bruch membrane were independent of axial elongation. Axial elongation did not lead to lengthening of Bruch membrane in the macular region in eyes without macular chorioretinal lesions.
轴性近视与后眼球段的伸长有关。作者测量了眼底标志点，并评估了它们与眼轴长度的关系。
使用眼底照片，作者测量了颞上动脉弓和颞下动脉弓之间的垂直距离（VDA）以及颞动脉弓之间的角度 Kappa 等形态变量。
该研究包括 456 只眼，平均年龄 61.2±14.2 岁（范围：13-88 岁），平均眼轴长度为 29.4±2.1mm（范围：23.2-35.3mm）。平均角度 Kappa 为 91.3±17.2°（范围：39-161°），平均 VDA 为 7.93±1.71mm（范围：2.72-12.85mm）。在多元回归分析中，较宽的角度 Kappa 与较短的眼轴长度相关（回归系数 r：0.47）（P=0.002；β：-0.17；B：-1.37；95%置信区间[CI]：-2.23 至-0.51），较长的 VDA（P<0.001；β：0.27；B：2.70；95%CI：1.85-3.54），较短的盘-黄斑距离（P<0.001；β：-0.22；B：-4.76；95%CI：-7.05 至-2.46），较短的垂直视盘直径（P=0.002；β：-0.14；B：-6.83；95%CI：-11.1 至-2.56），较少的任何脉络膜视网膜病变（P=0.007；β：-0.13；B：-2.11；95%CI：-3.63 至-0.58），以及较长的最大垂直脉络膜视网膜病变直径（P=0.05；β：0.09；B：0.92；95%CI：-0.02 至 1.86）。较长的 VDA 与较长的眼轴长度相关（r：0.31）（P<0.001；β：0.22；B：0.18；95%CI：0.10-0.25），较宽的角度 Kappa（P<0.001；β：0.28；B：0.03；95%CI：0.02-0.04）和更多的脉络膜视网膜病变（P=0.03；β：0.10；B：0.16；95%CI：0.02-0.31）。如果排除有脉络膜视网膜病变的眼睛，较长的 VDA 与较长的眼轴长度之间的关联不再具有统计学意义（P>0.10）。
轴向伸长与角度 Kappa 的减小有关，这是由于盘-黄斑距离的伸长，这是由于γ区的扩大，而 VDA 保持不变。相比之下，黄斑区布鲁赫膜的水平长度和黄斑区布鲁赫膜的垂直长度与轴向伸长无关。在没有黄斑脉络膜视网膜病变的眼中，轴向伸长不会导致黄斑区布鲁赫膜的延长。
