Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Fundus Diseases, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
Br J Ophthalmol. 2024 Feb 21;108(3):405-410. doi: 10.1136/bjo-2022-322165.
BACKGROUND/AIMS: We aim to explore the effect of sympathetic nervous system (SNS) on choroid thickness (ChT) and axial length (AL).
Students of grade 2 and 3 from a primary school were included and followed for 1 year. Visual acuity, refraction, AL and ChT were measured. Morning urine samples were collected for determining SNS activity by analysing concentrations of epinephrine, norepinephrine and dopamine using the liquid chromatography-tandem mass spectrometry. The most important factor (factor 1) was calculated using factor analysis to comprehensively indicate the SNS activity.
A total of 273 students were included, with an average age of 7.77±0.69 years, and 150 (54.95%) were boys. Every 1 µg/L increase in epinephrine is associated with 1.60 µm (95% CI 0.30 to 2.90, p=0.02) decrease in average ChT. Every 1 µg/L increase in norepinephrine is associated with 0.53 µm (95% CI 0.08 to 0.98, p=0.02) decrease in the ChT in inner-superior region. The factor 1 was negatively correlated with the ChT in the superior regions. Every 1 µg/L increase in norepinephrine was associated with 0.002 mm (95% CI 0.0004 to 0.004, p=0.016) quicker AL elongation. The factor 1 was positively correlated with AL elongation (coefficient=0.037, 95% CI 0.005 to 0.070, p=0.023).
We hypothesised that chronic stress characterised by elevated level of the SNS, was associated with significant increase in AL elongation, probably through thinning of the choroid.
背景/目的：本研究旨在探讨交感神经系统（SNS）对脉络膜厚度（ChT）和眼轴长度（AL）的影响。
我们纳入了一所小学的 2 年级和 3 年级学生，并对其进行了为期 1 年的随访。测量了视力、屈光度、AL 和 ChT。采集早晨尿液样本，通过液相色谱-串联质谱法分析肾上腺素、去甲肾上腺素和多巴胺的浓度来测定 SNS 活性。采用因子分析计算出最重要的因素（因子 1），以综合反映 SNS 活性。
共纳入 273 名学生，平均年龄为 7.77±0.69 岁，其中 150 名（54.95%）为男生。肾上腺素每增加 1µg/L，平均 ChT 降低 1.60µm（95%CI 0.30 至 2.90，p=0.02）。去甲肾上腺素每增加 1µg/L，ChT 内上区域降低 0.53µm（95%CI 0.08 至 0.98，p=0.02）。因子 1 与上区域的 ChT 呈负相关。去甲肾上腺素每增加 1µg/L，AL 延长 0.002mm（95%CI 0.0004 至 0.004，p=0.016）。因子 1 与 AL 延长呈正相关（系数=0.037，95%CI 0.005 至 0.070，p=0.023）。
我们假设，以 SNS 水平升高为特征的慢性应激与 AL 延长显著增加有关，这可能是通过脉络膜变薄引起的。
