【摘要】 分析不同年龄阶段高度近视患者的性别、年龄、病程、视力、屈光度、眼底等情况并探讨它们与高度近视发生的风险,视力与屈光状态及眼底情况的关系，为防止高度近视的发生、发展提供一定依据。方法：根据年龄将高度近视患者分为4组：组1，年龄≤29岁的患者;组2，年龄为30～49岁;组3，年龄为50～69岁;组4，年龄为≥70岁。非睫状肌麻痹状态下自动验光仪验光，取等效球镜进行屈光度计算。用直接眼底镜行眼底检查，结果行相关统计学分析结果：各组男女患者比例有显著性差异，女性显著多于男性(P<0.01)，高度近视患者的年龄和病程有相关性，年龄越大的患者其病程越长。随着年龄增加，高度近视患者的视力显著的下降,且眼底出现漆裂纹、黄斑出血、Fuchs斑、脉络膜萎缩灶的比率呈增加趋势结论：女性可能是高度近视发生的风险因素之一，年龄增加是导致高度近视患者视力下降的一个重要因素，对高度近视患者宜进行早期治疗，以防治近视的发展及黄斑病变的发生。
【关键词】 高度近视;性别;年龄;屈光度;眼底
Risk factor analysis of 167 patients with high myopia Ya Mo, MingFang Wang, LüLü ZhouDepartment of Ophthalmology, the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, ChinaAbstract AIM:To analyse the risk factors of age, sex, course, best corrected visual acuity(BCVA),diopter and fundus features of high myopes with progressive high myopia. METHODS: A total of 167 patients with high myopes were categorized into four groups: group 1,age of 29 years or younger; group 2,between the age of 30 to 49 years; group 3,between the age of 50 to 69 years and group 4,age of 70 years or older. The refractive errors of all patients were measured without cycloplegia with an autorefractometer. Data of the spherical equivalent(SE) of the refractive errors in diopters (D)and fundus examed by direct ophthalmoscope were used in statistical analyses.
RESULTS: The number of female was statistically larger than that of male(P<0.01),also the disease course was correlated to the age. The visual acuity of high myopes significantly decreased as they grew older including the higher incidence of lacquer cracker, submacular hemorrhage, Fuchs spots, chorioretinal atrophy . CONCLUSION: Female maybe a risk factor of high myopia, advanced age is an important factor of visual acuity decrease. High myopes ought to be treated early to delay the progress of myopia and development of macular degeneration.
KEYWORDS: high myopia; sex; age; diopter; fundus
INTRODUCTION
Myopia is a leading cause of visual impairment[1]. High myopia is synonymous with pathologic myopia as the extreme form of myopia defined as refraction of at least 6.00 diopters, frequent cause of legal blindness, especially in younger patients[2],due to retinal detachment, macular degeneration[1] and choroidal neovascularization(CNV) [3] etc.
Its necessary to study the epidemiology of high myopic patients by their age, sex, course, best corrected visual acuity(BCVA), refractive error and fundus. Next, we hope to find ways in delaying the progression of myopia and exploring effective treatment of pathologic myopia.
Our work was conducted in accordance with the declaration of Helsinki.
PATIENTS AND METHODS
Patients A total of 167 patients 334 eyes of high myopes were studied from the Department of Ophthalmology in the Affiliated Hospital of Chengdu University of TCM, Patients were excluded if they met any one of the following criteria: connective tissue disease, diabetes mellitus, amblyopia, corneal disease, cataracts, previous ocular trauma. The spherical equivalent(SE)of refraction is at least 6.00D, age ranged from 16 to 87 years, male 46 cases, female 121 cases. All patients were categorized into four groups: group 1,age of 29 years or younger with 20 cases and 40 eyes; group 2,between the age of 30 to 49 years with 48 cases and 96 eyes; group 3,between the age of 50 to 69 years with 74 cases and 148 eyes and group 4,age of 70 years or older with 25 cases and 50 eyes.
Methods The refractive errors of all patients were measured without cycloplegia with an autorefractometer. The SE of the refractive errors in diopters (D) was used in statistical analyses. All fundus were examed by a direct ophthalmoscope through dilated pupil.
Statistical Analysis Using the Statistical Program for Social Sciences (SPSS)13.0 to analyze data: χ2 test was performed when there were data of frequency in different groups. Oneway ANOVA was used to evaluate differences in data with normal distribution and homogeneity, variance without normal distribution and homogeneity were analyzed by nonparametric test. Both sides of variance with normal distribution were analyzed by linear regression.
RESULTS
Sex, Age and Course There were 121 female and 46 male, and the number of female was statistically larger than that of male (Table 1). The age and course had significant difference in different groups, from group 1 to group 4 the age and course were statistically increasing(Table 2).
SE of Both Eyes The SE of eyes in group 1 were statistically lower than those in other groups (Table 2), the SE of eyes between group 2, 3 and 4 had no significant
difference. In our regression study, we defined age as independent variable χ and course and SE named as dependent variable Y (Table 3). Also we compared the parameter of right and left SE by t test and found no statistical difference, so they cant enter regression analyze, last the regress equation as follows: Course=0.641×Age8.654. The course of high myopes was positively correlated to the age of patients.Table 1 Sex and age difference in high myopia(略)Table 2 Age, course and SE of patients with high myopia(略)Table 3 Regression analysis of age, course and SE(略)Table 4 The visual acuity and fundus of patients with high myopian(略)Table 5 The fundus of patients in different groupsn(略)
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