成人单侧高度近视的临床特征和自然发展:一项比较研究

IF 3.2 Q1 OPHTHALMOLOGY
Dong Geun Kim MD , Seok Hyun Bae MD , Dong Ju Kim MD , Jong Suk Lee MD , Kwangsic Joo MD, PhD , Sang Jun Park MD, PhD , Se Joon Woo MD, PhD , Kyu Hyung Park MD, PhD
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引用次数: 0

摘要

目的探讨并比较单侧高度近视(UHM)和双侧高度近视(BHM)患者视轴长度(AL)的临床特征。设计:回顾性队列研究。参与者:2011年3月至2021年8月期间诊断为UHM或BHM的成年患者。方法单侧高度近视定义为一只眼AL≥26 mm,另一只眼AL≥26 mm,两者差异≥2 mm。双侧高度近视定义为双眼AL≥26 mm,差异≤3 mm。在每个患者中,AL较长的眼睛被指定为“较长眼睛”,另一只被指定为“较短眼睛”。我们分析了临床特征的差异,包括眼科病史、最佳矫正视力、眼部生物测量和近视黄斑病变等级。近视黄斑病变是根据萎缩,牵引和新血管形成使用已知的方法分级。长期特征包括近视新生血管性黄斑病变和近视牵拉性黄斑病变的治疗和AL随时间的变化。主要观察指标:UHM组与BHM组临床特征比较。结果我们分析了369例患者(79例UHM, 290例BHM),中位随访期为4.5年。UHM组的女性比例高于BHM组(88.8%比76.2%,P = 0.025)。与BHM组的长眼相比,UHM组的最佳矫正视力较差(最小分辨角的对数为0.8±0.6比0.6±0.6,P <;0.001),尽管AL较短(29.1±1.6 mm比30.6±1.9 mm), P <;0.001)。在AL变化的分析中,UHM组的短眼没有随着时间的推移而延长(0.014 mm/年,P = 0.12),而UHM组的长眼和BHM组的双眼则不同(0.049-0.071 mm/年,P <;0.01)。结论成人UHM患者多缺乏相关环境因素。UHM患者的长眼视力较差,这不能用结构异常来解释,这表明眼间差异可能起源于儿童早期。在随访期间,UHM组的长眼和BHM组的双眼的AL伸长和近视并发症发生率相似。同时,在UHM组的短眼中没有观察到这种变化。进一步调查潜在的机制,如导致这种极端不对称的遗传因素,是必要的。财务披露作者在本文中讨论的任何材料中没有专有或商业利益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Features and Natural Progression of Unilateral High Myopia in Adults: A Comparison Study

Purpose

To investigate and compare the clinical characteristics of patients with unilateral high myopia (UHM) and bilateral high myopia (BHM) based on axial length (AL).

Design

A retrospective cohort study.

Participants

Adult patients diagnosed with UHM or BHM between March 2011 and August 2021.

Methods

Unilateral high myopia was defined as ≥26 mm AL in 1 eye and <26 mm in the other, with ≥2 mm difference. Bilateral high myopia was defined as ≥26 mm AL in both eyes, with ≤3 mm difference. In each patient, the eye with the longer AL was designated the “longer eye” and the other the “shorter eye.” We analyzed differences in clinical features, including ophthalmic history, best-corrected visual acuity, ocular biometry, and myopic maculopathy grade. Myopic maculopathy was graded based on atrophy, traction, and neovascularization using a known method. Long-term features included treatments for myopic neovascular maculopathy and myopic tractional maculopathy and AL change over time.

Main Outcome Measures

Comparison of clinical characteristics between UHM and BHM groups.

Results

We analyzed 369 patients (79 with UHM and 290 with BHM) with a median follow-up period of 4.5 years. The UHM group had a higher proportion of women than the BHM group (88.8% vs. 76.2%, P = 0.025). Compared with longer eyes in the BHM group, those in the UHM group had worse best-corrected visual acuity (0.8 ± 0.6 vs. 0.6 ± 0.6 in logarithm of the minimum angle of resolution, P < 0.001) despite having shorter AL (29.1 ± 1.6 mm vs. 30.6 ± 1.9 mm, P < 0.001). In the analysis of AL changes, shorter eyes in the UHM group showed no elongation over time (0.014 mm/year, P = 0.12), unlike the longer eyes in UHM and both eyes in BHM (0.049–0.071 mm/year, P < 0.01).

Conclusions

Adult UHM patients mostly lacked associated environmental factors. The poorer visual acuity in the longer eyes of UHM patients, which cannot be explained by structural abnormalities, suggests that the interocular difference may have originated in early childhood. During the follow-up period, AL elongation and myopic complications occurred at similar rates in the longer eye of UHM and both eyes of BHM. Meanwhile, such changes were not observed in the shorter eye in UHM. Further investigation of the underlying mechanisms, such as the genetic factors contributing to this extreme asymmetry, is warranted.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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来源期刊
Ophthalmology science
Ophthalmology science Ophthalmology
CiteScore
3.40
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