早产儿视网膜病变激光光凝术后角膜地形图状况

doi:10.3760/cma.j.cn115909-20200329-00120

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摘要目的：观察早产儿视网膜病变（ROP）激光光凝术后儿童角膜地形图的改变。方法：病例对照研究。收集2015年9月至2018年4月于深圳市眼科医院行激光光凝术后的ROP儿童25例（50眼）为ROP组，同时收集年龄匹配的足月儿童23例（46眼）为对照组。2组儿童均行最佳矫正视力（BCVA）检查，统计分析时转换为LogMAR视力。Sirius眼前节分析系统测量2组儿童的各种角膜参数：角膜前后表面不同直径角膜曲率的最大值（K1）和最小值（K2）、平均角膜曲率（Avg）；角膜前后表面不同直径的陡峭半径（rs）、平坦半径（rf）、非球面参数（e）。数据采用独立样本t检验进行分析。结果：ROP组儿童BCVA（LogMAR）（0.24±0.25）较对照组儿童（0.07±0.10）差，2组间差异有统计学意义（t=3.20， P=0.003）。ROP组儿童角膜前后表面不同直径范围的角膜屈光力均比对照组儿童大，差异有统计学意义[K1（角膜前表面3、5、7 mm，角膜后表面3、5、7 mm）：t=3.139、3.050、2.710，-4.216、 -3.821、-2.474；K2：t=2.816、2.688、2.286，-4.252、-3.883、-3.178；Avg：t=3.190、3.041、 2.649，-4.848、-4.271、-3.121。均P<0.05]。ROP组儿童角膜前后表面不同直径范围的角膜形态与对照组儿童比较差异均有统计学意义[rf（角膜前表面6、8 mm，角膜后表面6、8 mm）：t=3.395、3.354， -4.427、-4.613；rs：t=2.928、2.807，-4.055、-4.175；e：t=3.437、3.991，2.268、4.355，均P<0.05]。结论：Sirius眼前节分析系统是研究ROP激光光凝术后全角膜发育方面的有利工具。ROP激光光凝术后早产儿儿童与足月产儿童相比，角膜前后表面不同范围的屈光力更大，BCVA更差，在视觉发育过程中更易发生屈光不正等视功能改变。

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关键词 ： , 早产儿视网膜病变, 视网膜激光光凝术, 角膜地形图, 角膜屈光度, 角膜形态指数

Abstract： Objective: To observe the changes in corneal topography of children after laser photocoagulation for retinopathy of prematurity (ROP). Methods: In this case-control study, 25 children (50 eyes) with ROP who received laser photocoagulation for ROP in Shenzhen Eye Hospital from September 2015 to April 2018 were selected after laser photocoagulation were the ROP group, and 23 full-term, age-matched children (46 eyes) were selected for the control group. The two groups of children underwent best corrected visual acuity (BCVA) testing, recalculated into logMAR visual acuity. For each group of children, the Sirius anterior eye assay system measured: Maximum value (K1), minimum value (K2), and average corneal curvature (Avg) of different diameter ranges on the anterior and posterior surfaces of the cornea; steep radius (rs), flat radius (rf), and aspheric parameter (e) of different diameter ranges on the anterior and posterior surfaces of the cornea. A t-test, was used for differences between the quantitative data between the groups. Results: ①The BCVAs of the ROP group and control group were 0.24±0.25 and 0.07±0.10, respectively, and the difference between the two groups was statistically significant (t=3.20, P=0.003). ②The corneal anterior and posterior surface curvature and corneal refractive power of different diameter ranges in the ROP group were greater than that of the control group, and the difference was statistically significant [K1 (anterior corneal surfaces 3 mm, 5 mm, 7 mm, posterior corneal surfaces 3 mm, 5 mm, 7 mm): t=3.139, 3.050, 2.710, -4.216, -3.821, -2.474; K2 (anterior corneal surfaces 3 mm, 5 mm, 7 mm, posterior corneal surfaces 3 mm, 5 mm, 7 mm): t=2.816, 2.688, 2.286, -4.252, -3.883, -3.178; Avg (anterior corneal surfacse 3 mm, 5 mm, 7 mm, posterior corneal surfaces 3 mm, 5 mm, 7 mm): t=3.190, 3.041, 2.649, -4.848, -4.271, -3.121, all P<0.05]. ③The corneal morphology of the ROP group was different than that of the control group, and the difference was statistically significant [rf (anterior corneal surfaces 6 mm, 8 mm, posterior corneal surfaces 6 mm, 8 mm): t=3.395, 3.354, -4.427, -4.613; rs (anterior corneal surfaces 6 mm, 8 mm, posterior corneal surfaces 6 mm, 8 mm): t=2.928, 2.807, -4.055, -4.175, e (anterior corneal surfaces 6 mm, 8 mm, posterior corneal surfaces 6 mm, 8 mm): t=3.437, 3.991, 2.268, 4.355, all P<0.05]. Conclusions: The Sirius anterior eye assay system has a significant advantage in our study of total corneal development. We found that after laser photocoagulation, ROP children have a higher refractive power in different ranges of the anterior and posterior surfaces of the cornea, and a lower BCVA. They are more likely to have refractive errors and other changes in visual function during visual development compared with full-term children.

Key words： retinopathy of prematurity laser photocoagulation corneal topography corneal diopter corneal morphological index

收稿日期: 2020-03-29

PACS:

基金资助: 深圳市学科布局项目（JCYJ20170817112542555）

通讯作者: 张国明（ORCID：0000-0023-2123-8125），Email：13823509060@163.com

引用本文:

曾宪露1，2 赵金凤1，2 王施丹2 陈妙虹2 严宗辉2 张巧琦2 姚雪2 何红辉2 郭金莲2 郑磊2 曾键2 汪建涛2 张国明1，2. 早产儿视网膜病变激光光凝术后角膜地形图状况[J]. 中华眼视光学与视觉科学杂志, 2021, 23(7): 522-527. xXianlu Zeng1, 2, Jinfeng Zhao1, 2, Shidan Wang2,Miaohong Chen2,Zonghui Yan2,Qiaoqi Zhang2,Xue Yao2,Honghui He2,Jinlian Guo2,Lei Zheng2,Jian Zeng2,Jiantao Wang2,Guoming Zhang1, 2. Corneal Topography of Children after Laser Photocoagulation for Retinopathy of Prematurity. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(7): 522-527. DOI: 10.3760/cma.j.cn115909-20200329-00120

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20200329-00120 或 https://www.cjoovs.com/CN/Y2021/V23/I7/522

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