目的：应用超广角激光扫描检眼镜(Daytona P200T)对小、初、高中学段的低、中、高度近视学生的周边视网膜进行扫描，了解其周边视网膜变性的患病率和近视屈光度等的关系。

方法：采用分层随机整群抽样方法，在绵阳市随机抽取2所小学、1所初中、1所高中，筛选出近视眼学生，按屈光度不同划分为低、中、高度近视。先应用Daytona P200T在自然瞳孔下行眼底图像采集，然后散瞳后由高年资眼科主治医师在裂隙灯下前置镜眼底检查有无遗漏。

结果：不同屈光度组间周边视网膜变性患病率不同，且近视屈光度越高，周边视网膜变性患病率增高(趋势χ²=75.76，P<0.001)。比较不同屈光度组间周边视网膜变性患病率：霜样变性(STD)三组间无差异(χ²=5.66，P=0.059)，格子样变性(LD)、蜗牛迹样变性(SD)、非压迫性变白(WWP)、囊样变性(CD)、裂孔(DRP)、色素样变性(RP)三组间均有差异(P<0.01)。进一步两两比较，除WWP(χ²=9.385，P=0.002)外，低度组与中度组比较均无差异(P>0.017)，低度与高度组两两比较均有差异(P<0.017)。中度组和高度组比较，除CD(χ²=8.525，P=0.004)和RP(χ²=6.454，P=0.011)，其余均无差异。不同学段周边视网膜变性患病率比较：小学段共34眼视网膜变性(5.7%)，初中段共90眼(14.9%)，高中段130眼(21.9%)； 随学段增高周边视网膜变性患病率增高(趋势χ²=64.79，P<0.001)。WWP患病率三组间无差异(χ²=5.63，P=0.060)，其它各组间患病率均有差异。进一步两两比较，除LD(χ²=6.209，P=0.013)和STD(χ²=9.953，P=0.002)外，小学段与初中段、初中段和高中段比较，均无差异(P>0.017)； 小学段与高中段两两比较均有差异(P<0.017)。

结论：青少年近视周边视网膜变性患病率与屈光度、学段成正相关。

AIM: To investigate the relationship between the prevalence of peripheral retinal degeneration and myopic degree by using the fort ultra wide angle scanning laser ophthalmoscope(Daytona P200T)for small, early and high middle school period of low, medium and high myopia students peripheral retinal scan.

METHODS: With method of stratified random cluster sampling, to select myopia students in two primary schools, one junior middle school and one senior high school in Mianyang. According to different degrees, the myopia was divided into low, medium and high myopia, with 300 people and 600 eyes respectively. Application of Daytona P200T in natural pupil downward fundus image acquisition, and then the senior ophthalmologist performed the fundus examination under the slit lamp after pupil dilation.

RESULTS: The prevalence of peripheral retinal degeneration was different among different refractive groups, and the higher the myopia, the higher the prevalence of peripheral retinal degeneration(χ²=75.76, P<0.001). Comparison between different degree groups prevalence of peripheral retinal degeneration: frost degeneration(STD)no statistical difference between the three groups(χ²=5.66, P=0.059), lattice degeneration(LD), snail track degeneration(SD), non-oppressive whitening(WWP), cystic degeneration(CD), hiatal(DRP), pigment degeneration(RP)were differences among three groups. For further comparison, except WWP(χ²=9.385, P=0.002), low height both two(P>0.017). Moderately and highly group compared, in addition to the CD(χ²=8.525, P=0.004)and the RP(χ²=6.454, P=0.011), the rest were not tested statistically. Compared with the prevalence of peripheral retinal degeneration in different segments, retinal degeneration was observed in 34 eyes(5.7%)in primary school, 90 eyes(14.9%)in junior middle and 130 eyes(21.9%)in senior high. The prevalence of peripheral retinal degeneration increased with the increase of medical grade(χ²=64.79, P<0.001). The prevalence of WWP and CD showed no statistical difference between junior middle school and primary school and senior high school(P>0.05). For further comparison, except LD(χ²=6.209, P=0.013)and STD(χ²=9.953, P=0.002), no statistical difference in the primary schools and junior middle, junior middle and senior high(P>0.017), statistical difference was detected between the primary schools and senior high school(P<0.017).

CONCLUSION: The prevalence of peripheral retinal degeneration of myopia was positively correlated with myopia and learning period.

四川省卫生和计划生育委员会普及应用项目(No.17PJ536); 绵阳市科技局资助项目(No.15S-02-9); 绵阳市卫生局资助课题(No.2014010)