高度近视合并青光眼患者黄斑区脉络膜厚度的多元回归分析

摘要

Abstract? AIM: To evaluate the characteristic of choroidal thickness ( CT ) in highly myopic glaucoma eyes, and investigate the factors that affect the CT in various regions of the macula.?METHODS: Thirty -two highly myopic eyes of 18 patients with primary open angle glaucoma ( POAG ) , 36 non-highly myopic eyes of 20 patients with POAG, and 33 non -glaucoma highly myopic eyes of 21 matched volunteers were enrolled.CT at subfoveal, and 1mm and 3mm nasal, temporal, superior, and inferior to the fovea was measured using enhanced depth imaging coherence tomography. Multiple linear regression analyses were performed to detect the effects of diagnosis, spherical equivalent ( SE) , age, intraocular pressure ( IOP) , central corneal thickness ( CCT ) , and mean deviation ( MD ) of visual field defect on CT at all measured points.?RESULTS:The choroid of highly myopic glaucoma eyes was statistically thinner than non -highly myopic glaucoma eyes at various locations (all P0.05 ). Multiple regression analysis showed that SE was the most influential factor on CT in all regions of the macula, and CT varied significantly with age in 3mm superior to fovea ( S3CT ), but not with diagnosis, MD of visual field defect, IOP, or CCT.? CONCLUSION: CT in highly myopic glaucoma is equivalent in comparison with non -glaucoma highly myopia, although it's thinner than that in glaucoma eyes without high myopia.This implies the lack of association between CT and progression of glaucomatous optic neuropathy.%目的：探讨高度近视合并原发性开角型青光眼（ POAG ）患者的黄斑区脉络膜厚度分布特征及影响黄斑区脉络膜厚度的相关因素。方法：研究共纳入高度近视合并POAG患者18例32眼， POAG患者20例36眼，以及高度近视患者21例33眼。采用频域OCT增强深度扫描测定中心凹下（ SFCT ）、距中心凹1 mm和3 mm处上、下、鼻、颞四个方位的脉络膜厚度（S1CT、S3CT、I1CT、I3CT、N1CT、N3CT、T1CT、T3CT）。比较三组间黄斑区脉络膜厚度的差异，并利用多元回归分析对POAG患者的诊断、屈光度、年龄、眼压、角膜厚度、视野缺损等对黄斑区脉络膜厚度的影响进行分析。结果：高度近视合并POAG患者的黄斑区脉络膜厚度较POAG患者在各测量位置均明显变薄（均P＜0．05），但与高度近视患者在各测量点的脉络膜厚度差异均无统计学意义（均P＞0．05）。屈光度是POAG患者黄斑区各测量点脉络膜厚度的主要影响因素，颞侧距中心凹3 mm处的脉络膜厚度（ S3 CT ）受年龄的影响，而诊断、视野缺损、眼压及角膜厚度不是脉络膜厚度的影响因素。结论：高度近视合并POAG患者黄斑区脉络膜厚度比单纯POAG患者薄，但与高度近视患者无统计学差异，黄斑区脉络膜厚度与青光眼性视神经损伤程度无明显关联。