Haplotype analysis of Japanese families with a superficial variant of granular corneal dystrophy: evidence for multiple origins of R124L mutation of kerato-epithelin

To see whether or not reduced light input in children with congenital cataract produces degenerative myopia and whether it is associated with an impairment of the hypophyseal-adrenal cortical axis, the authors studied biometric values and circadian rhythm and cortisol reserve in nine children with monolateral and ten children with bilateral cataract.

38.75% of patients had: (a) refractions <10D, (b) increased antero-posterior diameter of the eyeball, (c) varying degrees of myopic chorioretinitis, showing that the lack of light input induces degenerative myopia only in a group of patients who are probably genetically predisposed.

The negative correlation between cortisol reserve and ocular lesions seems to reveal a precocious negative effect of the lack of light input on the development of the hypothalamic-hypophyseal-adrenal cortical axis. The alteration of the circadian cortisol rhythm and the reduction of the cortisol reserve found exclusively in children with monolateral cataract must be studied further to be explained.

The slight increase in plasma cortisol levels earlier described in adults with acquired degenerative myopia was not found in children with congenital cataract. This difference could be due to: (a) special endocrine characteristics in children with congenital cataract, (b) endocrine differences between childhood and adulthood, (c) differing influences of hormonal factors on myopia, or vice versa, in childhood and adulthood.     

湖北地区17～19岁人群角膜散光与近视度相关性情况调查

目的:对湖北地区17～19岁人群的角膜散光情况与不同近视度数的关系进行调查,找出其变化规律。方法:对随机抽取的762例湖北地区17～19岁居民进行散光度、轴向及近视度数的测定,并分析其变化规律。结果:湖北地区17～19岁居民中,各个近视度段散光在25°～150°范围内所占人数比例最大,各个近视度段均呈现顺规散光人数多于逆规散光。其中女性高度近视段约为70.1%,中度近视段约为78.6%,低度近视段约为83·8%;男性高度近视段约为64.7%,中度近视段约为73.8%,低度近视段约为82.3%。17～19岁男性及女性中各近视度段顺规散光人数比例差异没有统计学意义。17～19岁男性低度近视段者0°～200°散光比例高于其他两组,差异有统计学意义,且有随近视度数增高,0°～200°散光人数所占比例有减低趋势;女性高度近视段在0°～200°散光人数比例低于其它两组,差异有统计学意义。结论:湖北地区17～19岁居民中,各个近视度段散光在25°～150°范围内所占人数比例最大,且各个近视度段不论男女均呈现顺规散光人数多于逆规散光;男性低度近视段在0°～200°散光比例高于其它两组;女性高度近视段0°～200°散光人数比例低于其它两组。     

负透镜诱导型近视豚鼠视网膜中谷氨酸及其受体的表达

目的　观察谷氨酸及其离子型受体Ｎ-甲基-Ｄ-天冬氨酸受体（Ｎ-ｍｅｔｈｙｌ-Ｄ-ａｓｐａｒｔａｔｅｒｅｃｅｐｔｏｒ,ＮＭＤＡＲ）功能亚单位ＮＲ２Ａ在近视豚鼠视网膜上的动态表达,探讨其在近视发病过程中的作用。方法　选取３周龄健康三色短毛豚鼠１２０只,采用随机数字表法分为０周正常组、２周正常组、２周近视组、４周正常组、４周近视组,每组２４只;正常组不作任何干预,近视组右眼均戴－１０Ｄ透镜,左眼不戴镜作为对照。入组前与处死前均进行屈光度及眼轴长度检测,腹腔注射过量水合氯醛处死,并分离视网膜,采用高效液相色谱分析检测视网膜中谷氨酸的含量变化,实时荧光定量ＰＣＲ以及ＥＬＩＳＡ分别检测豚鼠视网膜中ＮＲ２ＡｍＲＮＡ及其蛋白水平的表达变化。结果　造模前各组屈光度及眼轴长度差异均无统计学意义（均为Ｐ＞０．０５）。造模后各组与造模前比较,眼轴长度及屈光度差异均有统计学意义（２周正常组Ｐ＜０．０５,２周近视组Ｐ＜０．００５,４周正常组Ｐ＜０．０１,４周近视组Ｐ＜０．００１）。造模后,正常组间眼轴长度和屈光度比较差异均有统计学意义（Ｆ＝２０．３２,Ｐ＜０．０１;Ｆ＝１９９．６５,Ｐ＜０．０１）;２周近视组与４周近视组比较,右眼眼轴长度和屈光度差异均有统计学意义（Ｆ＝７８．９６,Ｐ＜０．００１;Ｆ＝２５２．１０,Ｐ＜０．００１）,左眼眼轴长度和屈光度差异均无统计学意义（Ｆ＝１３．６６,Ｐ＞０．０５;Ｆ＝２１．２０,Ｐ＞０．０５）;２周近视组与４周近视组右眼分别与相应的左眼比较,眼轴长度差异均有统计学意义（２周近视组:ｔ＝９．５１５,Ｐ＜０．００５;４周近视组:ｔ＝９．４４９,Ｐ＜０．００１）,屈光度差异同样均有统计学意义（２周近视组:ｔ＝８．８９７,Ｐ＜０．００１;４周近视组:ｔ＝１７．２３５,Ｐ＜０．００１）。视网膜中谷氨酸含量正常组之间差异均无统计学意义（均为Ｐ＞０．０５）;造模后２周近视组与４周近视组比较,右眼视网膜中谷氨酸含量逐渐增加,差异有统计学意义（ｔ＝３６．２３０,Ｐ＜０．０１）。造模后２周近视组较２周正常组右眼谷氨酸含量增加,差异有统计学意义（ｔ＝－２３．２４０,Ｐ＜０．０５）;同样４周近视组较４周正常组右眼谷氨酸含量亦增加,差异亦有统计学意义（ｔ＝－５３．６９０,Ｐ＜０．０１）。视网膜中ＮＲ２ＡｍＲＮＡ的表达量,正常组之间差异均无统计学意义（均为Ｐ＞０．０５）。造模后４周近视组与２周近视组比较,右眼视网膜ＮＲ２ＡｍＲＮＡ表达量明显上调,差异有统计学意义（ｔ＝５５．６６０,Ｐ＜０．００１）;２周近视组与２周正常组右眼比较表达量增加,差异有统计学意义（ｔ＝－１５．０８６,Ｐ＜０．００５）,同样４周近视组与４周正常组右眼比较差异亦有统计学意义（ｔ＝－４３．２７６,Ｐ＜０．００１）。正常组之间视网膜中ＮＲ２Ａ蛋白表达量,差异无统计学意义（均为Ｐ＞０．０５）。４周近视组与２周近视组比较,右眼视网膜ＮＲ２Ａ蛋白表达量明显上调,差异有统计学意义（ｔ＝４３．２１０,Ｐ＜０．００５）;２周近视组与２周正常组右眼比较ＮＲ２Ａ蛋白表达量增加,差异有统计学意义（ｔ＝－２．３６５,Ｐ＜０．０５）,同样４周近视组与４周正常组右眼比较差异亦有统计学意义（ｔ＝－５．５１８,Ｐ＜０．０１）。结论负透镜诱导型近视豚鼠视网膜中谷氨酸及其ＮＭＤＡＲ受体亚单位ＮＲ２Ａ在透镜诱导眼中表达上调,并随透镜诱导时间的延长和近视程度的加深而增加。     

An analysis of the fundus changes in families with high myopia

PURPOSE: Of this study is to present fundus changes in members of families with high myopia. MATERIAL AND METHODS: Detailed clinical examination of the enrolled subjects have been performed in the high myopia families. Both affected (presented with high myopia) and unaffected individuals (without high myopia) are given an ophthalmologic examination: best-corrected visual acuity testing, intraocular pressure examination, fundoscopy, axial length determination (using ultrasonography), refractometry. RESULTS: In the 19 high myopia families, 152 individuals were carefully examined. In 11 individuals retinal detachment have been observed. Additionally, myopic degeneration of the central retina (15 cases), degeneration of the peripherial retina (20 subjects), AMD (4 subjects), hypertrophy of the RPE (2 subjects), CNV (1 case), striae medullares (1 case) and macular foramen (1 case), have been identified. CONCLUSIONS: In the affected individuals (presented with high myopia) changes of the eye fundus and retinal detachment were more frequently observed comparing to unaffected members of the families without high myopia. In unaffected individuals genetic factor seems to play insignificant role in apperance of fundus. Changes within central retina in the high myopia individuals may conduce to severe visual impairment.     

Age of lens use onset in a myopic sample of office-workers

PURPOSE: The present study was developed to assess prevalence of myopic refractive error and the relative percentages of youth- and adult- onset myopia in a Caucasian adult population. METHODS: Subjects were office-workers sent consecutively from their workplace for a general health check-up, without refractive selection. Each subject received a questionnaire about academic achievement and family history of myopia. Subsequently, an ophthalmologist performed the vision examination. Although age of initial lens use is not necessarily the same as age of onset of myopia, it was considered to be so for this paper. A subject was considered an adult-onset myope if lens use began at age 18 or later. RESULTS: Subjects (n=349) had a mean age of 37.6 +/- 9.3 years. One hundred seventeen subjects (33.5% prevalence) had myopic spherical equivalent refraction. Further analysis comprises only subjects with simple myopia (astigmatism <1 diopter, n=95). Nearly half of the simple myopic subjects were of adult-onset (47.8%). There was no difference in family history of myopia between youth- and adult-onset myopes (at least one myopic parent in 53.1% and 47.8% respectively, p=0.53), and no clear cut-off point separated the two myopic subgroups with respect to the age of lens use onset. However, adult-onset myopes had myopia of lower diopter amount than youth-onset myopes. CONCLUSIONS: Adult-onset myopes comprised nearly half of the simple myopic subjects, and their family history of myopia was similar to that of youth-onset myopes. There is no clear cut-off point between both myopic subgroups when age of onset is the variable considered.     

不同屈光状态在校大学生调节幅度和立体视的测定

目的:分析在校大学生不同屈光状态与调节幅度、立体视的关系。方法:对入选的150名在校大学生行客观验光、综合验光及相关双眼视功能的检查,包括立体视、调节幅度等的测量。按是否有近视分为:(1)正视组(11名),+0.75D≤SE(等效球镜度数)<-0.50D;(2)近视组(139名),SE≥-0.5D。近视组中按近视的度数分为:低度近视组(51名),中度近视组(69名),高度近视组(19名)。按是否有屈光参差分为:非屈光参差组(123名),屈光参差组(27名)。分析研究不同屈光状态学生的调节幅度、立体视的状况以及屈光参差对立体视的影响。结果:近视组的调节幅度较正视组的调节幅度大,差异有统计学意义(t=1.16,P<0.05),近视组间调节幅度值有差异(F=1.474,P<0.05),其中高度近视组与低度近视组、中度近视组之间差异有统计学意义(P<0.05),近视度数越大,测得的调节幅度值越大(r=0.2698,P<0.05);正视组与近视组之间立体视无显著差异(χ2=0.325,P>0.05),低、中、高度近视组之间立体视无显著差异(χ2=0.16,P>0.05);屈光参差组的立体视功能比非屈光参差组差,差异有统计学意义(Fisher,P<0.05)。结论:近视组较正视组的调节幅度大,近视组中,调节幅度与近视的度数呈正相关性。屈光参差组较非屈光参差组的立体视功能差。     

Decreased response of plasma cortisol to intravenous metyrapone in ocular hypertension and primary open-angle glaucoma

PURPOSE: To determine if there is a difference in response to metyrapone, which blocks the conversion of 11-deoxycortisol to cortisol in the adrenal gland between normals and ocular hypertensives (OH) plus primary open-angle glaucomas (POAG) without pigmented angles. METHODS: Intravenous metyrapone was given to 20 normals and 15 ocular hypertensives plus primary open-angle glaucomas without pigmented angles. Blood samples were obtained at 4, 6, and 8 hours after administration of intravenous metyrapone for analyses of 11-deoxycortisol and cortisol. RESULTS: The ocular hypertensives plus primary open-angle glaucoma group showed significantly lower cortisol values compared with the normal group at 6 hours (P = 0.002) but not at 4 or 8 hours. There were no significant differences between the two groups for 11-deoxycortisol values at 4, 6, or 8 hours. The percent decrease of plasma cortisol from baseline was significantly greater for the ocular hypertensives plus open-angle glaucoma group compared with the normals at 4 hours (P = 0.010) and 6 hours (P = 0.0004). Significant negative correlations were observed for the total group of subjects between levels of plasma cortisol at 6 hours and intraocular pressure, worse eye (P = 0.029), percent area of cupping, worse eye (P = 0.045), pallor, worse eye (P = 0.001), and visual field loss, worse eye (P = 0.048), so that the less the plasma cortisol, the greater the abnormality of the glaucomatous parameters. Multivariate analyses with the 6-hour plasma cortisol level as the dependent variable showed that the only significant (P = 0.0004) independent variable was the percent area of pallor, worse eye, associated with a smaller level of plasma cortisol at 6 hours. Similarly, the multiple regression models using the percent change from baseline of the 6-hour plasma cortisol value showed a significant association of larger percent decreases of plasma cortisol in the ocular hypertensives plus open-angle glaucoma compared with the normals. CONCLUSIONS: The ocular hypertensives plus primary open-angle glaucoma subjects show greater adrenal inhibition to metyrapone in the synthesis of cortisol from 11-deoxycortisol compared with normals. This observation suggests an adrenal abnormality in the ocular hypertensive plus primary open-angle glaucoma subjects.     

病理性近视患者黄斑功能的微视野检查

　　目的　观察病理性近视患者黄斑功能的微视野检查表现。方法　回顾分析90例病理性近视患者142只眼的临床资料。所有患者均详细询问病史,并行最佳矫正视力（BCVA）、屈光度、眼轴、荧光素眼底血管造影（FFA）、间接检眼镜和黄斑部光相干断层扫描（OCT）检查。根据检查结果将患者分为无黄斑病理改变和黄斑病理改变组,分别为20例24只眼、70例118只眼。采用MP-1微视野计对两组患者行眼底成像和黄斑部微视野检查,记录受检眼黄斑10°范围内视网膜平均光敏感度（MS）、固视稳定性、2°和4°固视率及固视点位置。结果　无黄斑病理改变组和黄斑病理改变组MS值分别为（16.39±2.12）、（10.80±4.53） dB,二者比较,差异有统计学意义（F=15.044,t=-9.314;P=0.000）。无黄斑病理改变组24只眼中,固视稳定19只眼,占79.2%;相对不稳定5只眼,占20.8%。黄斑病理改变组118只眼中,固视稳定45只眼,占38.1%;相对不稳定52只眼,占44.1%;不稳定21只眼,占17.8%。两组固视稳定率比较,差异有统计学意义（χ²=13.56,P=0.000）。两组2°和4°固视率比较,差异均有统计学意义(F=5.773,13.230;t=-4.110,-5.465;P值均=0.000)。无黄斑病理改变组24只眼中,中心固视23只眼,占95.8%;弱中心固视1只眼,占4.2%。黄斑病理改变组118只眼中,中心固视81只眼,占68.6%;弱中心固视16只眼,占13.6%;旁中心固视21只眼,占17.8%。两组中心固视率比较,差异有统计学意义(F=9.618,t=-5.773;P=0.000)。结论　病理性近视有黄斑病理改变者较无黄斑病理改变者MS、固视稳定性下降,并有旁中心固视点形成。      

Unilateral high myopia: optical components,associated factors,and visual outcomes

AIM: To elucidate the optical basis for unilateral high myopia and to identify the factors associated with its development. METHODS: Medical records of 48 children (aged 4 months to 17 years; mean age 6.8 years) with unilateral high myopia (5 dioptres or more) seen consecutively by the author during a 15 year period were reviewed. 45 (94%) of the 48 patients had unilateral axial myopia. RESULTS: The mean refractive difference between paired eyes was 9.4 (SD 3.6) dioptres and the more myopic eye was on average 3.3 (1.8) mm longer than the less myopic eye. All but three of the patients had an ocular disorder associated with reduced acuity, central nervous system abnormality, or family history of high myopia. CONCLUSION: Clinical conditions associated with unilateral high myopia can be identified in the majority of patients and often account for the associated visual impairment.     

变性性近视与糖尿病视网膜病变的相关性

目的：探讨变性性近视（ degenerative myopia ）与糖尿病视网膜病变（ diabetic retinopathy,DR）的相关性。 方法：2型糖尿病患者106例,按是否合并变性性近视分为变性性近视组（48例）和非近视组（58例）,均行眼底检查及眼底血管荧光造影（ fluorescence fundus angiography,FFA）,明确DR分期,对两组DR患病率及分期进行比较分析。 结果：变性性近视组DR患病率70.8%,仅有Ⅰ期或Ⅱ期表现,无增殖期改变;非近视组患者DR患病率93.1%,Ⅰ～Ⅴ期病变均有发生。 结论：变性性近视可以阻止DR的发生,可能是DR的保护性因素。     

Comparison of Serum Cortisol and Testosterone Levels in Acute and Chronic Central Serous Chorioretinopathy

PurposeTo compare the levels of serum cortisol and testosterone in acute and chronic central serous chorio-retinopathy (CSC).MethodsSerum cortisol and testosterone levels in 30 patients with either acute or chronic CSC were evaluated using chemiluminescent immunoassay.ResultsThe mean age was 42.43 ± 6.37 years (range, 32 to 56 years). The mean 8:00 to 9.00 a.m. serum cortisol level was 12.61 ± 4.74 µg/dL (range, 6.58 to 27.42 µg/dL). The mean serum testosterone level was 5.88 ± 1.57 ng/dL (range, 2.81 to 9.94 ng/dL). The mean visual acuity was 20 / 65.07 ± 40.56 (range, 20 / 25 to 20 / 200). There was no statistically significant difference in the mean levels of serum cortisol and testosterone between the acute and chronic cases (p > 0.05), but there was a statistically significant difference in the mean presenting visual acuity in the two groups (p < 0.05).ConclusionsAll except one patient in the acute group had normal levels of serum cortisol. Testosterone levels were within the normal range in both the acute and chronic cases of CSC. There is unlikely to be any statistically significant difference in the mean levels of serum cortisol and testosterone between the acute and chronic cases, but there may be a statistically significant difference in the mean presenting visual acuity in these groups.     

Decreased plasma cortisol in response to intramuscular ACTH in ocular hypertensives and primary open-angle glaucomas

PURPOSE: To determine if there is a difference in response of the adrenal gland to intramuscular adrenocorticotropic hormone (ACTH) between normals and ocular hypertensives (OHs) plus primary open-angle glaucomas (POAGs) without pigmented angles. METHODS: Intramuscular ACTH was given to 29 normals and 24 OH plus POAG hospitalized in a Clinical Study Unit. Blood samples were obtained at baseline (0 hours) before administration of intramuscular ACTH and 4, 8, and 24 hours after administration of intramuscular ACTH for analysis of plasma cortisol/body mass index (BMI). RESULTS: The OH plus POAG group showed lower cortisol/BMI values compared with the normal group at 4, 8, and 24 hours with a significantly lower peak/BMI value (P=0.030). Multivariate analyses with the peak plasma cortisol/BMI level as the dependent variable showed that a lower peak plasma/BMI was associated with the OH plus POAG group. Also, a lower peak plasma cortisol/BMI level was associated with a lower 0-hour cortisol/BMI (Log). CONCLUSIONS: Compared with normals, the OH plus POAG subjects showed lower plasma cortisol levels in response to intramuscular ACTH. This observation suggests adrenal suppression in the OH plus OAG group.     

玻璃体内注射雷珠单抗治疗变性近视黄斑脉络膜新生血管形成

目的 评价玻璃体内注射雷珠单抗（Ranibizumab）治疗变性近视黄斑脉络膜新生血管形成（CNV）的临床疗效.方法 单中心随机对照临床回顾性研究.并发黄斑CNV的变性近视连续病例34例（36眼）,玻璃体内注射雷珠单抗0.5 mg（0.05 ml）,注射后第1、2、3、6个月各随访1次,并于第1、2个月随访时各追加注射1次.通过最佳矫正视力、裂隙灯显微镜、眼压、检眼镜、眼底彩色照像、光学相关断层扫描（OCT）及荧光素眼底血管造影（FFA）检查,分析治疗前后最佳矫正视力、黄斑视网膜纤维层厚度的变化.结果 术前视力为0.15±0.10,术后6个月为0.25±0.16,差异有统计学意义（t=6.02,P＜0.04）.黄斑视网膜厚度术前为（315.94±13.19） μm,术后为（292.19±20.24） μm,差异有统计学意义（t=7.87,P＜0.01）.FFA显示有22眼渗漏消失,13眼渗漏面积明显减小,1眼发现新鲜出血.结论 玻璃体内注射雷珠单抗治疗变性近视黄斑CNV可使脉络膜新生血管逐渐萎缩,减少出血及渗漏,从而减轻黄斑水肿,提高视力,是目前治疗变性近视黄斑CNV的有效方法之一.     

儿童原发性近视眼

目的　分析儿童原发性近视眼的特点。方法　①对象流行病学调查发现的50例(3～7岁)及临床就诊的39例(1～12岁),静态屈光均为近视眼。②观察指标远视力、近视力、屈光(用1%阿托品)、眼底、角膜曲率、眼轴。结果　儿童近视眼多数为原发性(82例),继发于其它疾病的有7例,无明显性别差异。儿童原发性近视眼为先天性,眼轴多明显延长,长度与屈光度成正相关,角膜屈折力无明显病理意义。屈光度进行性发展,随年龄增加而加深,是日后成年期变性近视眼的主要组成。结论　儿童近视眼可分为原发性和继发性。其中主要为原发性变性近视眼。     

白内障在超声乳化术后未脱残因素分析

目的分析白内障在超声乳化术后未脱残的原因。方法对458例（466眼）白内障行超声乳化吸出及人工晶状体植入术，以术后最佳矫正视力为准。根据全国残疾人五类《残疾标准》分类，对“未脱残（视力〈0．3）”的病例进行主要原因归类分析。结果术后有98例未脱残，占21．03％。其中变性近视引起者38例，黄斑病变引起者31例，视神经萎缩引起者16例，其他13例。结论白内障在超声乳化术后未脱残的主要原因是变性近视、黄斑病变及视神经萎缩。     

Impact of family history of high myopia on level and onset of myopia

PURPOSE: To investigate the impact of a positive family history of high myopia on the level and onset of myopia and its ocular components. METHODS: A cross-sectional study was conducted. The participants (aged 17 to 45 years) were categorized into four groups: normal, mild, moderate, and high myopia. The age of first glasses for myopia was used as the onset of myopia. The impact of the family history on the level and the onset of myopia was quantified. Parental effect on corneal curvature (CC), anterior chamber depth (ACD), and axial length (AXL) was analyzed. RESULTS: The study included 185 normal subjects, 170 mild, 140 moderate, and 392 high myopes. Family history was strongly associated with the probands' status (P < 6 x 10(-12)). When there was >or=1 highly myopic parent, the odds ratios (ORs) of developing mild or moderate myopia were between 2.5 and 3.7 (95% CI: 1.1-6.5) and the ORs of having high myopia were > 5.5 (95% CI: 3.2-12.6). A strong association (P = 2 x 10(-6)) between parental myopic state and the AXL in the subjects was also found, but there was no statistical relationship for ACD or CC. There was an association between high myopia in parents and the onset of myopia in children. Siblings had a weaker association with the level of myopia and had no effect on the onset of myopia. CONCLUSIONS: This study found strong familial effects on the level and onset of myopia even after adjusting for environmental factors. The parental effect on ocular components in their offspring was primarily on AXL.     

近距隐斜视与屈光不正的关系研究

目的 探讨近距隐斜视的发生、类型与屈光不正的关系.方法 连续收集近距隐斜视患者267例,男145例,女122例,年龄(8.05+5.0)岁(3～44岁),分别进行近距隐斜视检测,静态检影.结果 正视者63例,其中发生近距外隐斜60例,近距内隐斜3例,近距外隐斜所占比重明显高于内隐斜(P=0.000).近距内隐斜47例,其屈光状态构成分别为正视和近视各3例,远视41例;近距外隐斜220例,其屈光状态构成分别为正视60例,近视64例,远视96例,经卡方检验,近距隐斜视类型与屈光状态有关(X2=29.47,P=0.000).就137例远视患者而言,发牛近距内隐斜41例,其不同程度屈光构成分别为轻度远视12例,中度远视18例,重度远视11例;发生近距外隐斜96例,其不同程度屈光构成分别为轻度远视56例,中度远视27例,重度远视13例,经卡方检验,对远视患者而言,近距隐斜视类型与远视的程度有关(X2=16.61,P=0.000),近距内隐斜多发生于中度远视,而近距外隐斜多发生于轻度远视.结论 近距隐斜视类型与屈光状态相关,其中近距内隐斜主要为远视眼未经屈光矫正引致;一定范嗣内的近距外隐斜可能是一种,圭理性眼位,而近距内隐斜则可能是一种病理性眼位,并与近视的发生发展相关.     

上海市杨浦区幼儿园儿童眼轴的光学相干生物测量调查与分析

目的 探讨学龄前正常发育状态下,幼儿园学龄前儿童眼轴长度的分布范围和发育规律,为近视的早期预防提供理论依据.方法 对上海市杨浦区104所幼儿园儿童进行全覆盖的眼轴测量,排除弱视、近视和有高度近视家族史者的情况下,筛选出正常身高、体重的儿童14 584名(共29 168眼)进行分析.采用Zeiss IOL Master光学相干生物测量仪测量眼轴长度.参照上海市制定的男、女儿童年龄划分标准,将被调查儿童分别划分为○～Ⅷ9个不同年龄段,再进行各组数据对照分析.结果 男、女儿童9个组中,Ⅷ(年龄为≥6.5～＜7)组样本量均较小,分析结果不稳定,不对其进行分析.○～Ⅶ8个年龄组眼轴数据显示:①女童各个年龄段之间的眼轴总体比较差异有统计学意义(F=85.25,P＜0.000 1);除○与Ⅰ组、Ⅵ与Ⅶ组两两比较差异无统计学意义之外,其余各组间比较差异均有统计学意义.②男童的眼轴总体比较差异有统计学意义(F=110.38,P＜0.000 1),○～Ⅶ各年龄组间相互比较亦均有统计学意义.③性别、年龄、身高、体重对眼轴均有影响.结论 2.5 ～6.5岁儿童不论男女,眼轴均处于快速增长期.总体结果显示,学龄前阶段眼轴生长迅速,应该列为近视早期预防的重点阶段.     

儿童单侧高度近视性弱视眼视网膜神经纤维层厚度的分析

目的 探讨儿童单侧高度近视性弱视眼视乳头周围视网膜神经纤维层(RNFL)厚度变化.方法 采用偏振激光扫描测量仪对23例(23只眼)单侧高度近视性弱视儿童的视乳头周围RNF进行检查.计算以视乳头为中心,3.2 mm为外环直径,2.4 mm为内环直径圆周的RNFL相对厚度值,分别与对侧眼,正常眼和单纯高度近视眼比较.组间一般资料的比较采用方差分析;两组间RNFL参数比较采用两样本独立t检验;眼轴与RNFL厚度的相关性采用Spearman相关分析法.结果 高度近视性弱视眼RNF的椭圆平均值、上方平均值及下方平均值分别为56.39±5.69、68.30±10.16及67.34±5.83,与对侧眼(t=2.090,2.243,4.236)和正常眼(t=3.087,1.025,3.481)比较,差异有统计学意义(P<0.05);与单纯高度近视眼比较差异无统计学意义(t=0.872,0.297,0.658;P>0.05);高度近视性弱视眼和单纯高度近视眼RNF椭圆平均值均随着眼轴的增加逐渐变薄,呈负相关(r=-0.462,-0.395;P<0.05).结论 儿童单侧高度近视性弱视眼视乳头周围的RNF厚度较正常眼薄,但与单纯高度近视眼比较改变不明显.单侧高度近视性弱视眼矫正视力低下的原因有待进一步研究.     

多焦视网膜电流图用于近视眼视网膜功能的研究

目的应用多焦视网膜电流图(mltifocal electroretinogram,mERG)探讨不同程度近视眼不同部位视网膜的功能状态,并与正常人作比较,评价其差异。方法收集我院眼科门诊就诊的18～32岁的病例68例(101眼),分为中低度近视组(23例40眼)、高度近视组(24例40眼)和正常对照组(21例21眼)。所有病例均应用德国罗兰公司的mERG仪记录各环N1波、P1波的潜伏期和振幅密度,再比较3组各检查结果之间的差别。结果 3组N1波和P1波的振幅密度在第1环最大,随离心度的增加而逐渐降低;潜伏期在第1环最小,随离心度增加而逐渐延长。经统计学处理,高度近视组N1波和P1波各环的振幅密度较正常对照组及中低度近视组低,差异均有统计学意义(均为P<0.05);中低度近视组与正常对照组N1波和P1波各环的振幅密度比较,差异均无统计学意义(均为P>0.05)。高度近视组N1波P1波第1环潜伏期较正常对照组及中低度近视组延长,差异有统计学意义(P<0.05),其余组间比较差异均无统计学意义(P>0.05)。结论高度近视眼mERG各环振幅密度较正常眼下降,1环潜伏期较正常眼延长;中低度近视眼与正常眼振幅密度及潜伏期无明显变化。