轴性近视对青光眼眼底特征的影响。

The influence of axial myopia on optic disc characteristics of glaucoma eyes.

机构信息

Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0946, USA.

Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

出版信息

Sci Rep. 2021 Apr 23;11(1):8854. doi: 10.1038/s41598-021-88406-1.

Abstract

This study characterizes differences in glaucomatous eyes with and without high axial myopia using custom automated analysis of OCT images. 452 eyes of 277 glaucoma patients were stratified into non (n = 145 eyes), mild (n = 214 eyes), and high axial myopia (axial length (AL) > 26 mm, n = 93 eyes). Optic disc ovality index, tilt and rotation angle of Bruch´s membrane opening (BMO) and peripapillary choroidal thickness (PCT) were calculated using automated and deep learning strategies. High myopic optic discs were more oval and had larger BMO tilt than mild and non-myopic discs (both p < 0.001). Mean PCT was thinnest in high myopic eyes followed by mild and non-myopic eyes (p < 0.001). BMO rotation angle, global retinal nerve fiber layer (RNFL) thickness and BMO-minimum rim width (MRW) were similar among groups. Temporal RNFL was thicker and supranasal BMO-MRW was thinner in high myopic eyes. BMO tilt and PCT showed moderate and temporal RNFL and nasal BMO-MRW showed weak but significant associations with AL in multivariable analyses (all p < 0.05). Large BMO tilt angle and thin PCT are characteristics of highly myopic discs and were not associated with severity of glaucoma. Caution should be exercised when using sectoral BMO-MRW and RNFL thickness for glaucoma management decisions in myopic eyes.

摘要

本研究使用 OCT 图像的定制自动化分析,对伴或不伴高度轴向近视的青光眼眼进行特征描述。将 277 名青光眼患者的 452 只眼分为非(n=145 只眼)、轻度(n=214 只眼)和高度轴向近视(眼轴(AL)>26 毫米,n=93 只眼)。使用自动化和深度学习策略计算视盘椭圆度指数、Bruch 膜开口(BMO)倾斜和旋转角度以及脉络膜厚度(PCT)。高度近视的视盘更椭圆,BMO 倾斜度也大于轻度和非近视的视盘(均 p<0.001)。平均 PCT 在高度近视眼中最薄,其次是轻度近视和非近视眼(均 p<0.001)。BMO 旋转角度、全局视网膜神经纤维层(RNFL)厚度和 BMO 最小 rim 宽度(MRW)在各组之间相似。高度近视眼中颞侧 RNFL 较厚,上方 BMO-MRW 较薄。多变量分析显示,BMO 倾斜度和 PCT 与 AL 呈中度相关,颞侧 RNFL 和鼻侧 BMO-MRW 与 AL 呈弱相关但有统计学意义(均 p<0.05)。大的 BMO 倾斜角度和薄的 PCT 是高度近视盘的特征,与青光眼的严重程度无关。在近视眼中,使用 BMO-MRW 和 RNFL 厚度的扇形分析来进行青光眼管理决策时应谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8931/8065167/47d57da4fad6/41598_2021_88406_Fig1_HTML.jpg

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