Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.
Acta Ophthalmol. 2022 Dec;100(8):e1708-e1718. doi: 10.1111/aos.15187. Epub 2022 May 25.
The aim of this study was to investigate the association between morphological characteristics of Bruch's membrane opening distance (BMOD), border length (BL), border tissue angle (BTA), peripapillary atrophy (PPA) as well as axial length (AL) and incident decreased macular choroidal thickness (mChT) in young healthy myopic eyes.
A total of 323 participants aged 17-30 years were included in the current 2-year longitudinal study. Each participant underwent detailed ocular examinations at baseline and follow-up. Data of AL, refraction error, PPA area, BMOD, BL, BTA and mChT were measured individually. Incident decreased mChT was defined as follow-up mChT of participants decreased into the lowest quartile of baseline mChT.
Subjects with longer AL, longer BMOD were more likely to have incident decreased mChT (odds ratio [OR], 1.56; 2.09, respectively, per 1 Z-score increment), whereas larger BTA was less likely to develop decreased mChT (odds ratio [OR], 0.51, per 1 Z-score increment). The area under the receiver operating curve (AUROC) of basic risk model for incident decreased mChT was 0.6284. After adding BMOD, BTA and AL separately to the basic risk model, the AUROC of the combination could reach 0.6967, 0.6944 and 0.7383, respectively. After combining BMOD, BTA and AL to the basic model, the AUROC of the combination showed the highest AUROC of 0.7608.
Bruch's membrane opening distance and AL are significant risk factors for incident decreased mChT, whereas BTA played protective role in the deterioration of mChT. In addition, a combination of BMOD, BTA and AL could serve as earlier predictors of the attenuation of mChT in myopia progression.
本研究旨在探讨青年近视人群中脉络膜视网膜神经纤维层（RNFL）神经纤维层厚度（RNFLT）、盘沿长度（PL）、盘沿组织角度（PTA）、视盘周围萎缩（PPA）以及眼轴长度（AL）与黄斑脉络膜厚度（mChT）下降的关系。
本研究共纳入 323 名年龄在 17-30 岁之间的参与者，他们参加了一项为期 2 年的纵向研究。每位参与者在基线和随访时都接受了详细的眼部检查。单独测量了 AL、屈光不正、PPA 面积、BMOD、BL、BTA 和 mChT 数据。将随访时 mChT 降低到基线 mChT 最低四分位数的参与者定义为发生 mChT 下降。
AL 较长和 BMOD 较长的受试者发生 mChT 下降的可能性更大（优势比[OR]分别为 1.56 和 2.09，每增加 1 个 Z 分数增量），而较大的 PTA 发生 mChT 下降的可能性较小（OR，0.51，每增加 1 个 Z 分数增量）。用于预测 mChT 下降的基本风险模型的受试者工作特征曲线（ROC）下面积（AUROC）为 0.6284。在基本风险模型中分别加入 BMOD、BTA 和 AL 后，其 AUROC 分别达到 0.6967、0.6944 和 0.7383。将 BMOD、BTA 和 AL 结合到基本模型中后，组合模型的 AUROC 显示出最高的 AUROC 为 0.7608。
BMOD 和 AL 是 mChT 下降的重要危险因素，而 PTA 在 mChT 恶化中起保护作用。此外，BMOD、BTA 和 AL 的组合可作为近视进展中 mChT 衰减的早期预测指标。
