He Jingxin, Lian Zhangkai, Cao Qianzhong, Liu Zhenzhen, Young Charlotte Aimee, Zhang Xinyu, Zheng Danying, Jin Guangming
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China.
Department of Ophthalmology, Third Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China.
J Ophthalmol. 2022 Jun 7;2022:4032283. doi: 10.1155/2022/4032283. eCollection 2022.
To investigate the longitudinal changes and associated factors of axial length (AL) in congenital ectopia lentis (CEL) patients.
In this retrospective study, medical records of CEL patients were reviewed from January 2014 to December 2019 at the Zhongshan Ophthalmic (ZOC) in China. Patients were divided into the surgery group and the nonsurgery group. Data of refractive power, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) as well as ocular biometrics including AL, corneal curvature, white-to-white (WTW), and central corneal thickness (CCT) were collected at baseline and each follow-up visit. Multiple linear regression was performed to assess the potential associated factors for axial length growth in congenital ectopia lentis patients.
Compared with the nonsurgery group, the change rate of AL among children aged 3 to 6 years old was slower in the surgery group (0.443 ± 0.340 mm/year vs. 0.278 ± 0.227 mm/year, < 0.05). However, no statistically significant difference for the change rate of AL was detected between the surgery group and the nonsurgery group ( > 0.05) among patients aged 7 years or older. For the surgery group, the results of the linear regression model showed that a higher change rate of AL was associated with younger age (older age: = -0.009, 95% CI: -0.014 to -0.003, and =0.002) and worse baseline BCVA (logMAR) ( = 0.256, 95% CI: 0.072 to 0.439, and =0.007). As for the nonsurgery group, younger baseline age (older age: = -0.027, 95% CI: -0.048 to -0.007, and =0.01) and longer baseline AL ( = 0.073, 95% CI: 0.023 to 0.122, and =0.006) were associated with a higher change rate of AL.
The AL change rate was clearly associated with age both in the surgery group and in the nonsurgery group. Intervention strategies such as surgery should be performed earlier for CEL that meets the surgical criteria. Worse baseline BCVA and longer baseline AL are associated factors that would affect the growth rate of AL in the surgery and nonsurgery group, respectively.
探讨先天性晶状体异位（CEL）患者眼轴长度（AL）的纵向变化及相关因素。
在这项回顾性研究中，回顾了2014年1月至2019年12月期间中国中山眼科中心（ZOC）的CEL患者的病历。患者分为手术组和非手术组。在基线和每次随访时收集屈光力、最佳矫正视力（BCVA）、眼压（IOP）以及包括眼轴长度、角膜曲率、白对白（WTW）和中央角膜厚度（CCT）在内的眼部生物测量数据。进行多元线性回归以评估先天性晶状体异位患者眼轴长度增长的潜在相关因素。
与非手术组相比，手术组中3至6岁儿童的眼轴长度变化率较慢（0.443±0.340毫米/年对0.278±0.227毫米/年，P<0.05）。然而，在7岁及以上的患者中，手术组和非手术组之间的眼轴长度变化率未检测到统计学上的显著差异（P>0.05）。对于手术组，线性回归模型的结果显示，较高的眼轴长度变化率与较年轻的年龄相关（年龄较大：β=-0.009，95%CI：-0.014至-0.003，P=0.002）以及较差的基线BCVA（logMAR）相关（β=0.256，95%CI：0.072至0.439，P=0.007）。至于非手术组，较年轻的基线年龄（年龄较大：β=-0.027，95%CI：-0.048至-0.007，P=0.01）和较长的基线眼轴长度（β=0.073，95%CI：0.023至0.122，P=0.006）与较高的眼轴长度变化率相关。
手术组和非手术组的眼轴长度变化率均与年龄明显相关。对于符合手术标准的CEL患者，应尽早实施手术等干预策略。较差的基线BCVA和较长的基线眼轴长度分别是影响手术组和非手术组眼轴长度增长率的相关因素。
