- 學位論文
探討高度近視視網膜形變與周邊屈光狀態之關係
The relationship between the shapes of highly myopic eyes and their peripheral refraction errors by using high-resolution three-dimensional magnetic resonance imaging
摘要
目的：本研究之目的為了解高度近視患者視網膜形變之狀態，並對其照周邊屈光度，找出兩者之間的相關聯性。 方法：受測者為台灣年輕人共35位，年齡介於20至30歲，組別則按照中央屈光度分成正視眼組(+0.50 D至-0.50 D)與高度近視眼組(＜-6.00 D)，兩組受測者之散光度數皆低於1.00 D (＞-1.00 D)。利用開放式自動驗光儀測量其中央屈光度與周邊屈光度，水平周邊屈光度每3度一跳直至鼻側及顳側30度，垂直周邊屈光度3度一跳直至上側9度及下側12度，再使用眼軸測量儀測量眼軸長及磁振造影測量眼球形狀。 結果：研究結果發現正視眼組周邊屈光呈現相對性近視，視網膜形變則是中間較平周邊較陡，周邊屈光與視網膜形變相關性，顳側與鼻側呈現正相關，但未達統計上意義(顳側：Pearson r = 0.224；p = 0.059；鼻側：Pearson r = 0.137；P = 0.250)；上側與下側則呈現負相關，但未達統計上意義(上側：Pearson r = -0.021；P=0.904；下側：Pearson r = -0.009；p = 0.957)。高度近視眼組周邊屈光呈現相對性遠視，視網膜形變則是中間較陡周邊較平，周邊屈光與視網膜形變相關性，顳側與鼻側呈現負相關，且達統計上意義(顳側：Pearson r = -0.459；P＜0.01；鼻側：Pearson r = -0.277；P = 0.011)；上側與下側則呈現負相關，但未達統計上意義(上側：Pearson r = -0.066；P = 0.679；下側：Pearson r = -0.260；P = 0.096)。 結論：結果顯示正視眼組呈現相對周邊近視；高度近視眼呈現相對周邊遠視。高度近視的周邊遠視失焦確實與視網膜形變有相關性，或許可以藉由減少周邊遠視失焦，減緩視網膜形變，以達到控制近視的效果。未來可以利用這樣的分析方式製作符合視網膜形變的矯正鏡片，來控制近視發展。
並列摘要
Purpose: This study aims to determine whether the relative peripheral refractive errors and the shape of retina by high-resolution three-dimensional magnetic resonance imaging in high myopia. Methods: Sixteen young adults with high myopia (over＞6.00 D) and nineteen emmetropic ( +0.50 to -0.50 D) young adults were investigated. An open-field auto-refractor was used to measure on- and off-axis refractions in horizontal meridian every 3° out to 30° in nasal and temporal retina, and in vertical meridian every 3° out to 12° in superior and inferior retinal. Axial ocular dimensions were measured by A-scan ultrasonography. Axial (horizontal through middle of eye), sagittal (vertical through axis) and tangential (horizontal through axis) sections were taken with a magnetic resonance imaging. Result: High myopic subjects had greater relative hyperopia in the periphery 30° temporal (+2.48 ± 0.90 D),30° nasal (+2.68 ± 1.16 D), 9° Superior (+0.64 ± 0.58 D) and 12° Inferior (+0.65 ± 0.63 D), indicating a prolate ocular shape (longer axial length than equatorial diameter), compared with relative peripheral myopia and an oblate shape (broader equatorial diameter than axial length) for emmetropes 30° temporal (-1.64 ± 0.42 D)and 30° nasal(-1.39 ± 0.44 D), 9° Superior (- 0.55 ± 0.27D) and 12° Inferior (-0.860 ± 0.29 D) .High myopic eyes showed much larger in all three dimensions, but more so in length (26.15 ± 1.05 mm) than in height (24.59 ± 0.87 mm) and more so in height than in width (24.41 ± 1.21mm). Emmetropic eyes showed the similar in three dimensions (height is 23.58 ± 0.61 mm, length is 23.40 ± 0.68 mm, and width is 23.19 ± 0.90 mm). In high myopic groups, the curvature of retina showed a significant negative correlation with the relative peripheral refraction(Temporal：Pearson r = -0.459；P＞0.01；Nasal：Pearson r = -0.277；P = 0.011；Superior：Pearson r = -0.066；P = 0.679；Inferior：Pearson r = -0.260；P = 0.096). Conclusions: In this study, the emmetropic groups showed relative peripheral myopic refrction and oblate ocular shape；The high myopic groups showed relative peripheral hyperopic refraction and prolate ocular shape. In high myopic eyes are negative correlation with the curvature of retina and relative peripheral refraction.