本文選題：光學(xué)相干斷層掃描 + 脈絡(luò)膜厚度��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景隨著科技的進(jìn)步,人們的生活方式有了較大改變,電子產(chǎn)品已走進(jìn)千家萬戶,豐富了人們的生活,但問題隨之而來,目前我國成為了近視人數(shù)最多的國家,近視患者占總?cè)丝诘娜种蛔笥摇＝陙碛捎诓涣嫉挠醚哿?xí)慣,“低頭族”已不僅僅是成年人的專屬,青少年近視的發(fā)病率在逐年增加,近視的發(fā)生、發(fā)展,尤其是高度近視,導(dǎo)致眼部組織發(fā)生一系列變化,如眼軸的拉長、玻璃體的混濁、后鞏膜葡萄腫的發(fā)生、視網(wǎng)膜色素上皮層和脈絡(luò)膜的萎縮等。而脈絡(luò)膜厚度的變化與多種眼底疾病的發(fā)生息息相關(guān),視網(wǎng)膜脫離、脈絡(luò)膜新生血管等等,這些疾病都會(huì)導(dǎo)致視力不可逆性下降甚至失明。一直以來,受醫(yī)療技術(shù)和設(shè)備限制,人們對(duì)于近視的發(fā)生、發(fā)展仍處于不斷探索階段,隨著先進(jìn)設(shè)備的臨床應(yīng)用,人們可以清晰的觀測到近視患者眼后節(jié)的變化,量化脈絡(luò)膜的厚度,為近視的形成與發(fā)展提供更深層次的理論依據(jù)。目的應(yīng)用光學(xué)相干斷層掃描技術(shù)(Optical Coherence Tomography,OCT)測量青少年近視患者黃斑區(qū)域脈絡(luò)膜的厚度,觀察青少年近視患者與正常青少年脈絡(luò)膜厚度的差異,探討低度、中度、高度近視患者不同方位脈絡(luò)膜厚度的變化特點(diǎn),進(jìn)一步分析青少年近視患者黃斑區(qū)域脈絡(luò)膜厚度的變化與屈光度、眼軸長度、眼壓之間的相關(guān)性。方法采用臨床對(duì)照研究。選取2015年9月至2016年9月在我院眼視光中心門診就診和體檢的青少年60例120眼,年齡12~17歲,平均年齡(14.57±1.63)歲,按等效球鏡和裸眼視力及最佳矯正視力把研究對(duì)象分為4組,其中正常組15例30眼(裸眼視力≥1.0),低度近視組15例30眼(-0.50D≤等效球鏡-3.00D,最佳矯正視力≥1.0),中度近視組15例30眼(-3.00D≤等效球鏡-6.00D,最佳矯正視力≥1.0),高度近視組15例30眼(-6.00D≤等效球鏡-10.00D,最佳矯正視力≥0.8)。運(yùn)用蔡司頻域光學(xué)相干斷層掃描儀Cirrus HD OCT(Carl Zeiss Meditrc Inc,4000),采用高清五線光柵,對(duì)黃斑中心凹分別行0°和90°方位加強(qiáng)深度掃描(enhanced depth imaging,EDI),獲取經(jīng)黃斑中心凹下水平和垂直橫斷面圖像,手動(dòng)測量黃斑中心凹下和距黃斑中心凹1000μm、3000μm的鼻側(cè)、顳側(cè)、上方、下方9個(gè)位點(diǎn)脈絡(luò)膜厚度值。所有測量均由兩名經(jīng)驗(yàn)豐富醫(yī)師獨(dú)立完成,分別測量3次,共6次取其平均值為最終參考數(shù)據(jù)。結(jié)果本次研究共選取60例120眼,各組間年齡、性別差異不顯著,無統(tǒng)計(jì)學(xué)意義(P0.05);正常組、低度近視組、中度近視組、高度近視組黃斑中心凹脈絡(luò)膜厚度分別為(347.62±6.00)μm、(300.14±13.85)μm、(234.49±18.71)μm、(183.39±25.12)μm;各組內(nèi)不同位點(diǎn)脈絡(luò)膜厚度差異有統(tǒng)計(jì)學(xué)意義(P0.05);不同組間,低度近視組顳側(cè)1000μm脈絡(luò)膜平均厚度大于正常組顳側(cè)1000μm,正常組顳側(cè)3000μm和低度近視組顳側(cè)3000μm、正常組上方3000μm和低度近視組上方3000μm、正常組下方3000μm和低度近視組下方3000μm、正常組鼻側(cè)3000μm和低度近視組鼻側(cè)3000μm差異無統(tǒng)計(jì)學(xué)意義(P0.05),其余各組間相同位點(diǎn)脈絡(luò)膜厚度差異均有統(tǒng)計(jì)學(xué)意義(P0.05),隨著屈光度越偏向負(fù)值,脈絡(luò)膜厚度越薄;黃斑中心凹脈絡(luò)膜厚度與等效球鏡呈顯著正相關(guān)、與眼軸長度呈顯著負(fù)相關(guān)、與眼壓呈負(fù)相關(guān)。結(jié)論青少年近視患者黃斑區(qū)脈絡(luò)膜厚度隨著屈光度越偏向負(fù)值,脈絡(luò)膜厚度越薄,黃斑中心凹較周邊部變化明顯。青少年近視患者黃斑中心凹脈絡(luò)膜厚度與屈光度呈顯著正相關(guān)、與眼軸長度呈顯著負(fù)相關(guān)、與眼壓呈負(fù)相關(guān)。
[Abstract]:Background with the progress of science and technology, people's way of life has changed greatly, electronic products have entered thousands of households and enrich people's lives, but the problems come with them. At present, our country has become the country with the largest number of myopia, and the myopia patients account for about 1/3 of the total population. In recent years, due to bad eye use habits, "low head family" has already been used. The incidence of myopia is increasing year by year, the incidence of myopia is increasing year by year, the occurrence of myopia, development, especially high myopia, causing a series of changes in ocular tissue, such as the lengthening of the eye axis, the opacity of the vitreous, the occurrence of the staphyloma in the posterior sclera, the atrophy of the retina and the choroid, and the change of the choroid thickness. It is closely related to the occurrence of a variety of fundus diseases, retinal detachment, choroidal neovascularization, and so on. These diseases will cause the decrease of vision irreversibility or even blindness. Since the limitation of medical technology and equipment, the development of myopia is still in the stage of exploration, with the clinical application of advanced equipment, people The changes in the posterior segment of the eye can be clearly observed and the thickness of the choroid can be quantified to provide a deeper theoretical basis for the formation and development of myopia. Objective to use Optical Coherence Tomography (OCT) to measure the choroidal thickness of the macular region of adolescent myopia and to observe the juvenile myopia. The difference of choroidal thickness between the normal and normal adolescents and the characteristics of the different azimuth choroidal thickness of the low, moderate and high myopia patients were discussed. The correlation between the changes of the choroidal thickness in the macular region and the refractive index, the axial length and the intraocular pressure were further analyzed. The clinical control study was conducted in September 2015. In September 2016, 60 teenagers, aged 12~17, aged (14.57 + 1.63) years old, were divided into 4 groups, including 15 cases in normal group 30 eyes (naked eye > 1), 15 in low myopia group and 30 eyes (-0.50D < -3 equivalent sphere -3). .00D, the best corrected visual acuity was more than 1), 15 cases in the moderate myopia group, 30 eyes (-3.00D < -6.00D, the best corrected visual acuity > 1), 15 cases in the high myopia group 30 eyes (-6.00D < -10.00D, the best corrected visual acuity > 0.8). Using Zeiss frequency domain optical coherence tomography Cirrus HD OCT (Carl Zeiss Meditrc Inc, 4000), using high definition five line The enhanced depth imaging (EDI) was performed on the macular central fovea (enhanced depth imaging, EDI) to obtain the horizontal and vertical cross-sectional images of the macular fovea, and to manually measure the choroidal thickness of the nasal, temporal, upper and lower 9 loci of the macular fovea and 1000 mu m to the macular fovea, 3000 mu m. All the measurements were made. Two experienced doctors were completed independently and measured 3 times respectively. The average value of 6 times was taken as the final reference data. Results this study selected 60 cases and 120 eyes. The age of each group was not significant, no significant difference (P0.05); normal group, low myopia group, moderate myopia group, and high myopia group with macular choroid thickness were 3 47.62 + 6) mu m, (300.14 + 13.85) mu m, (234.49 + 18.71) mu m, (183.39 + 25.12) mu m, and the difference of choroidal thickness between the different points in each group was statistically significant (P0.05). The average thickness of the temporal 1000 mu choroidal membrane in the low myopia group was greater than that of the normal temporal side 1000 mu m, and the normal group was on the temporal lateral temporal 3000 mu m in the temporal lateral 3000 and myopia group, and in the normal group, the normal group was on the normal group. 3000 u m and low myopia group were 3000 m above, below the normal group of 3000 mu m and low myopia group 3000 m. There was no statistical difference between the normal group and the nasal side 3000 mu m and the low myopia group (P0.05). The difference of choroidal thickness between the other groups was statistically significant (P0.05), with the diopter negative, choroid membrane The thickness of the macular fovea choroidal thickness was significantly positively correlated with the equivalent lens, and the length of the ocular axis was negatively correlated with the ocular pressure. Conclusion the choroidal thickness of the macular area in adolescent myopia was negative with the diopter, the thinner the choroidal thickness was, the change of the macular fovea was more obvious than that of the surrounding area. Foveal choroidal thickness was positively correlated with diopter, negatively correlated with axial length, and negatively correlated with IOP.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R778.11

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