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中国高度近视儿童近视性黄斑病变的进展:一项长期随访研究。

PROGRESSION OF MYOPIC MACULOPATHY IN CHINESE CHILDREN WITH HIGH MYOPIA: A Long-Term Follow-Up Study.

机构信息

Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.

Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China.

出版信息

Retina. 2021 Jul 1;41(7):1502-1511. doi: 10.1097/IAE.0000000000003018.

Abstract

PURPOSE

To investigate the progression of myopic maculopathy and associated factors in highly myopic Chinese children.

METHODS

In this retrospective observational case series, biometric fundus features were morphometrically measured on photographs. Myopic maculopathy was defined as recommended by the Meta-analysis of Pathologic Myopia Study Group.

RESULTS

The study included 274 children (mean age: 11.7 ± 2.5 years; mean refractive error: -7.66 ± 1.87 diopters [D]) with a mean follow-up of 4.9 ± 1.2 years. Myopic maculopathy progression was detected in 52 eyes (18.9%; 95% confidence interval [CI]: 14.3-23.7%). In multivariable analysis, myopic maculopathy progression was associated with a decrease in refractive error (odds ratio [OR]: 0.72; 95% CI: 0.56-0.92; P < 0.001) (i.e., higher myopization) and enlargement of parapapillary gamma zone (OR: 7.68; 95% CI: 1.63-36.2; P = 0.002). Incident peripapillary diffuse choroidal atrophy, noted in 47 of 236 eyes (20.0%; 95% CI: 14.8-25.2%), was correlated with a decrease in refractive error (OR: 0.70; 95% CI: 0.54-0.92; P = 0.009) (i.e., higher myopization) and greater gamma zone enlargement (OR: 8.28; 95% CI: 1.33-51.7; P = 0.02).

CONCLUSION

Myopia in schoolchildren may have a considerable risk of progressing to myopic maculopathy. Enlargement of parapapillary gamma zone was a main independent risk factor.

摘要

目的

研究中国高度近视儿童近视性黄斑病变的进展及其相关因素。

方法

本回顾性观察性病例系列研究对照片上的生物测量眼底特征进行形态测量。近视性黄斑病变的定义采用病理性近视研究组的荟萃分析建议。

结果

本研究共纳入 274 名儿童(平均年龄:11.7 ± 2.5 岁;平均屈光度:-7.66 ± 1.87 屈光度[D]),平均随访时间为 4.9 ± 1.2 年。52 只眼(18.9%;95%置信区间[CI]:14.3-23.7%)检测到近视性黄斑病变进展。多变量分析显示,近视性黄斑病变进展与屈光度下降(比值比[OR]:0.72;95%CI:0.56-0.92;P<0.001)(即更高的近视化)和视盘旁伽马区扩大(OR:7.68;95%CI:1.63-36.2;P=0.002)相关。236 只眼中有 47 只(20.0%;95%CI:14.8-25.2%)出现新发性视盘周围弥漫性脉络膜萎缩,与屈光度下降(OR:0.70;95%CI:0.54-0.92;P=0.009)(即更高的近视化)和更大的伽马区扩大(OR:8.28;95%CI:1.33-51.7;P=0.02)相关。

结论

学龄儿童的近视可能有相当大的进展为近视性黄斑病变的风险。视盘旁伽马区扩大是主要的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb7c/8210785/b7ce99b9ca97/retina-41-1502-g001.jpg

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