Department of Ophthalmology, Heping Eye Hospital, Shanghai, China.
Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, Shanghai, China; and.
Cornea. 2020 Feb;39(2):140-145. doi: 10.1097/ICO.0000000000002200.
To test the hypothesis that pterygium presents with both refractive and anatomical changes, especially short axial length.
A retrospective, hospital-based cross-sectional study included 521 eyes from 521 patients who were enrolled through a community survey by Shanghai Heping Eye Hospital was conducted. Patients with primary pterygium in at least 1 eye were considered the pterygium group, and those with normal eyes were considered the nonpterygium group. The prevalence and length of pterygium, refractive characteristics including spherical power, astigmatism, corneal curvature, and anatomical parameters including axial length, anterior chamber depth, endothelial cell density, and corneal thickness were compared between groups.
Five hundred twenty-one eyes of 521 patients (214 men and 307 women) with a mean age of 70.5 ± 7.6 years were included in the study. The prevalence of hyperopia (81.6%, 65.1%, P = 0.001), axial length (23.1 ± 1.2 mm, 24.2 ± 2.4 mm, P < 0.001), anterior chamber depth (2.9 ± 0.3 cm, 3.1 ± 0.4 cm, P = 0.001), flat K value (42.94 ± 2.16 diopters, 43.73 ± 1.48 diopters, P = 0.002), Kmax (51.13 ± 7.74 diopters, 47.49 ± 5.62 diopters, P < 0.001), and spherical power (0.97 ± 2.40 diopters, -0.82 ± 4.40 diopters, P < 0.001) were statistically different between the pterygium and nonpterygium groups. Age (r = -0.21, P = 0.025), corneal astigmatism (r = -0.41, P < 0.001), flat K value (r = -0.39, P < 0.001), and endothelial cell density (r = -0.33, P = 0.001) were all negatively correlated with the length of pterygium. The prevalence of pterygium and severe pterygium over 3 mm were statistically different according to the severity of hyperopia (P < 0.001) and axial length (P < 0.001). Stratified χ analysis showed that axial length, rather than hyperopia, was a related factor to pterygium (odds ratio = 5.23, 95% confidence interval: 2.50-10.93).
We conclude from our study that the prevalence of pterygium is related to small eye size. SDF-1/CXCR4 signaling may play a vital role in pterygium and shorter axial length. Further study focused on SDF-1/CXCR4 signaling will be needed.
验证翼状胬肉表现为屈光和解剖变化，特别是短轴向长度的假说。
本回顾性、基于医院的横断面研究纳入了通过上海和平眼科医院社区调查招募的 521 名患者的 521 只眼。至少有 1 只眼患有原发性翼状胬肉的患者被视为翼状胬肉组，而正常眼的患者被视为非翼状胬肉组。比较两组间翼状胬肉的患病率和长度、包括球镜度数、散光、角膜曲率在内的屈光特征，以及包括眼轴长度、前房深度、内皮细胞密度和角膜厚度在内的解剖学参数。
本研究纳入了 521 名患者（214 名男性和 307 名女性）的 521 只眼，平均年龄为 70.5±7.6 岁。远视的患病率（81.6%、65.1%，P=0.001）、眼轴长度（23.1±1.2mm、24.2±2.4mm，P<0.001）、前房深度（2.9±0.3cm、3.1±0.4cm，P=0.001）、平 K 值（42.94±2.16 屈光度、43.73±1.48 屈光度，P=0.002）、最大 K 值（51.13±7.74 屈光度、47.49±5.62 屈光度，P<0.001）和球镜度数（0.97±2.40 屈光度、-0.82±4.40 屈光度，P<0.001）在翼状胬肉组和非翼状胬肉组间存在统计学差异。年龄（r=-0.21，P=0.025）、角膜散光（r=-0.41，P<0.001）、平 K 值（r=-0.39，P<0.001）和内皮细胞密度（r=-0.33，P=0.001）与翼状胬肉的长度均呈负相关。翼状胬肉的患病率和超过 3mm 的严重翼状胬肉与远视的严重程度（P<0.001）和眼轴长度（P<0.001）有关。分层 χ 分析表明，眼轴长度而不是远视是翼状胬肉的相关因素（比值比=5.23，95%置信区间：2.50-10.93）。
本研究得出的结论是，翼状胬肉的患病率与小眼球大小有关。SDF-1/CXCR4 信号可能在翼状胬肉和较短的眼轴长度中发挥重要作用。需要进一步研究 SDF-1/CXCR4 信号。
