Zhu Xiaohui, Zhao Rulian, Wang Yang, Ouyang Lijuan, Yang Jing, Li Yong, Pi Lianhong
Department of Ophthalmology, Affiliated Children's Hospital of Chongqing Medical University, Chongqing, China.
Medicine (Baltimore). 2017 Nov;96(45):e8565. doi: 10.1097/MD.0000000000008565.
This study aimed to investigate the refractive state and optical compositions of preterm children with and without mild retinopathy of prematurity (ROP) and explore the influence of prematurity and mild ROP on the development of refractive state and optical compositions.Preterm children who received fundus screening were recruited, and divided into ROP group and non-ROP group. Term children matched in age were also recruited as controls. Several correspondence indicators were measured before and after ciliary muscle paralysis with 1% cyclopentanone.A total of 250 eyes from 126 patients were included for analysis. The incidence of myopia was the highest in ROP group. The incidence of hyperopia was the highest in control group. The incidence of astigmatism was the highest in ROP group. The corneal astigmatism and mean astigmatism in ROP group and non-ROP group were significantly higher than in control group. Corneal refraction in ROP was markedly higher than in non-ROP group and control group; corneal curvature in ROP group increased significantly as compared with non-ROP group and control group (P < .05). The axial eye length in ROP group and non-ROP group reduced significantly as compared with control group (P < .05). Gestational age had negative relationships with corneal astigmatism (P = .019) and astigmatism (P = .001) and positive relationship with axial eye length (P = .005). Birth weight had negative relationships with corneal astigmatism (P = .001), astigmatism (P < .001), corneal refraction (P = .001), and corneal curvature (P = .001) and positive relationships with axial eye length (P = .001) and spherical equivalent refraction (P = .039). The incidence of myopia increased and that of hyperopia reduced in children over age. In children aged 3 to 4 years, the anterior chamber depth, lens thickness, vitreous thickness, and axial eye length significantly increased as compared with those aged 5 years (P < .05); the vitreous thickness and axial eye length in children aged 5 years increased significantly as compared with those aged 6 years (P < .05).This study shows that preterm children with and without mild ROP are more likely to develop myopia and astigmatism, and low birth weight, prematurity, and ROP may simultaneously affect the development of optical compositions, leading to myopia and astigmatism.
本研究旨在调查有无轻度早产儿视网膜病变(ROP)的早产儿的屈光状态和眼屈光成分,并探讨早产和轻度ROP对屈光状态和眼屈光成分发育的影响。招募接受眼底筛查的早产儿,分为ROP组和非ROP组。同时招募年龄匹配的足月儿作为对照组。用1%环戊通麻痹睫状肌前后测量多项相应指标。共纳入126例患者的250只眼进行分析。ROP组近视发生率最高。对照组远视发生率最高。ROP组散光发生率最高。ROP组和非ROP组的角膜散光和平均散光均显著高于对照组。ROP组的角膜屈光显著高于非ROP组和对照组;ROP组的角膜曲率与非ROP组和对照组相比显著增加(P<0.05)。ROP组和非ROP组的眼轴长度与对照组相比显著缩短(P<0.05)。胎龄与角膜散光(P=0.019)和散光(P=0.001)呈负相关,与眼轴长度呈正相关(P=0.005)。出生体重与角膜散光(P=0.001)、散光(P<0.001)、角膜屈光(P=0.001)和角膜曲率(P=0.001)呈负相关,与眼轴长度(P=0.001)和等效球镜度(P=0.039)呈正相关。随着年龄增长,儿童近视发生率增加,远视发生率降低。3至4岁儿童的前房深度、晶状体厚度、玻璃体厚度和眼轴长度与5岁儿童相比显著增加(P<0.05);5岁儿童的玻璃体厚度和眼轴长度与6岁儿童相比显著增加(P<0.05)。本研究表明,有无轻度ROP的早产儿更易发生近视和散光,低出生体重、早产和ROP可能同时影响眼屈光成分的发育,导致近视和散光。