Fledelius Hans C, Jacobsen Nina, Li Xiao Q, Goldschmidt Ernst
Copenhagen University Eye Clinics, Rigshospitalet and Glostrup, Capital Region, Denmark.
Danish Myopia Institute, Espergaerde, Denmark.
Acta Ophthalmol. 2018 Feb;96(1):46-50. doi: 10.1111/aos.13659.
A population-based Copenhagen birth year 1948 cohort with high myopia recorded since age 14 years (spherical equivalent less than or equivalent to -6 D) has been followed over 50 years. Despite complications, current follow-ups have outlined a better visual prognosis than usually drawn from selected clinical series in the literature. For the present status at age 66 years, focus was on visual ability and choroidal thickness.
Twenty-eight of the original 39 participants were available in 2014. Medical history was updated. Best-corrected visual acuity (BCVA) data were compared with subfoveal choroidal thickness (SFCT), now measured by enhanced depth optical coherence tomography.
Due to at least better eye visual acuity (VA), all patients had maintained their everyday visual capacity. Only one participant was marginal regarding visual status for a driver's licence; low vision was not on record. Based on all eyes, choroidal thickness correlated negatively with axial length (AL), which also held for the fraction with high myopia (AL >26.5 mm). In high myopia, the mean choroidal subfoveal thickness was 114 ± 75 μm versus 182 ± 94 μm in lower myopia (p = 0.01).
Despite the generally maintained individual visual capacity in the series, significant correlation could be demonstrated between SFCT and (i) axial elongation and (ii) recorded VA, with a negative and a positive sign, respectively. Overall, the visual prognosis was relatively benign, in particular when compared with the selected high myopia hospital series that predominate in the ophthalmic literature.
对一组以哥本哈根1948年出生队列人群为基础的研究进行了50多年的跟踪随访,该队列自14岁起就记录有高度近视(等效球镜小于或等于-6D)。尽管存在并发症,但目前的随访结果显示其视觉预后比文献中通常从选定临床系列研究得出的结果要好。对于66岁时的现状,重点关注视觉能力和脉络膜厚度。
2014年,最初的39名参与者中有28人可供研究。更新了病史。将最佳矫正视力(BCVA)数据与现在通过增强深度光学相干断层扫描测量的黄斑中心凹下脉络膜厚度(SFCT)进行比较。
由于至少有较好的眼部视力(VA),所有患者都保持了日常视觉能力。只有一名参与者在驾驶执照的视觉状态方面处于边缘状态;未记录有低视力情况。基于所有眼睛,脉络膜厚度与眼轴长度(AL)呈负相关,高度近视(AL>26.5mm)部分也是如此。在高度近视中,黄斑中心凹下脉络膜平均厚度为114±75μm,而低度近视中为182±94μm(p=0.01)。
尽管该系列研究中个体视觉能力总体上得以维持,但可以证明SFCT与(i)眼轴伸长和(ii)记录的VA之间存在显著相关性,分别为负号和正号。总体而言,视觉预后相对良好,特别是与眼科文献中占主导地位的选定高度近视医院系列研究相比。