中青年高度近视眼球结构和视力变化的研究

发布时间：2018-02-28 17:09

本文关键词： 法医临床学高度近视视力屈光度眼轴眼底　出处：《苏州大学》2009年硕士论文　论文类型：学位论文

【摘要】： 目的:研究中青年近视者的眼球结构变化与近视程度改变的规律,探讨高度近视者眼球结构和视力的关系,筛选出与视力变化关系密切的眼球结构相关检查指标,据此建立根据高度近视眼球结构变化的相关参数推断受试者行为视力的方法,确保眼损伤法医学鉴定的科学性和准确性。方法:检查受试者(152人,283眼)的矫正视力、角膜曲率半径、前房深度、眼轴长度、眼底、黄斑6mm直径范围视网膜厚度,根据眼底图像测量近视弧与视盘的面积并计算得出弧盘比值;根据受试者屈光度、眼轴及眼底参数的不同进行分组或分级;采用SAS8.1及SPSS15.0统计软件包对数据进行统计分析,分别进行年龄、屈光度、眼轴长度、角膜曲率半径、前房深度、弧盘比值、眼底分级、黄斑厚度、黄斑容积与视力之间的相关性分析、多元回归分析,探讨屈光度、眼轴长度及眼底近视改变与视力的关系,最后拟出根据受试者眼球结构指标推导受试者视力的数学模型。结果:①年龄、眼底分级、近视弧大小、眼轴长度、屈光度与视力呈中度相关(｜r｜0.4,p0.0001),黄斑容积、黄斑厚度与视力呈低度相关(｜r｜接近于0.4,p0.0001),角膜曲率及前房深度与视力无显著相关性。②在一定范围内,近视眼球结构改变对视力没有显著影响,但当屈光度增加到一定程度时,视力会随着眼球结构改变加重而下降:如眼轴长度小于28.5mm、屈光度低于-10.00D、眼底分级在2级以下者,其视力多在正常范围内(1.0左右);当眼轴长度大于30.00mm、屈光度大于-20.00D、眼底分级为4级者,其视力多低于0.5。③建立了根据高度近视眼患者眼球结构参数推断视力的数学模型,将样本进行自身回代,误差在±0.1时,准确率达到75%以上,误差在±0.15时,准确率高达90%。结论:①高度近视眼患者视力随年龄增长、眼轴延长、屈光度加深、眼底病变程度加重而降低,眼球后极部尤其是黄斑区病变的类型与程度为影响视力的主要因素。②通过对高度近视者眼球形态结构的检查,根据高度近视者眼球形态结构变化的相关参数以及依此建立的数学模型可以较准确地评估受试者的行为视力。
[Abstract]:Objective: to study the regularity of the changes of eyeball structure and degree of myopia in young and middle-aged myopia, to explore the relationship between eyeball structure and visual acuity in high myopia, and to screen out the relative examination indexes of eyeball structure which are closely related to the change of eyesight. Based on this, a method to infer the behavioral visual acuity of the subjects according to the parameters of ocular structure changes in high myopia was established to ensure the scientific and accurate forensic identification of ocular injuries. Methods: the corrected visual acuity, radius of curvature of cornea, depth of anterior chamber, axial length, fundus, macular diameter and retinal thickness were examined in 152 patients (283 eyes). The area of myopic arc and optic disc was measured according to the fundus image and the ratio of arc to disc was calculated. According to the diopter, the axial and fundus parameters of the subjects were grouped or graded. The data were analyzed by SAS8.1 and SPSS15.0 statistical software package. Age, diopter, length of eye axis, radius of curvature of cornea, depth of anterior chamber, arc disc ratio, fundus grade, macular thickness, macular volume and visual acuity were analyzed. The relationship between the length of eye axis and the change of myopia and visual acuity was discussed. Finally, the mathematical model of visual acuity was deduced according to the index of eyeball structure. Results the age, fundus grade, myopic arc size, axial length and diopter were moderately correlated with visual acuity (r 0.4 p 0.0001, macular volume). There was a low correlation between macular thickness and visual acuity (r = 0.4 p 0.0001g). There was no significant correlation between corneal curvature and anterior chamber depth and visual acuity in a certain range. The change of myopic eye structure had no significant effect on visual acuity, but when the diopter increased to a certain extent, there was no significant correlation between macular thickness and visual acuity. Visual acuity decreases as the structure of the eyeball worsens: if the axial length is less than 28.5 mm, the diopter is less than -10.00D, and the fundus grade is below grade 2, The visual acuity was about 1.0 in the normal range, and when the axial length was more than 30.00mm, the diopter was greater than -20.00D, and the fundus grade was grade 4, the visual acuity of the patients with high myopia was more than 0.5.3. A mathematical model was established to infer the visual acuity based on the eyeball structure parameters of the patients with high myopia. The error is 卤0.1, and the accuracy is more than 75%. When the error is 卤0. 15, the accuracy is as high as 90. Conclusion the visual acuity of the patients with high myopia increases with age, the axis of the eye lengthens, the diopter deepens, and the degree of fundus lesion becomes worse. The type and extent of the lesions in the posterior pole of the eyeball, especially in the macular area, were the main factors affecting the visual acuity by examining the morphology and structure of the eyeball in the patients with high myopia. According to the parameters of the morphological changes of the eyeball and the mathematical model, the behavioral visual acuity of the subjects can be evaluated more accurately.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：D919

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