框架眼镜与角膜塑形镜矫正的近视儿童脉络膜厚度差异比较研究
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摘要
目的应用光学相干断层扫描(optical coherence tomography,OCT)在水平方向上进行近视儿童脉络膜厚度区域性厚度分析,比较首诊发现近视的儿童与OK镜戴镜1 a以上儿童脉络膜厚度差异。方法回顾性分析就诊于我院的低至中度近视(-1.00~-6.00 D)近视儿童,对其中进行OCT脉络膜图像采集的68位儿童进行研究,其中首诊发现近视并以框架眼镜矫正的34人,持续配戴用OK镜1 a以上的34人,仅分析右眼数据。以自行编制的软件以500μm为间隔分析以黄斑中心凹为中心共3.5 mm范围内的脉络膜图像,分为7区进行统计。单因素方差分析比较每组各区域间的脉络膜厚度差异,以配对t检验比较两组间脉络膜厚度差异。结果 OK镜组年龄为(12.3±1.8)岁,框架镜组年龄(11.8±1.4)岁,两组间差异无统计学意义。OK镜组各区域脉络膜厚度分别为:颞侧3区(296.7±61.8)μm,颞侧2区(290.7±58.9)μm,颞侧1区(285.7±57.4)μm,黄斑中心凹区(278.5±57.7)μm,鼻侧1区:(262.2±57.9)μm,鼻侧2区(239.8±59.7)μm,鼻侧3区(214.7±59.0)μm;框架镜组分别为:颞侧3区(294.2±45.4)μm,颞侧2区(292.0±44.0)μm,颞侧1区(283.6±45.5)μm,黄斑中心凹区(272.0±51.6)μm,鼻侧1区(255.2±56.3)μm,鼻侧2区(236.5±58.1)μm,鼻侧3区(212.8±57.7)μm。两组都是颞侧脉络膜比鼻侧更厚,差异均有统计学意义(均为P<0.05)。而两组间在各个区域上的脉络膜厚度差异均无统计学意义(均为P>0.05)。结论近视儿童的脉络膜厚度呈区域性差异分布,在水平方向上颞侧脉络膜最厚,鼻侧最薄。干预时间超过1 a的OK镜组儿童与近视屈光度匹配的初次戴框架镜儿童之间脉络膜厚度无明显差异。
Objective To investigate choroid thickness at horizontal meridian with optical coherence tomography( OCT) and compare the choroid thickness difference between first visit myopia children with those children who wear orthokeratology lens for more than 1 year. Methods This retrospective study enrolled 68 myopia children with low to moderate myopia(-1.00--6. 00 D) who visited our hospital and took choroid images by OCT. The total subjects were divided into 2 groups. The subjects of 34 children in group 1 visited for myopia initially and wear spectacles. The other one group wear orthokeratology lens more than 1 year. Only the data of right eye were analyzed. Scans through the fovea at horizontal meridian were acquired with OCT. Choroid images were detected by custom software with 500 μm intervals up to 3. 5 mm around fovea. Choroid thickness( CT) was calculated based on the average of the 7 zones. Statistical analysis was performed to evaluate choroid thickness at each zone. ANOVA was used to compare choroid thickness differences between various zones in each group. Paired t test was used to compare choroid thickness difference at the same zone between two groups. Results The mean age of OK lens group was( 12. 3 ± 1. 8) years old, and the spectacles group was( 11. 8 ± 1. 4)years old,there was no statistical difference. From temple to nasal choroid,the mean CT of the orthokeratology lens group were( 296. 7 ± 61. 8) μm( T3),( 290. 7 ± 58. 9) μm( T2),( 285. 7± 57. 4) μm( T1),( 278. 5 ± 57. 7) μm( M),( 262. 2 ± 57. 9) μm( N1),( 239. 8 ± 59. 7) μm( N2),( 214. 7 ± 59. 0) μm( N3); And the mean CT of the spectacles group were( 294. 2 ±45. 4) μm( T3),( 292. 0 ± 44. 0) μm( T2),( 283. 6 ± 45. 5) μm( T1),( 272. 0 ± 51. 6) μm( M),( 255. 2 ± 56. 3) μm( N1),( 236. 5 ± 58. 1) μm( N2),( 212. 8 ± 57. 7) μm( N3), respectively.The thicknesses were significantly thicker in temple zones than that in nasal zones in each group( all P < 0. 05),but the CT was not significantly different between the two groups in each zone( all P > 0. 05). Conclusion The choroid thickness has regional deference in myopia children,the thickest is in the temple and the thinnest in the nasal region. There is no significant difference between the children who initially corrected by spectacles and those who wear OK lens more than 1 year.
Objective To investigate choroid thickness at horizontal meridian with optical coherence tomography( OCT) and compare the choroid thickness difference between first visit myopia children with those children who wear orthokeratology lens for more than 1 year. Methods This retrospective study enrolled 68 myopia children with low to moderate myopia(-1.00--6. 00 D) who visited our hospital and took choroid images by OCT. The total subjects were divided into 2 groups. The subjects of 34 children in group 1 visited for myopia initially and wear spectacles. The other one group wear orthokeratology lens more than 1 year. Only the data of right eye were analyzed. Scans through the fovea at horizontal meridian were acquired with OCT. Choroid images were detected by custom software with 500 μm intervals up to 3. 5 mm around fovea. Choroid thickness( CT) was calculated based on the average of the 7 zones. Statistical analysis was performed to evaluate choroid thickness at each zone. ANOVA was used to compare choroid thickness differences between various zones in each group. Paired t test was used to compare choroid thickness difference at the same zone between two groups. Results The mean age of OK lens group was( 12. 3 ± 1. 8) years old, and the spectacles group was( 11. 8 ± 1. 4)years old,there was no statistical difference. From temple to nasal choroid,the mean CT of the orthokeratology lens group were( 296. 7 ± 61. 8) μm( T3),( 290. 7 ± 58. 9) μm( T2),( 285. 7± 57. 4) μm( T1),( 278. 5 ± 57. 7) μm( M),( 262. 2 ± 57. 9) μm( N1),( 239. 8 ± 59. 7) μm( N2),( 214. 7 ± 59. 0) μm( N3); And the mean CT of the spectacles group were( 294. 2 ±45. 4) μm( T3),( 292. 0 ± 44. 0) μm( T2),( 283. 6 ± 45. 5) μm( T1),( 272. 0 ± 51. 6) μm( M),( 255. 2 ± 56. 3) μm( N1),( 236. 5 ± 58. 1) μm( N2),( 212. 8 ± 57. 7) μm( N3), respectively.The thicknesses were significantly thicker in temple zones than that in nasal zones in each group( all P < 0. 05),but the CT was not significantly different between the two groups in each zone( all P > 0. 05). Conclusion The choroid thickness has regional deference in myopia children,the thickest is in the temple and the thinnest in the nasal region. There is no significant difference between the children who initially corrected by spectacles and those who wear OK lens more than 1 year.
引文
[1]LIN HJ,WAN L,TSAI FJ,TSAI YY,CHEN LA,TSAI AL,et al.Overnight orthokeratology is comparable with atropine in controlling myopia[J].BMC Ophthalmol,2014,14(1):40.
[2]LIU HH,XU L,WANG YX,WANG S,YOU QS,JONAS JB.Prevalence and progression of myopic retinopathy in Chinese adults:the Beijing Eye Study[J].Ophthalmology,2010,117(9):1763-1768.
[3]CHO P,CHEUNG SW,MOUNTFORD J,WHITE P.Good clinical practice in orthokeratology[J].Cont Lens Anterior Eye,2008,31(1):17-28.
[4]WALLINE JJ,RAH MJ,JONES LA.The Children’s overnight orthokeratology investigation(COOKI)pilot study[J].Optom Vis Sci,2004,81(6):407-413.
[5]SWARBRICK HA,WONG G,O’LEARY DJ.Corneal response to orthokeratology[J].Optom Vis Sci,1998,75(11):791-799.
[6]NICHOLS JJ,MARSICH MM,NGUYEN M,BARR JT,BULLIMOREMA.Overnight orthokeratology[J].Optom Vis Sci,2000,77(5):252-259.
[7]CHAN B,CHO P,CHEUNG SW.Orthokeratology practice in children in a university clinic in Hong Kong[J].Clin Exp Optom,2008,91(5):453-460.
[8]GIFFORD P,LI M,LU H,MIU J,PANJAYA M,SWARBRICKHA.Corneal versus ocular aberrations after overnight orthokeratology[J].Optom Vis Sci,2013,90(5):439-447.
[9]READ SA,COLLINS MJ,VINCENT SJ,ALONSO-CANEIROD.Choroidal thickness in myopic and nonmyopic children assessed with enhanced depth imaging optical coherence tomography[J].Invest Ophthalmol Vis Sci,2013,54(12):7578-7586.
[10]FUJIWARA A,SHIRAGAMI C,SHIRAKATA Y,MANABES,IZUMIBATA S,SHIRAGA F.Enhanced depth imaging spectraldomain optical coherence tomography of subfoveal choroidal thickness in normal Japanese eyes[J].Jpn J Ophthalmol,2012,56(3):230-235.
[11]MANJUNATH V,TAHA M,FUJIMOTO JG,DUKER JS.Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography[J].Am J Ophthalmol,2010,150(3):325-329.
[12]IKUNO Y,KAWAGUCHI K,NOUCHI T,YASUNO Y.Choroidal thickness in healthy Japanese subjects[J].Invest Ophthalmol Vis Sci,2010,51(4):2173-2176.
[13]DING X,LI J,ZENG J,MA W,LIU R,LI T,et al.Choroidal thickness in healthy Chinese subjects[J].Invest Ophthalmol Vis Sci,2011,52(13):9555-9560.
[14]READ SA,COLLINS MJ,VINCENT SJ,ALONSO-CANEIROD.Choroidal thickness in childhood[J].Invest Ophthalmol Vis Sci,2013,54(5):3586-3593.
[15]CHAKRABORTY R,READ SA,COLLINS MJ.Diurnal variations in axial length,choroidal thickness,intraocular pressure,and ocular biometrics[J].Invest Ophthalmol Vis Sci,2011,52(8):5121-5129.
[16]HUA R,LIU L,LI C,CHEN L.Evaluation of the effects of photodynamic therapy on chronic central serous chorioretinopathy based on the mean choroidal thickness and the lumen area of abnormal choroidal vessels[J].Photodiagnosis Photodyn Ther,2014,11(4):519-525.
[17]MWANZA JC,SAYYAD FE,BANITT MR,BUDENZ DL.Effect of pupil dilation on macular choroidal thickness measured with spectral domain optical coherence tomography in normal and glaucomatous eyes[J].Int Ophthalmol,2013,33(4):335-341.
[18]HUNG LF,WALLMAN J,SMITH EL,3RD.Vision-dependent changes in the choroidal thickness of macaque monkeys[J].Invest Ophthalmol Vis Sci,2000,41(6):1259-1269.
[19]TROILO D,NICKLA DL,WILDSOET CF.Choroidal thickness changes during altered eye growth and refractive state in a primate[J].Invest Ophthalmol Vis Sci,2000,41(6):1249-1258.
[20]SUMMERS JA.The choroid as a sclera growth regulator[J].Exp Eye Res,2013,114(9):120-127.
[21]HUANG W,WANG W,ZHOU M,CHEN S,GAO X,FANQ,et al.Peripapillary choroidal thickness in healthy Chinese subjects[J].BMC Ophthalmol,2013,13(1):23.
[22]MARGOLIS R,SPAIDE RF.A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes[J].Am J Ophthalmol,2009,147(5):811-815.
[23]MAY CA.Non-vascular smooth muscle cells in the human choroid:distribution,development and further characterization[J].JAnat,2005,207(4):381-390.
[2]LIU HH,XU L,WANG YX,WANG S,YOU QS,JONAS JB.Prevalence and progression of myopic retinopathy in Chinese adults:the Beijing Eye Study[J].Ophthalmology,2010,117(9):1763-1768.
[3]CHO P,CHEUNG SW,MOUNTFORD J,WHITE P.Good clinical practice in orthokeratology[J].Cont Lens Anterior Eye,2008,31(1):17-28.
[4]WALLINE JJ,RAH MJ,JONES LA.The Children’s overnight orthokeratology investigation(COOKI)pilot study[J].Optom Vis Sci,2004,81(6):407-413.
[5]SWARBRICK HA,WONG G,O’LEARY DJ.Corneal response to orthokeratology[J].Optom Vis Sci,1998,75(11):791-799.
[6]NICHOLS JJ,MARSICH MM,NGUYEN M,BARR JT,BULLIMOREMA.Overnight orthokeratology[J].Optom Vis Sci,2000,77(5):252-259.
[7]CHAN B,CHO P,CHEUNG SW.Orthokeratology practice in children in a university clinic in Hong Kong[J].Clin Exp Optom,2008,91(5):453-460.
[8]GIFFORD P,LI M,LU H,MIU J,PANJAYA M,SWARBRICKHA.Corneal versus ocular aberrations after overnight orthokeratology[J].Optom Vis Sci,2013,90(5):439-447.
[9]READ SA,COLLINS MJ,VINCENT SJ,ALONSO-CANEIROD.Choroidal thickness in myopic and nonmyopic children assessed with enhanced depth imaging optical coherence tomography[J].Invest Ophthalmol Vis Sci,2013,54(12):7578-7586.
[10]FUJIWARA A,SHIRAGAMI C,SHIRAKATA Y,MANABES,IZUMIBATA S,SHIRAGA F.Enhanced depth imaging spectraldomain optical coherence tomography of subfoveal choroidal thickness in normal Japanese eyes[J].Jpn J Ophthalmol,2012,56(3):230-235.
[11]MANJUNATH V,TAHA M,FUJIMOTO JG,DUKER JS.Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography[J].Am J Ophthalmol,2010,150(3):325-329.
[12]IKUNO Y,KAWAGUCHI K,NOUCHI T,YASUNO Y.Choroidal thickness in healthy Japanese subjects[J].Invest Ophthalmol Vis Sci,2010,51(4):2173-2176.
[13]DING X,LI J,ZENG J,MA W,LIU R,LI T,et al.Choroidal thickness in healthy Chinese subjects[J].Invest Ophthalmol Vis Sci,2011,52(13):9555-9560.
[14]READ SA,COLLINS MJ,VINCENT SJ,ALONSO-CANEIROD.Choroidal thickness in childhood[J].Invest Ophthalmol Vis Sci,2013,54(5):3586-3593.
[15]CHAKRABORTY R,READ SA,COLLINS MJ.Diurnal variations in axial length,choroidal thickness,intraocular pressure,and ocular biometrics[J].Invest Ophthalmol Vis Sci,2011,52(8):5121-5129.
[16]HUA R,LIU L,LI C,CHEN L.Evaluation of the effects of photodynamic therapy on chronic central serous chorioretinopathy based on the mean choroidal thickness and the lumen area of abnormal choroidal vessels[J].Photodiagnosis Photodyn Ther,2014,11(4):519-525.
[17]MWANZA JC,SAYYAD FE,BANITT MR,BUDENZ DL.Effect of pupil dilation on macular choroidal thickness measured with spectral domain optical coherence tomography in normal and glaucomatous eyes[J].Int Ophthalmol,2013,33(4):335-341.
[18]HUNG LF,WALLMAN J,SMITH EL,3RD.Vision-dependent changes in the choroidal thickness of macaque monkeys[J].Invest Ophthalmol Vis Sci,2000,41(6):1259-1269.
[19]TROILO D,NICKLA DL,WILDSOET CF.Choroidal thickness changes during altered eye growth and refractive state in a primate[J].Invest Ophthalmol Vis Sci,2000,41(6):1249-1258.
[20]SUMMERS JA.The choroid as a sclera growth regulator[J].Exp Eye Res,2013,114(9):120-127.
[21]HUANG W,WANG W,ZHOU M,CHEN S,GAO X,FANQ,et al.Peripapillary choroidal thickness in healthy Chinese subjects[J].BMC Ophthalmol,2013,13(1):23.
[22]MARGOLIS R,SPAIDE RF.A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes[J].Am J Ophthalmol,2009,147(5):811-815.
[23]MAY CA.Non-vascular smooth muscle cells in the human choroid:distribution,development and further characterization[J].JAnat,2005,207(4):381-390.