高度近视人群黄斑视网膜脱离症的患病率、特征和风险因素：2011 年北京眼科研究：高度近视人群中的黄斑视网膜脱离症。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-10-09 DOI:10.1016/j.ajo.2024.10.003

Zhe Pan , Yu Huang , Zihan Li , Wenqing Liu , Ziyao Wang , Chun Zhang , Jost B. Jonas , Ya Xing Wang

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引用次数: 0

摘要

目的：研究中国人群高度近视眼黄斑视网膜脱离症（MRS）的患病率、特征、风险因素及其形态学特征：设计：基于人群的横断面研究：方法：所有参与者均接受了光谱-视网膜成像检查：所有参与者均接受了光谱域光学相干断层扫描，以眼窝为中心进行 30° × 30° 的黄斑立方体扫描：高度近视的定义是屈光不正≤-6 斜度或轴向长度≥ 26.0 mm。根据位置评估是否存在 MRS 及其亚型，并评估受影响的视网膜层。评估了高度近视人群中 MRS 及其亚型的患病率、特征和相关因素：在 213 只高度近视眼（129 名参与者）中，有 48 只眼睛观察到 MRS，每只眼睛的发病率为 22.5%（95%CI：16.9%, 28.6%），36 名参与者的发病率为 27.9%（95%CI：20.5%, 35.7%）。除了年龄较大和近视度数较高这些有据可查的因素外，MRS的患病率还与眼压较高（P=0.013，OR：1.25；95%CI：1.05，1.48）、眼底脉络膜厚度较薄（P=0.006 OR：0.86；95%CI：0.77，0.96）、更宽的伽马区（P=0.003，OR：1.99；95%CI：1.05，3.11）、存在青光眼（P=0.010，OR：3.37；95%CI：1.34，8.48）和存在视网膜外膜（P=0.023，OR：3.13；95%CI：1.17，8.36）。高度近视（P=0.021）和伽马区较宽（P=0.005）的眼睛更容易发生眼窝 MRS。与内视网膜 MRS 相比，青光眼患者的外视网膜 MRS 发生率更高（60.9% 对 36.0%），但差异无统计学意义（P=0.06）。与位于眼窝周围或影响其他区域的MRS相比，位于眼窝区域或影响外层视网膜的MRS与最佳矫正视力（BCVA）明显较差有关（PConclusions.MRS发生率为60.9%对36.0%，差异无统计学意义（P=0.06））：在高度近视的老年人群中，MRS的发病率为27.9%。发生在眼窝区或涉及视网膜外层的 MRS 对 BCVA 有重大影响，因此需要提高警惕。研究结果有助于加深对MRS的理解，为其发病机制和视力预后提供见解。

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Prevalence, Features, and Risk Factors of Macular Retinoschisis in High Myopic Population: The Beijing Eye Study 2011

PURPOSE

To investigate the prevalence, features, and risk factors of macular retinoschisis (MRS) in highly myopic eyes and their morphological features in a Chinese population.

DESIGN

Population-based, cross-sectional study. From the Beijing Eye Study 2011, a total of 213 highly myopic eyes from 129 participants were included.

METHODS

All participants underwent spectral-domain optical coherence tomography with a macula cube scan of 30°×30°centered in the fovea. High myopia was defined as a refractive error ≤–6 diopters or an axial length ≥26.0 mm. MRS presence and its subtypes were assessed based on location, and affected retinal layers were evaluated. Prevalence, features, and associated factors of MRS and its subtypes in highly myopic population were assessed.

RESULTS

Of 213 highly myopic eyes (129 participants), MRS was observed in 48 eyes, with a prevalence of 22.5% (95% CI, 16.9-28.6) per eye, or 36 participants with 27.9% (95% CI, 20.5-35.7) per subject. In addition to well-documented factors such as older age and higher myopia, the prevalence of MRS was found to be related with a higher intraocular pressure (P = .013, odds ratio [OR], 1.25; 95% CI, 1.05-1.48), a thinner subfoveal choroidal thickness (P = .006, OR, 0.86; 95% CI, 0.77-0.96), a wider Gamma zone (P = .003, OR, 1.99; 95% CI, 1.05-3.11), the presence of glaucoma (P = .010, OR, 3.37; 95% CI, 1.34-8.48), and the presence of epiretinal membrane (P = .023, OR, 3.13; 95% CI, 1.17-8.36) after multivariate analysis. Eyes with advanced high myopia (P = .021) and wider gamma zone (P = .005) were more likely to develop foveal MRS. Eyes with glaucoma tended to have a higher prevalence of outer retinal MRS compared with inner retinal MRS (60.9% vs 36.0%), although the difference was not statistically significant (P = .06). MRS located in the foveal region or affecting the outer retina was related with a significantly worse best-corrected visual acuity (BCVA) compared with MRS that was perifoveally located or affected other regions (P < .05).

CONCLUSIONS

The prevalence of MRS was 27.9% among the elderly highly myopic population. MRS occurring in the foveal region or involving the outer retina demands increased vigilance due to its significant impact on BCVA. The findings contribute to a deeper understanding of MRS, offering insights into its mechanisms and vision prognosis.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.