Tarutta E P, Markossian G A, Sianosyan A A, Milash S V
Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia.
Vestn Oftalmol. 2020;136(3):10-17. doi: 10.17116/oftalma202013603110.
To study the choroidal thickness (CT) in children with myopia and hyperopia and its changes after sclera reinforcement surgeries addressing the progression of myopia.
The study involved 133 patients: 78 children (average age 12.5±0.35 years) with mild hyperopia, low, moderate and high myopia and 55 children with moderate and high myopia who received low invasive scleroplasty (LSP, average age 12.31±0.49 years), or bandaging scleroplasty (BSP, average age 12.59±0.24 years) according to Snyder-Thompson technique and were examined prior to and after the procedure. All patients underwent standard ophthalmologic examination and had choroidal thickness manually measured with EDI-SD-OCT; 55 patients were examined before and 1 week after scleroplasty.
A reduction of CT with refraction growth and axial elongation was found in 78 patients. Among the 55 patients, changes in CT were statistically significant: in the operated eyes, CT increased by 42.5±3.17 μm after LSP and by 62.1±1.06 μm after BSP. In fellow eyes, CT showed an increase of 26.1±1.79 μm after LSP and 33.7±0.55 μm after BSP.
In the early period after sclera strengthening, CT significantly increased both in the operated and in the fellow eye. An increase of CT seems to stimulate the collagen biosynthetic activity of the scleral matrix and the collagen synthesis, and to boost the inhibitory effect that scleroplasty has on the myopia progression.
研究近视和远视儿童的脉络膜厚度(CT)及其在针对近视进展的巩膜加固手术后的变化。
该研究纳入133例患者:78例患有轻度远视、低度、中度和高度近视的儿童(平均年龄12.5±0.35岁),以及55例患有中度和高度近视的儿童,他们接受了根据Snyder - Thompson技术进行的低侵入性巩膜成形术(LSP,平均年龄12.31±0.49岁)或包扎巩膜成形术(BSP,平均年龄12.59±0.24岁),并在手术前后接受检查。所有患者均接受标准眼科检查,并使用EDI - SD - OCT手动测量脉络膜厚度;55例患者在巩膜成形术前和术后1周接受检查。
在78例患者中发现脉络膜厚度随屈光度增加和眼轴延长而降低。在55例患者中,脉络膜厚度的变化具有统计学意义:在手术眼,LSP术后脉络膜厚度增加42.5±3.17μm,BSP术后增加62.1±1.06μm。在对侧眼,LSP术后脉络膜厚度增加26.1±1.79μm,BSP术后增加33.7±0.55μm。
在巩膜加固后的早期,手术眼和对侧眼的脉络膜厚度均显著增加。脉络膜厚度的增加似乎刺激了巩膜基质的胶原蛋白生物合成活性和胶原蛋白合成,并增强了巩膜成形术对近视进展的抑制作用。