| Purpose:To evaluate morphological feature of optic nerve head(ONH)area?macluar area and eyeball wall in high myopia(HM)as a function of extent of age,axial length(AL),refractive diopter and posterior sclera shape(PSS).Methods:Medical records from patients(n=184)seen in the Ophthalmology Department of the Third Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,China,and diagnosed with high myopia(HM)were included in this study.Eyes were classified according to age,spherical equivalent(SE),AL and PSS.Using the Topocon three dimensional optical coherence tomograph(3D-OCT)?DRI-OCT Atlantis OCT?eye fundus camera?IOL Mster to detect the parameters,Include size and type of ONH?peripapillary atrophy(PPA)?peripapillary chorioretinal atrophy(PCA),myopia maculopathy,the location of macular central,the shape of the macular(MS),the thickness of retinal?choriodal?scheral in the EDTRS Grid area and PSS.Groups Age1?Age2?Age3 for the age classification.Groups SE1?SE2?SE3for the SE classification.Groups AL1?AL2?AL3 and AL4 for the AL classification.Groups PS1,PS2,PS3 and PS4 according to the Curtin for the PSS classification.Individual eyes were grouped as simple HM and degenerative myopia according to the myopia macularpathy(MM).To discuss how the Age,SE,AL and PSS effect the above parameters and correlation.Results:1.Area related ONH:1.1 PPA?ONH Size:Average areas—ONH(PPA,PCA)-were 1.99(1.40,0.03),2.49(4.68,1.92),and 2.28(5.99,2.78)mm~2 in groups Age1,Age2,and Age3,respectively.Average areas in groups SE1,SE2,and SE3 were 1.95(2.05,0.42),2.42(4.44,1.39),and 2.52(7.19,3.64)mm~2,respectively;There were statistically significant differences among groupsAge1,Age2,and Age3(F=5.46,21.89,13.06,all p<0.01).and amongSE1,SE2,and SE3(F=6.03,18.91,13.86,all p<0.01).1.2 Type:The pure and hemi PPA mainly seen in group Age1.The number of PPA combine PCA and ring PPA increased in group Age2.And increased further in group Age3.There were statistically significant differences in the distrubition of the difference type and range eyes among age groups(?~2=41.30?60.41,all p<0.01)The pure and hemi PPA mainly seen in groups AL1?AL2.PPA combine PCA and ring PPA mainly seen in groups AL3?AL4.There were statistically significant differences in the distrubition of the difference type and range eyes among AL groups(?~2=31.42?23.49,allp<0.01).The pure and hemi PPA mainly seen in the type?and?PSS;The pure and ring PPA seen in the type?PSS and The PCA and ring PPA seen in the type?PSS.There were statistically significant differences in the distrubition of the difference type eyes among PSS groups(?~2=16.44,p<0.01)and no difference in range(?~2=15.11,p>0.05).1.3 Correlation:The size of PPA and PCA correlated with age,and AL(PPA:r=0.47,0.61;PCA:r=0.46,0.48;all p<0.01).The size of ONH no correlated with age and AL(r=0.14,p=.05;r=0.15,p=0.17).2.Macluar Area:2.1 Myopia maculopathy(MM):Most MM were tessellated fundus eye(M1)(14.4%)in group Age1 and most serious MM was macular atrophy(M4)eye.Most MM were M1(14.4%)and diffuse choridal retina atrophy eye(M2)(8.0%)in group Age2 and most serious MM was M4.The percentage order were M1,M2,M4,patchy choridal retina atrophy(M3)(20.1%?17.2%?13.8%?6.9%,respectively)in group Age3.There were statistically significant differences in the distrubition of the MM among age groups(?2=42.09,p=0.00).Most MM were M1 in groups AL1,AL2,AL3,the percentage were 9.9%?21.1%?12.5%,respectively and Most MM were M2(9.2%)?M4(9.2%)in groups AL4,There were statistically significant differences in the distrubition of the MM among AL groups(?2=54.31,p=0.00).The percentage of M1,M2 were 12%,6.6%in group PS1,The percentage of M1,M2were 26.9%?16.8%in group PS2 respectively,Most MM were M1(4.8%)in group PS3 and 5.9%of M4 in group PS4,There were statistically significant differences in the distrubition of the MM among PS groups(?2=34.03,p=0.001).2.2 Location of macular:The vertical distance of macular to the central of ONH(dMOv)were 907±1147um?680±365um?1012±561um in groups Age1?Age2 and Age3;And were 703±672um?889±743um?849±465um?1217±759um in groups AL1?AL2?AL3?AL4;And were 1082±859um?769±438um?1073±1059um?1127±529um in groups PS1?PS2?PS3?PS4.There were statistically significant differences among groups(F=3.21,3.12,2.85;p=0.04,0.02,0.03).The horizontal distance of macular to the central of ONH(dMOh)were were 4896±433um?4907±731um?4948±636 in groups Age1?Age2 and Age3;And were 4871±354um?4851±470um?4883±482um?5013±925um in groups AL1?AL2?AL3?AL4;And were 4849±497um?4965±549um?4550±464um?5789±1031um in groups PS1?PS2?PS3?PS4.There were statistically significant differences among PSS groups(F=9.00,p<0.01),And no differences among Age groups and AL groups(F=0.10?0.48,p=0.90?0.69).2.3 Correlation:The dMOv correlated with age,and AL(r=0.19,0.23,allp<0.01).3.Wall of eyeball:3.1 Retina:The central thickness of retinal(RTc)were 226±25um?229±27um?226±58um in groups Age1?Age2 and Age3;And were 225±25um?234±39um?227±39um?221±60um in groups AL1?AL2?AL3?AL4;no differences among groups(F=0.05,0.63,p=0.94,0.59).RTc were 241±53um?224±34um?249±25um?168±58um in groups PS1?PS2?PS3?PS4.And there were statistically significant differences among groups(F=9.33,p<0.01).The thickness of retinal nerve fiber layer(RNFLT)were 98±18um?86±28um?61±30um in groups Age1?Age2 and Age3;And were 100±21um?88±30um?69±22um?53±28um in groups AL1?AL2?AL3?AL4;And were77±32um?79±30um?58±21um?28±17um in groups PS1?PS2?PS3?PS4.And there were statistically significant differences among groups(F=21.79,21.36,8.51;all p<0.01).3.2 Choridal:The central thickness of choridal(CTc)were 160±60um?110±72um?68±52um in groups Age1?Age2 and Age3;And were 141±65um?137±79um?82±56um?58±35um in groups AL1?AL2?AL3?AL4;And were113±86um?101±62um?72±48um?43±27um in groups PS1?PS2?PS3?PS4.And there were statistically significant differences among groups(F=30.87,19.87,4.66;all p<0.01).3.3 Sclera:The sub-macluar thickness of sclera(STc)were 246±149um?226±86um?244±84umin groups Age1?Age2 and Age3;And were193±115um?251±130um?229±73um?247±84um in groups AL1?AL2?AL3?AL4;And were253±54um?228±77um?257±155um?238±104um in groups PS1?PS2?PS3?PS4.And there were no statistically significant differences among groups(F=0.29,0.55,0.59;p=0.74,0.64,0.62).3.4 Correlation:RT correlated with AL(r=-0.37,p<0.05).RNFLT and CT correlated with age,and AL(RNFLT:r=-0.52,-0.64,CT:r=-0.56,-0.49;all p<0.01).4.The pure HM and pathological myopia(MP):There were statistically significant differences in age?SE and AL between the pure HM and MP(t=-6.32,-6.47,-7.09,all p<0.01).No difference in dMOh(t=-0.84;p=0.40)and were significant differences in dMOv(t=-2.06;p=0.04)between the pure HM and MP.There were 59.5%and 50.7%?type MS in the pure HM and MP,respectively.There were statistically significant differences in the distrubition of the difference MS and PSS eyes between the pure HM and MP(?~2=12.67,47.60;all p<0.01).There were statistically significant differences in the RT of the nasal area of 1 circle and 2 circle of EDTRS Grid between the pure HM and MP(t=2.62,2.35,p=0.01,0.02.And no difference in the other area(p>0.05).There were statistically significant differences in the RNFL thickness of the superior?inferior and nasal area between the pure HM and MP(t=2.58,3.07,4.70.All p<0.01).And no difference in the temple area(t=0.88,p=0.38).There were statistically significant differences in the CT between the pure HM and MP(p<0.01).And no difference in ST(all p>0.05).Conclusions:1.The size?range of PPA?PCA increased?RNFLT and CT thinner and the location of macular changed vertically with the age?AL and PSS developement in HM.2.PPA?PCA?RT?RNFLT?CT and dMOv correlated with age and AL.3.Compare to the pure HM,The characterictic of MP include older age,higher SE,longer AL,longer dMOv,thinner the nasal RT,thinner RNFLT,thinner CT,PCA and ring PPA. |
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