配戴角膜塑形镜后光学治疗区偏心对视网膜离焦量的影响

Effect of eccentricity of optical treatment zone on retinal defocus after wearing orthokeratology lens

摘要:

目的：观察配戴角膜塑形镜12mo后光学治疗区偏心对视网膜离焦量的影响。

方法：病例对照研究。选取2021-03/09在我院完成验配并坚持配戴角膜塑形镜12mo的近视患者120例120眼，根据戴镜12mo后偏心量分为低度偏心组(<0.5mm，58例58眼)和中高度偏心组(≥0.5mm，62例62眼)。评估配戴角膜塑形镜12mo后光学治疗区直径(OTZD)和偏心量、眼轴长度(AL)、基线瞳孔直径(PD)及视网膜离焦量(RDV)，分析视网膜离焦量与偏心量的相关性。

结果：配戴角膜塑形镜12mo后，中高度偏心组AL增长量、距黄斑30°～40°和40°～53°范围RDV明显低于低度偏心组(均P<0.05)。纳入患者距黄斑40°～53°范围RDV与AL增长量、OTZD呈正相关(r_s=0.544、0.333，均P<0.01)，与偏心量呈负相关(r_s=-0.224，P=0.014)。

结论：配戴角膜塑形镜后周边视网膜离焦与偏心量、OTZD相关，一定范围内偏心量越大、OTZD越小可诱导更多周边视网膜近视性离焦，控制眼轴增长效果越好。

Abstract:

AIM: To observe the effect of eccentricity of the optical treatment zone on retinal defocus after wearing orthokeratology lens for 12mo.

METHODS: In this case-control study, a total of 120 myopic patients(120 eyes)who completed the fitting in our hospital from March 2021 to September 2021 and insisted on wearing orthokeratology lenses for 12mo were selected. According to the eccentricity after wearing lenses for 12mo, they were divided into the low eccentricity group(<0.5mm, 58 cases, 58 eyes)and the moderate and high eccentricity group(≥0.5mm, 62 cases, 62 eyes). The optical treatment zone diameter(OTZD), eccentricity, axial length(AL), pupil diameter(PD)and refraction difference value(RDV)were evaluated after 12mo of wearing orthokeratology lenses, and the correlation between RDV and eccentricity was analyzed.

RESULTS: After wearing orthokeratology lenses for 12mo, AL growth and RDV at 30°～40° and 40°～53° from the fovea were significantly lower in the moderate and high eccentricity group than in the low eccentricity group(all P<0.05). In all patients, RDV at 40°～53° from the fovea was positively correlated with AL growth and OTZD(r_s=0.544, 0.333, both P<0.01), and negatively correlated with eccentricity(r_s=-0.224, P=0.014).

CONCLUSION: Peripheral retinal defocus is related to eccentricity and OTZD after wearing orthokeratology lenses. The greater eccentricity and the smaller OTZD within a certain range can induce more peripheral retinal myopic defocus, leading to a better control of AL growth.