高度近视眼屈光度与眼轴在不同年龄段的进展及其相关性研究(1)
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[摘要] 目的 研究高度近视在不同年龄段的具体进展规律及各阶段屈光度和眼轴相关性的发展轨迹。方法 按年龄将高度近视患者176例(352眼)分为四组：1组≤14岁32眼(9.1%)；2组15～30岁(包括30岁)96眼(27.3%)；3组31～50岁(包括50岁)164眼(46.6%)；4组>50岁60眼(17.0%)，分别测量四组患者屈光度、眼轴及其各屈光间质成分长度。结果 2组比1组近视屈光度加深(-5.94±1.63)D(t=-3.651，P=0.001)，眼轴延长(3.25±0.70)mm(t=4.662，P<0.001)，而2组与3组、3组与4组的屈光度、眼轴都没有明显差异。各年龄阶段高度近视眼屈光度都主要与眼轴相关(r=0.649)且两者比例较稳定，总体来说眼轴每延长1mm，近视度约增加1.73D。结论 高度近视眼在30岁前都处在迅速进展期，30岁以后发展趋于稳定，且高度近视屈光度始终主要与眼轴相关。
[关键词] 高度近视；进展；屈光度；眼轴
[中图分类号] R778.1+1 [文献标识码] B [文章编号] 1673-9701(2011)32-31-02
The Progression of High Myopia and the Correlation between Refraction and Axial Length
FANG Youfa REN Yueping
Shangyu People’s Hospital，Shangyu 312300，China
[Abstract] Objective To study the progression of high myopia at different ages，and the correlation between refraction error and axial length. Methods According to the age，176 cases(352 eyes)of high myopia were assigned to four groups：Group 1(below 14-year-old，32 eyes)，Group 2(15 to 30-year-old，96 eyes)，Group 3(31 to 50-year-old，164 eyes)，Group 4(above 50-year-old，60 eyes). The refractive error，axial length including anterior chamber depth，lens thickness and vitreaous chamber depth in each groups were measured. Results The myopic refraction of Group 2 increased by(-5.94±1.63)D(t=-3.651，P=0.001)，compared with Group 1，and the axial length elongated by(3.25±0.70)mm(t=4.662，P<0.001)；while there were no significant differences between Group 3 and Group 2，and neither between Group 4 and Group 3. In every age group，the high myopic refraction was mainly correlated to axial length(r=0.649). Conclusion High myopia is in great progression before the age of thirty，and turns to be stable henceforth，and the refraction is always related to axial length.
[Key words] High myopia；Progrssion；Refraction；Axial length
近视是现代社会较为普遍的屈光性眼疾，高度近视是指近视屈光度大于-6.00D的近视，其发病率为0.95%，而其在近视人群中的比例达18%～24%[1-3]。通常认为，角膜屈光力、晶状体系统、眼轴等是影响近视眼屈光度数的主要因素，近年的研究已经证明眼轴的异常延长是导致高度近视的决定因素[4-6]。流行病学调查显示，高度近视在亚裔黄色人种的发病率远远高于欧美白色人种[1，2，7]。而且高度近视不是一种单纯的屈光性眼疾，除了本身的眼底近视弧、眼轴过度延长而变薄的巩膜后葡萄肿，它还大大增加了青光眼、视网膜脱离、脉络膜新生血管等眼病的患病几率，而这些疾病如不采取及时而合理的诊治，将导致永久性的视觉损害甚至眼盲。正因为其严重性，高度近视的病因学研究始终是眼科界一大热点，至今对其的基因定位已确定在Xq28、Xq23两个性染色体和MYP2至MYP15的14个常染色体基因位点[8-10] ......
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