5岁段早产儿及早产儿视网膜病变患儿屈光状态及光学部件的研究

发布时间：2019-04-19 11:14

【摘要】：目的:研究5岁段早产儿伴或不伴早产儿视网膜病变(Retinopathy of Permaturity,ROP)的屈光状态及光学部件的变化,观察孕周、体重及ROP对幼儿眼部发育的影响。方法:从2009年1月起至2011年2月止,我院行眼底检查的早产儿,将其分为ROP组和早产无ROP组(简称早产组),并纳入同岁段的正常无早产儿童为对照组。第5年进行角膜屈光力(Corneal Refraction,CR),角膜曲率(Corneal Curvature,CC),前房深度(Anterior Chamber Depth,ACD),晶状体厚度(Lens Thickness,LT),玻璃体厚度(Vitreous Thickness,VITR),眼轴长度(Axial Length,AL),并进行大瞳下的检影验光(1%环戊通扩瞳)。三组间各结果进行比较,并进行孕周,出生体重与各因素的相关性比较。结果:1.共120人237眼,按上诉方法分为三组:ROP组(31例59眼,1期至3期阈值前期),早产组(47例94眼),足月儿组(42例84眼)。2.近视发生率ROP组最高(8/59,占13.56%),早产组次之(5/94,占5.32%),足月儿组最低(1/84,占1.19%)。散光发生率ROP组(24/59,占40.68%)、早产组(17/94,占18.09%)均高于足月儿组(7/84,占8.33%)。3.ROP组和早产组角膜散光(-1.47DC,-1.10DC,-1.05DC)和散光均值(1.08DC,1.08DC,0.56DC)比足月儿组高;早产组及足月儿组角膜屈光力(42.86D,42.91D,43.86D)、角膜曲率(7.69 mm,7.68 mm,7.89 mm)比ROP组低;ROP组及早产组眼轴长度比足月儿组短(22.15mm,22.16mm,22.47mm),且均有统计学意义(P0.05)。晶状体厚度三组间无统计学差异(4.41mm,4.41mm and 4.41 mm,P0.05)。4.孕周与角膜散光(r=-0.184,p=0.016),散光(r=-0.231,p=0.003)为负相关,与眼轴长度(r=0.228,p=0.003)为正相关;出生体重与角膜散光(r=-0.254,p=0.001),散光(r=-0.279,p0.001),角膜屈光力(r=-0.258,p=0.001),角膜曲率(r=0.243,p=0.001)呈负相关,与眼轴长度(r=0.248,p=0.001),等效球镜(r=0.155,p=0.044)呈正相关。结论:(1)5岁阶段随访资料显示早产儿及ROP患儿较足月儿发生近视及散光几率更大。(2)低出生体重、低孕周及ROP的发生均可影响眼部各光学部件的生长,最终导致近视及散光的发生。
[Abstract]:Aim: to study the changes of refractive state and optical components in 5-year-old premature infants with or without retinopathy of prematurity (Retinopathy of Permaturity,ROP), and to observe the effects of gestational weeks, weight and ROP on the development of children's eyes. Methods: from January 2009 to February 2011, premature infants underwent fundus examination in our hospital were divided into ROP group and preterm non-ROP group (referred to as preterm delivery group), and normal non-preterm infants in the same age group were included as control group. In the fifth year, corneal refractive power (Corneal Refraction,CR), corneal curvature (Corneal Curvature,CC), anterior chamber depth (Anterior Chamber Depth,ACD), lens thickness (Lens Thickness,LT), vitreous thickness (Vitreous Thickness,VITR) and axis length (Axial Length,AL) were performed. The examination and optometry under large pupil (1% cyclopentone dilated pupil) were carried out. The results were compared among the three groups, and the correlation between gestational weeks, birth weight and various factors was compared. Results: 1. According to the appeal method, 237 eyes were divided into three groups: ROP group (31 cases 59 eyes, stage 1-3 pre-threshold), premature labor group (47 cases 94 eyes), term group (42 cases 84 eyes). The incidence of myopia was the highest in ROP group (8 / 59, 13.56%), the second in preterm delivery group (5 / 94, 5.32%), and the lowest in full-term group (1 / 8 / 84, 1.19%). The incidence of astigmatism in ROP group (24 / 59, 40.68%), premature delivery group (17 / 94, 18.09%) was higher than that in term group (7 / 84, 8.33%). The incidence of astigmatism in 3.ROP group and premature delivery group (- 1.47DC, / 1.10DC, P < 0.05) was higher than that in term group (- 1.47DC, 1.10DC, P < 0.05). -1.05DC) and mean astigmatism (1.08DC, 1.08DC, 0.56DC) were higher than that of full-term infants. The corneal refractive power (42.86 D, 42.91 D, 43.86 D) and corneal curvature (7.69 mm,7.68 mm,7.89 mm) in premature and full term infants were lower than those in ROP group. The length of ocular axis in ROP group was shorter than that in term group (22.15mm, 22.16mm, 22.47mm), and all of them were statistically significant (P0.05). There was no significant difference in lens thickness among the three groups (4.41 mm, 4.41 mm and 4.41 mm, P0.05). Gestational weeks were negatively correlated with corneal astigmatism (r = 0.184, p = 0.016), astigmatism (r = 0.231, p = 0.003), and positively correlated with axial length (r = 0.228, p = 0.003). Birth weight was negatively correlated with corneal astigmatism (r = 0.254, p = 0.001), astigmatism (r = 0.279, p < 0.001), corneal refractive power (r = 0.258, p = 0.001), corneal curvature (r = 0.243, p = 0.001), corneal refractive power (r = 0.248, p = 0.001), corneal refractive power (r = 0.248, p = 0.001), corneal curvature (r = 0.243, p = 0.001). It was positively correlated with the axial length (r = 0.248, p = 0.001) and the equivalent spherical mirror (r = 0.155, p = 0.044). Conclusion: (1) the incidence of myopia and astigmatism in preterm and ROP infants is higher than that in term infants at 5 years old. (2) low birth weight, low gestational week and ROP can affect the growth of optical components in the eye. Eventually leading to myopia and astigmatism.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R774.1

【参考文献】