He Wenwen, Wei Ling, Liu Shuyu, Huang Zhiqian, Qi Jiao, Zhang Keke, Meng Jiaqi, Du Yu, Lu Yi, Zhu Xiangjia
Department of Ophthalmology, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, 200031, China.
NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
Ophthalmol Ther. 2023 Aug;12(4):2023-2033. doi: 10.1007/s40123-023-00714-z. Epub 2023 May 13.
To evaluate the characteristics of optic nerve head (ONH) in highly myopic eyes and its role in predicting intraocular pressure (IOP) spikes after cataract surgery.
Patients who are highly myopic and were scheduled for cataract surgery were enrolled in this prospective case series study. IOP was measured preoperatively and at 1 day and 3 days postoperatively. ONH characteristics including area, tilt ratio, lamina cribrosa (LC) thickness, and depth, and the presence of LC defects were evaluated with enhanced depth imaging optical coherence tomography. Factors influencing LC defects and early IOP spike were investigated using multivariate stepwise logistic regression.
In total, 200 highly myopic eyes of 200 patients were analyzed: 35.00% had small ONH, 53.00% had ONH tilt, and 14.00% had LC defects. Multivariate analysis demonstrated female patients with larger ONH area and deeper LC tended to have LC defects (all P < 0.05). As to postoperative IOP, IOP change, and incidence of IOP spikes, eyes with small ONH, ONH tilt, and LC defects had similar (all P > 0.05), higher (all P < 0.05), and lower (all P < 0.05) outcomes compared with those without the corresponding characteristic, respectively. Multivariate analysis showed that presence of LC defects and thicker LC were protective factors for early IOP spikes, and axial length > 28 mm was a risk factor (all P < 0.05).
Female patients with larger ONH area and deeper LC tend to have LC defects, which, together with thicker LC, was correlated with less IOP spikes in highly myopic eyes.
This study was conducted as part of a larger project, the Shanghai High Myopia Study, registered at www.
gov (accession number NCT03062085).
评估高度近视眼视神经乳头（ONH）的特征及其在预测白内障手术后眼压（IOP）升高方面的作用。
本前瞻性病例系列研究纳入了计划进行白内障手术的高度近视患者。术前及术后1天和3天测量眼压。使用增强深度成像光学相干断层扫描评估ONH特征，包括面积、倾斜率、筛板（LC）厚度和深度以及LC缺损的存在情况。采用多因素逐步逻辑回归分析影响LC缺损和早期IOP升高的因素。
共分析了200例患者的200只高度近视眼：35.00%的患者ONH较小，53.00%的患者ONH倾斜，14.00%的患者存在LC缺损。多因素分析显示，ONH面积较大且LC较深的女性患者倾向于有LC缺损（所有P<0.05）。关于术后眼压、眼压变化和IOP升高的发生率，与没有相应特征的眼睛相比，ONH较小、ONH倾斜和有LC缺损的眼睛分别具有相似（所有P>0.05）、更高（所有P<0.05）和更低（所有P<0.05）的结果。多因素分析表明，LC缺损的存在和LC较厚是早期IOP升高的保护因素，眼轴长度＞28mm是危险因素（所有P<0.05）。
ONH面积较大且LC较深的女性患者倾向于有LC缺损，这与较厚的LC一起，与高度近视眼较少的IOP升高相关。
本研究作为一个更大项目“上海高度近视研究”的一部分进行，该项目在www.CLINICALTRIALS.gov上注册（注册号NCT03062085）。
