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[儿童及青少年周边视网膜离焦的分布特征研究]

[A study on the distribution characteristics of peripheral retinal defocus in children and adolescents].

作者信息

Zheng X H, Shi H L, You J X, Li Y S, Li C R

机构信息

Department of Ophthalmology, The People's Hospital of Lincang, Lincang 677000, China.

Department of Ophthalmology, the First Affiliated Hospital of Dali University, Dali 671000, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2024 Apr 11;60(4):337-342. doi: 10.3760/cma.j.cn112142-20231025-00185.

Abstract

To explore the distribution characteristics of peripheral retinal defocus in children and adolescents. This cross-sectional study included 500 individuals aged 3 to 18 years, who visited the People's Hospital of Lincang, the First Affiliated Hospital of Dali University and Dali Ophthalmology Hospital between January and December 2021. Data of the right eye of each participant was analyzed. There were 226 males (45.20%) and 274 females (54.80%), with an average age of (10.79±3.79) years. All participants underwent post-cycloplegic refraction, optical biometry, and intraocular pressure measurement to obtain spherical equivalent, average corneal curvature, axial length, and intraocular pressure. Multispectral refraction topography was performed to obtain topographic maps and values at various field angles and orientations of peripheral retinal defocus. Based on multispectral refraction topography, peripheral retinal defocus values were categorized as crater type, hemilateral upturn type, saddle type, and relatively flat type. The distribution of different refractive states was analyzed. The spherical equivalent of the 500 participants was(-1.51±2.61) D, axial length was (24.10±1.28) mm, and average corneal curvature was (43.20±1.22) D. Among the 500 eyes, 382 exhibited hyperopic peripheral retinal defocus values, with 316 eyes (82.72%) being myopic. Myopic peripheral retinal defocus values were observed in 118 eyes, with 15 eyes (12.72%) being myopic. Among different types of peripheral retinal defocus values, 112 eyes (22.4%) exhibited a crater type, 153 eyes (30.6%) exhibited a hemilateral upturn type, 107 eyes (21.4%) exhibited a saddle type, and 128 eyes (25.6%) exhibited a flat type. The proportion of myopia was 82.14% (92 eyes), 69.28% (106 eyes), 60.75% (65 eyes), and 3.90% (5 eyes), respectively. The peripheral retinal defocus values at 15°, 30°, and 45° were (0.01±0.08) D, (0.06±0.21) D, and (0.20±0.37) D, respectively. The peripheral retinal defocus values at temporal, inferior, nasal, and superior locations were (0.58±0.69) D, (0.52±0.63) D, (0.21±0.64) D, and (-0.26±0.67) D, respectively. Notably, the superior primarily manifested as myopic, while the others were predominantly hyperopic. Approximately three-fourths of children and adolescents exhibit hyperopic peripheral retinal defocus values, with a higher prevalence of myopia in this subgroup. The hyperopia peripheral retinal defocus value increases with the distance from the retina to the macula. The peripheral retinal defocus values between superior and inferior, nasal and temporal locations are asymmetrical, with the temporal hyperopic peripheral retinal defocus value being most prominent and the superior myopic peripheral retinal defocus value being most evident.

摘要

探讨儿童及青少年周边视网膜离焦的分布特征。这项横断面研究纳入了500名年龄在3至18岁之间的个体,他们于2021年1月至12月期间就诊于临沧市人民医院、大理大学第一附属医院和大理眼科医院。对每位参与者的右眼数据进行分析。其中男性226名(45.20%),女性274名(54.80%),平均年龄为(10.79±3.79)岁。所有参与者均接受了睫状肌麻痹后验光、光学生物测量和眼压测量,以获取等效球镜度、平均角膜曲率、眼轴长度和眼压。进行多光谱屈光地形图检查,以获取周边视网膜离焦在不同视野角度和方位的地形图及数值。基于多光谱屈光地形图,周边视网膜离焦值分为火山口型、半侧上翻型、马鞍型和相对平坦型。分析不同屈光状态的分布情况。500名参与者的等效球镜度为(-1.51±2.61)D,眼轴长度为(24.10±1.28)mm,平均角膜曲率为(43.20±1.22)D。在这500只眼中,382只表现为远视性周边视网膜离焦值,其中316只眼(82.72%)为近视。118只眼观察到近视性周边视网膜离焦值,其中15只眼(12.72%)为近视。在不同类型的周边视网膜离焦值中,112只眼(22.4%)表现为火山口型,153只眼(30.6%)表现为半侧上翻型,107只眼(21.4%)表现为马鞍型,128只眼(25.6%)表现为平坦型。近视的比例分别为82.14%(92只眼)、69.28%(106只眼)、60.75%(65只眼)和3.90%(5只眼)。15°、30°和45°处的周边视网膜离焦值分别为(0.01±0.08)D、(0.06±0.21)D和(0.20±0.37)D。颞侧、下方、鼻侧和上方位置的周边视网膜离焦值分别为(0.58±0.69)D、(0.52±0.63)D、(0.21±0.64)D和(-0.26±0.67)D。值得注意的是,上方主要表现为近视,而其他方位主要为远视。约四分之三的儿童及青少年表现为远视性周边视网膜离焦值,该亚组中近视患病率较高。远视性周边视网膜离焦值随视网膜至黄斑距离的增加而增大。上方与下方、鼻侧与颞侧位置的周边视网膜离焦值不对称,颞侧远视性周边视网膜离焦值最为突出,上方近视性周边视网膜离焦值最为明显。

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