高度近視性斜視的臨床與CT研究
發(fā)布時(shí)間：2018-11-28 08:42
【摘要】：目的：通過CT掃描技術(shù)，從新的角度分析高度近視性內(nèi)下斜視患者眼直肌的最大橫截面積、位移、形態(tài)以及外直肌與眼軸長(zhǎng)度之間的關(guān)系，以對(duì)高度近視性斜視有更進(jìn)一步了解，，并對(duì)臨床診斷、鑒別診斷及手術(shù)方式的選擇提供影像學(xué)支持。 方法：選取2011年1月——2012年12月在山西省眼科醫(yī)院行眼眶CT檢查（機(jī)型: NeuViz Dual）并住院手術(shù)治療的高度近視性患者7例（12只眼）作為實(shí)驗(yàn)組，8例（16只眼）正常眼眶作對(duì)照組。A超測(cè)量眼軸長(zhǎng)度。冠狀位CT圖像選視神經(jīng)與眼球連接處層面，建立以眼眶中心為原點(diǎn)的坐標(biāo)系，測(cè)量各直肌切面中心和坐標(biāo)原點(diǎn)連線與相鄰坐標(biāo)軸的夾角（以下簡(jiǎn)稱夾角）；另外選視神經(jīng)與眼球連接層面后6-8mm測(cè)量各直肌最大橫截面積及其長(zhǎng)徑與寬徑，并計(jì)算長(zhǎng)徑與寬徑的比值（RLW）。使用SPSS13.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)處理。 結(jié)果：實(shí)驗(yàn)組眼軸長(zhǎng)度明顯增長(zhǎng)；兩組四條直肌切面中心的夾角t檢驗(yàn)：外直�。≒0.05）、上直�。≒0.05）,下直肌(P0.05)，均有統(tǒng)計(jì)學(xué)意義，內(nèi)直�。≒=0.7750.05），無統(tǒng)計(jì)學(xué)意義，說明實(shí)驗(yàn)組的外直肌、上直肌及下直肌產(chǎn)生移位，內(nèi)直肌無明顯移位；兩組四條直肌最大橫截面積t檢驗(yàn)，P值均大于0.05，無統(tǒng)計(jì)學(xué)意義，即兩組所有直肌最大橫截面積無明顯差別；兩組各直肌RLW的t檢驗(yàn)，內(nèi)直肌（P=0.03）外直�。≒0.05），上直肌（P=0.02），下直肌（P=0.02）, P值均小于0.05，有統(tǒng)計(jì)學(xué)意義，可以認(rèn)為實(shí)驗(yàn)組直肌的形態(tài)發(fā)生了改變；外直肌RLW與眼軸的長(zhǎng)度有一定的相關(guān)性。 結(jié)論： 1.高度近視性斜視組眼軸長(zhǎng)度與正常組比較明顯增長(zhǎng)，眼軸過度增長(zhǎng)，眼球重量增加形成重眼現(xiàn)象，可能是高度近視眼發(fā)生內(nèi)下斜視的主要原因； 2.高度近視性斜視組的眼直肌中，外直肌、上直肌、下直肌的位置較正常組有明顯移位，外直肌移位最明顯，內(nèi)直肌無移位；四條眼直肌的形態(tài)均發(fā)生了明顯改變，也以外直肌改變最明顯。眼直肌的改變是由于重眼現(xiàn)象及斜視所導(dǎo)致；眼直肌尤其是外直肌的移位及變形可能是高度近視性內(nèi)下斜視發(fā)生眼球運(yùn)動(dòng)障礙的主要原因之一。 3.本研究高度近視性內(nèi)下斜視組眼軸長(zhǎng)度和外直肌移位的角度、外直肌的長(zhǎng)徑與寬徑比值有一定的相關(guān)性，但不再是單純的直線正相關(guān)的關(guān)系。 4.眼軸明顯增長(zhǎng)、眼直肌移位、變形、眼球向內(nèi)下方斜視是高度近視性斜視在CT影像上的特征性表現(xiàn)，根據(jù)此征象可提出本病的診斷。
[Abstract]:Objective: to analyze the relationship between the maximal cross sectional area, displacement, shape of rectus muscle and axial length in patients with high myopic endotropia from a new angle by CT scanning. To have a better understanding of high myopic strabismus, and to provide imaging support for clinical diagnosis, differential diagnosis and choice of surgical methods. Methods: from January 2011 to December 2012, 7 patients (12 eyes) with high myopia who underwent orbital CT examination (model: NeuViz Dual) and surgical treatment) were selected as experimental group. 8 cases (16 eyes) of normal orbit were used as control group. In coronal CT images, the optic nerve and eyeball junction were selected and the coordinate system was established with the orbital center as the origin, and the angle between the center of rectus and the origin of the coordinate line and the adjacent coordinate axis was measured (hereinafter referred to as the angle of the coordinate axis). In addition, the maximum cross sectional area, length and width of rectus muscle were measured by 6-8mm after optic nerve and eyeball junction, and the ratio of length to width was calculated by (RLW). Use SPSS13.0 statistical software for data processing. Results: the axial length of the eyes in the experimental group increased obviously. T test of the center of four rectus muscles in the two groups: external rectus (P0.05), superior rectus (P0.05), inferior rectus (P0.05), and medial rectus (P0. 7750.05). The results showed that the external rectus muscle, superior rectus muscle and inferior rectus muscle of the experimental group were translocated, but the inner rectus muscle had no obvious displacement. The maximum cross sectional area of rectus muscle in the two groups was no significant difference (P > 0.05), that is, there was no significant difference in the maximum cross sectional area of all rectus muscles between the two groups. T test of RLW of each rectus muscle in the two groups showed that the values of the medial rectus muscle (P0. 03), the superior rectus muscle (P0. 02) and the inferior rectus muscle (P0. 02), P) were all less than 0. 05, which had statistical significance. It can be considered that the morphology of the rectus muscle in the experimental group has changed. The RLW of the external rectus muscle was correlated with the length of the eye axis. Conclusion: 1. The length of eye axis in high myopic strabismus group was significantly longer than that in normal group. The overgrowth of eye axis and the increase of eyeball weight might be the main reasons for the occurrence of hypotropia in high myopia group. 2. In the high myopic strabismus group, the position of the rectus muscle, the superior rectus muscle, the inferior rectus muscle was more obvious than that of the normal group, the displacement of the external rectus muscle was the most obvious, and there was no displacement of the inner rectus muscle in the high myopia strabismus group. The morphology of the rectus oculis muscle was obviously changed, and the most obvious change was also seen in the external rectus muscle. The change of rectus muscle is caused by the phenomenon of heavy eye and strabismus, and the displacement and deformation of rectus muscle, especially the external rectus muscle, may be one of the main causes of ocular movement disorder in high myopic endotropia. 3. In this study, the axial length and the angle of transposition of the external rectus muscle, the ratio of length to width of the external rectus muscle in the group of high myopic endotropia were related to each other, but were no longer the only linear positive correlation. 4. The obvious increase of eye axis, the displacement and deformation of rectus oculi, and the inward and inferior strabismus of the eyeball are the characteristic manifestations of high myopic strabismus on CT images. The diagnosis of this disease can be made on the basis of this sign.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R816.97;R777.41
本文編號(hào)：2362379
[Abstract]:Objective: to analyze the relationship between the maximal cross sectional area, displacement, shape of rectus muscle and axial length in patients with high myopic endotropia from a new angle by CT scanning. To have a better understanding of high myopic strabismus, and to provide imaging support for clinical diagnosis, differential diagnosis and choice of surgical methods. Methods: from January 2011 to December 2012, 7 patients (12 eyes) with high myopia who underwent orbital CT examination (model: NeuViz Dual) and surgical treatment) were selected as experimental group. 8 cases (16 eyes) of normal orbit were used as control group. In coronal CT images, the optic nerve and eyeball junction were selected and the coordinate system was established with the orbital center as the origin, and the angle between the center of rectus and the origin of the coordinate line and the adjacent coordinate axis was measured (hereinafter referred to as the angle of the coordinate axis). In addition, the maximum cross sectional area, length and width of rectus muscle were measured by 6-8mm after optic nerve and eyeball junction, and the ratio of length to width was calculated by (RLW). Use SPSS13.0 statistical software for data processing. Results: the axial length of the eyes in the experimental group increased obviously. T test of the center of four rectus muscles in the two groups: external rectus (P0.05), superior rectus (P0.05), inferior rectus (P0.05), and medial rectus (P0. 7750.05). The results showed that the external rectus muscle, superior rectus muscle and inferior rectus muscle of the experimental group were translocated, but the inner rectus muscle had no obvious displacement. The maximum cross sectional area of rectus muscle in the two groups was no significant difference (P > 0.05), that is, there was no significant difference in the maximum cross sectional area of all rectus muscles between the two groups. T test of RLW of each rectus muscle in the two groups showed that the values of the medial rectus muscle (P0. 03), the superior rectus muscle (P0. 02) and the inferior rectus muscle (P0. 02), P) were all less than 0. 05, which had statistical significance. It can be considered that the morphology of the rectus muscle in the experimental group has changed. The RLW of the external rectus muscle was correlated with the length of the eye axis. Conclusion: 1. The length of eye axis in high myopic strabismus group was significantly longer than that in normal group. The overgrowth of eye axis and the increase of eyeball weight might be the main reasons for the occurrence of hypotropia in high myopia group. 2. In the high myopic strabismus group, the position of the rectus muscle, the superior rectus muscle, the inferior rectus muscle was more obvious than that of the normal group, the displacement of the external rectus muscle was the most obvious, and there was no displacement of the inner rectus muscle in the high myopia strabismus group. The morphology of the rectus oculis muscle was obviously changed, and the most obvious change was also seen in the external rectus muscle. The change of rectus muscle is caused by the phenomenon of heavy eye and strabismus, and the displacement and deformation of rectus muscle, especially the external rectus muscle, may be one of the main causes of ocular movement disorder in high myopic endotropia. 3. In this study, the axial length and the angle of transposition of the external rectus muscle, the ratio of length to width of the external rectus muscle in the group of high myopic endotropia were related to each other, but were no longer the only linear positive correlation. 4. The obvious increase of eye axis, the displacement and deformation of rectus oculi, and the inward and inferior strabismus of the eyeball are the characteristic manifestations of high myopic strabismus on CT images. The diagnosis of this disease can be made on the basis of this sign.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R816.97;R777.41
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