不同高海拔地区青少年脉络膜厚度的差异

目的:测量长期居住在不同高海拔地区青少年的脉络膜厚度并探讨海拔对脉络膜厚度的影响。方法:横断面研究。2015年5月13日至6月10日期间,调查海拔1535m(A组)、1917m(B组)和2936m(C组)地区学生674人。CirrusTMHD-OCT4000扫描仪测量黄斑中心凹(Fovea)及鼻侧(N)、颞侧(T)象限距黄斑中心凹750、1500、2250μm处脉络膜厚度,选择单眼数据用于分析。连续变量比较采用单因素方差分析,分类变量比较采用χ^2检验。结果:最终共纳入学生624人,A、B、C组分别为172、242、210人。各组年龄、性别、等效球镜度、角膜曲率、前房深度和眼轴长度差异无统计学意义。C组T2250、T1500、T750、Fovea、N750、N1500、N2250处脉络膜厚度依次为(283±61)、(291±59)、(298±63)、(302±62)、(282±61)、(246±62)和(215±58)μm,均显著高于A组和B组(均P<0.05),而A、B组间差异无统计学意义。正视、轻度近视和7~14岁人群中,C组脉络膜厚度高于A和B组(均P<0.05),A、B组间差异无统计学意义;3组在中度近视人群中差异无统计学意义;15~19岁人群中,C组脉络膜厚度均高于B组(均P<0.05)。结论:不同高海拔地区青少年脉络膜厚度存在差异,随海拔升高,脉络膜厚度增加,在正视、轻度近视及7~14岁人群中增加明显,在中度近视、15~19岁人群中增加不明显。

Research on Choroidal Thickness of Adolescents Lived in Different High Altitude Areas

To measure the choroidal thickness (ChT) of adolescents and correlate the ChT with elevation at high altitude areas. Methods: A cross-sectional study. Between May 13, 2015 and June 10, 2015, 674 students lived at the altitude of 1 535 meters (group A), 1 917 meters (group B) and 2 936 meters (group C) were examine. CirrusTM HD-OCT 4000 scanner was used to measure ChT at 7 locations: Fovea and 750, 1 500, and 2 250 μm nasal (N) and temporal (T) to the fovea. Monocular data were used for analysis. Continuous variables were analyzed using univariate analysis of variance, and categorical variables were compared using the chi-square test. Results: A total of 624 participants (624 eyes) were included, and group A, B, and C was 172, 242, and 210 cases, respectively. There was no difference in age, gender, spherical equivalent, keratometry, anterior chamber depth, and axial length among three groups. The mean ChTs at the location of T2250, T1500, T750, Fovea, N750, N1500, N2250 in the group C were 283±61, 291±59, 298±63, 302±62, 282±61, 246±62, and 215±58 μm, respectively, which were thicker than the group A and B ( all P<0.05), there was no difference between group A and group B. Between the participants aged 7-14 years with emmetropia or mild myopia, the ChT in the group C were thicker than the group A and B (all P<0.05). There was no difference between group A and group B. Among the participants with moderate myopia, there was no difference in three groups. Among the participants aged 15-19 years, the ChT in the group C were thicker than the group B (all P<0.05). Conclusions: The ChT was significantly different in adolescents lived in different high altitude areas. ChT increased with elevation increasing, which was marked between the participants aged 7-14 years with emmetropia or mild myopia, and was unremarkable for the participants aged 15-19 years with moderate myopia. Key words: choroidal thickness; high altitude; optical coherence tomography; adolescents; ametropia