角膜生物力学及校正眼压与青少年屈光状态的相关性

doi:10.3760/cma.j.cn115909-20200428-00183

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摘要目的：探讨7～18岁青少年角膜生物力学及校正眼压与屈光状态的内在关系。方法：横断面研究。选择2017年11月至2018年2月于中山大学中山眼科中心屈光门诊就诊的中国青少年325例，年龄7～18 岁，等效球镜度（SE）-10.25～+16.50 D。采用IOLMaster测量眼轴长度（AL），Corvis ST测量角膜生物力学参数及生物力学校正眼压（bIOP），Pentacam测量眼前节生物学参数。按照右眼SE将受检者分为高度近视、中低度近视、正视和远视组。采用Pearson或Spearman相关分析SE与角膜生物力学参数的相关性。用协方差分析比较4组的角膜生物力学参数差异，用方差分析比较4组间的bIOP差异。结果：SE越偏向近视，第二次压平速率（VA2，r=0.180，P=0.001）越快，峰值距离（PD，r=-0.273， P<0.001）和形变幅度（DA，r=-0.167，P=0.002）越大。AL越长，PD（r=0.355，P<0.001）越大，VA2 （r=-0.138，P=0.021）越快。4组间PD（F=9.372，P<0.001）、DA（F=4.425，P=0.005）和VA2（F=4.961， P=0.002）的总体差异有统计学意义，进一步比较发现，PD、DA和VA2绝对值在高度近视、中低度近视、正视、远视组间依次下降，差异均有统计学意义（均P<0.05）。高度近视组（102.04±19.59）和中低度近视组（98.95±16.62）的角膜硬度参数（SP-A1）差异无统计学意义，但中低度近视组比正视组（107.49±18.66，P=0.010）和远视组（108.98±20.20，P=0.004）的SP-A1低，差异有统计学意义。眼压（IOP）和bIOP均与SE无相关性。结论：7～18岁青少年SE越偏向近视，角膜硬度越低。无论是否校正角膜生物力学因素的影响，眼压均与屈光度无关。

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关键词 ：角膜生物力学, 眼压, 近视, 正视, 远视

Abstract： Objective: To explore the relationship between corneal biomechanics, biomechanically corrected intraocular pressure (bIOP) and refractive status in Chinese juveniles. Methods: This was a cross-sectional study conducted at the Zhongshan Ophthalmic Center between November 2017 and February 2018. A total of 325 Chinese juveniles, aged 7 to 18 years with a spherical equivalent (SE) refraction between -10.25 and +16.50 diopters (D) were included. Axial length (AL) was measured using an IOLMaster. Corneal biomechanical metrics and bIOP were measured using a Corvis ST, and corneal biological parameters were measured using a Pentacam. Participants were divided into 4 groups: high myopia, low-to-moderate myopia, emmetropia, and hyperopia based on the right eye SE. Differences in corneal biomechanical characteristics among the 4 groups were analyzed by covariance analysis, while differences in bIOP were analyzed by ANOVA. Results: Higher myopic SE was significantly correlated with faster corneal velocity during the second applanation moment (VA2, r=0.180, P=0.001), the longer peak distance (PD, r=-0.273, P<0.001) and larger deformation amplitude (DA, r=-0.167, P=0.002). A longer AL was significantly correlated with a faster VA2 (r=-0.138, P=0.021) and longer PD (r=0.355, P<0.001). There were significant differences among the 4 groups in PD (F=9.372, P<0.001), DA (F=4.425, P=0.005), and VA2 (F=4.961, P=0.002). Further study found that the PD, DA and absolute value of VA2 successively decreased in high myopia, low-to-moderate myopia, emmetropia, and hyperopia groups (all P<0.05). The differences in the stiffness parameter at the first applanation (SP-A1) in high myopia (102.04±19.59) and low-to-moderate myopia groups (98.95±16.62) were not significant (P>0.05), while the SP-A1 of the lowto-moderate myopia group was significantly greater than that of the emmetropia (107.49±18.66, P=0.010) and hyperopia groups (108.98±20.20, P=0.004). There was no significant correlation between intraocular pressure (IOP)/bIOP and SE. Conclusions: Corneal stiffness seems to decrease with a higher myopic SE in Chinese juveniles aged 7 to 18 years. IOP, whether it was corrected by corneal biomechanics or not, is not related to refractive status.

Key words： corneal biomechanicalcharacteristics ntraocular pressure myopia emmetropia hyperopia

收稿日期: 2020-04-28

PACS:

基金资助:

广东省自然科学基金（2019A1515010077）

通讯作者: 杨晓（ORCID：0000-0001-5649-7763），Email：yangx_zoc@163.com

引用本文:

龙文李周越胡音崔冬梅赵峰曾骏文杨晓. 角膜生物力学及校正眼压与青少年屈光状态的相关性[J]. 中华眼视光学与视觉科学杂志, 2020, 22(9): 652-658. Wen Long, Zhouyue Li, Yin Hu, Dongmei Cui, Feng Zhao, Junwen Zeng, Xiao Yang. The Relationship between Corneal Biomechanics, Biomechanically Corrected Intraocular Pressure and Refractive Status in Chinese Juveniles. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(9): 652-658. DOI: 10.3760/cma.j.cn115909-20200428-00183

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20200428-00183 或 https://www.cjoovs.com/CN/Y2020/V22/I9/652

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