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河北省永年县农村成年人群黄斑区视网膜厚度的流行病学研究:邯郸眼病研究

吴建  蔡啸谷  林彩霞  王宁利   

  1. 100005 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2019-06-27 出版日期:2019-11-25 发布日期:2019-12-06
  • 通讯作者: 王宁利,Email:wningli@vip.163.com E-mail:wningli@vip.163.com
  • 基金资助:

    国家自然科学基金面上项目(81271005);北京市自然科学基金(7122038)

Epidemiological study of macular thickness in Yongnian County population: Handan Eye Study

WU Jian, CAI Xiao-gu, LIN Cai-xia, WANG Ning-li   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2019-06-27 Online:2019-11-25 Published:2019-12-06
  • Contact: WANG Ning-li, Email: wningli@vip.163.com E-mail:wningli@vip.163.com

摘要:

目的 探讨中国北方农村成年人群黄斑区视网膜厚度与性别、年龄及屈光状态的关系。设计 横断面研究。研究对象 2012-2013年“邯郸眼病研究”河北省永年县人群5394名,平均年龄(57.8±11.2)岁。方法 对所有受试者进行问卷调查、详细的眼科检查及全身系统检查。采用相干光断层扫描(optic coherence tomography,OCT)并利用内置软件根据黄斑区视网膜厚度分为九个区(黄斑中心区、内环上方、内环下方、内环鼻侧、内环颞侧、外环上方、外环下方、外环鼻侧、外环颞侧)测量视网膜厚度。主要指标 黄斑区视网膜厚度。结果 5394名受试者中4735名(87.8%)OCT结果符合纳入标准。黄斑中心区、内环区、外环区平均视网膜厚度分别为(237.73±22.67) μm、(310.26±18.47) μm、(278.36±22.26) μm。男性及女性黄斑厚度分别为中心区(242.40±22.32) μm、(234.03±18.47) μm,内环平均厚度(314.82±18.39) μm、(306.64±17.72) μm,外环平均厚度(280.37±14.33) μm、(276.76±14.40) μm,各区存在明显差异(P均<0.001),且女性视网膜较男性薄。不同年龄组黄斑中心区视网膜厚度与年龄呈非单调曲线关系,约60岁为厚度最大值(P<0.001)。内环区与外环区黄斑视网膜厚度与年龄显著相关,随年龄增长而逐渐变薄(P<0.001)。屈光度与黄斑视网膜厚度存在关联,黄斑中心区、内环区、外环区屈光度每增加1.00 D,对应黄斑厚度改变分别为(-0.6±0.2) μm、(0.2±0.1) μm、(0.5±0.1) μm。结论 河北永年县农村成年人群中,黄斑区视网膜厚度随年龄增长而下降,且不同年龄段视网膜厚度的变化率不同。女性黄斑区视网膜厚度较男性薄。黄斑中心区视网膜厚度随近视屈光度的增加而变薄,而在外环区,视网膜厚度随近视屈光度的增加而增厚。

关键词: 黄斑视网膜厚度, 人群为基础的流行病学研究, 相干光断层扫描

Abstract:

Objective To measure the association of macular thickness with sex, age and refractive status in middle-aged and elderly population of Handan Eye Study (Yongnian County in Hebei Province). Design Population-based cross-sectional study. Participants 5394 participants in Handan Eye Study 2012-2013 with the mean age of 57.8±11.2 years. Methods A detailed interview, general examinations and ophthalmic examinations were performed. Using optical coherence tomography (OCT) to measure the macular thickness, and separate to nine sectors of the ETDRS grid. Main Outcome Measures Macular thickness. Results 4735(87.8%) of 5394 participants in macular thickness measurements were available. The mean macular thickness of central foveal subfield, average pericentral ring and the average peripheral ring was 237.73±22.67 μm, 310.26±18.47 μm, and 278.36±14.48 μm, respectively. There was significant difference in macular thickness between different genders (P<0.001). The mean macular thicknesses of central foveal subfield, average pericentral ring and the average peripheral ring in the male were 242.40±22.32 μm, 314.82±18.39 μm, and 280.37±14.33 μm, and the mean  macular thicknesses of central foveal subfield, average pericentral ring and the average peripheral ring in the female were 234.03±18.47 μm, 306.64±17.72 μm, and 276.76±14.40 μm, the thinner overall average macular thickness was associated with female sex. In the fovea, there was a non-monotonic curved relationship between macular thickness and age in both sexes with a maximum at about 60 years (P<0.001). The pericentral ring and the peripheral ring in different age groups were significantly different (P<0.001). These thickness gradually decreased with age. Macular thickness was significantly associated with refraction, where mean change in retinal thickness per 1.00 D increase in spherical equivalent refraction (SER) was -0.6±0.2 μm in the fovea, 0.2±0.1 μm in the pericentral ring and 0.5±0.1 μm in the peripheral ring. Conclusion In Yongnian adult population, macular thickness was declined with age in both women and men in all macular regions, and the rate of change in macular thickness varied at different ages. Women had thinner macular than men. Higher SER was associated with thinner retina in central foveal subfield and thicker retina in the pericentral and the peripheral ring in both women and men.

Key words: macular thickness, population-based epidemiological survey, optical coherence tomography