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目的观察高度近视患者的视网膜中心部视功能状态分布特点—10°～30°视网膜光敏感度,以期建立监测高度近视眼视网膜中心部视功能的方法,为预防性治疗视网膜黄斑病变提供依据。方法采用OCTOPUS101中的中心低视力程序C08、M2程序,对373眼高度近视患者的视网膜中心视功能状态—10°～30°视网膜平均光敏感度、4象限光敏感度、4象限视野缺失点、平均视野缺失点进行定性定量检测,并分别与高度近视性视网膜脱离对侧眼149眼、中低度近视性视网膜脱离对侧眼51眼、正常108眼进行对比分析。结果(1)高度近视眼30°平均光敏感度(27.60±6.26)dB,视力0.57±0.39;高度近视视网膜脱离对侧眼(28.51±4.95)dB,视力0.62±0.39;中低度近视视网膜脱离对侧眼(28.45±6.53)dB,视力0.87±0.25;正常对照眼(34.05±2.29)dB,视力1.13±0.28。高度近视组视力仅与高度近视视网膜脱离对侧眼的差异无统计学意义(P>0.05),总平均光敏感度和4象限平均光敏感度在高度近视组与高度近视视网膜脱离对侧眼、中低度近视视网膜脱离对侧眼的差异均无统计学意义(P>0.05)。(2)高度近视眼30°视野平均缺失点(1.76±7.16)个,高度近视视网膜脱离对侧眼(0.50±2.58)个,中低度近视视网膜脱离对侧眼(0.88±4.16)个,正常对照眼(0.04±0.38)个。平均视野缺失点分别在高度近视组与高度近视视网膜脱离对侧眼与中低度近视视网膜脱离对侧眼的差异无统计学意义(P>0.05),与正常人眼的差异有统计学意义(P<0.05)。但除鼻上象限与正常人眼的差异有统计学意义外,其余三象限组间差异均无统计学意义。结论高度近视眼已经存在明显中心视网膜光敏感度的损害,但与视网膜脱离高危眼在发生视网膜脱离之前相似,他们与正常人群眼有着明显的功能差异;根据高度近视中心视网膜退行性病变形成机制和与中心视网膜光敏感度下降的关系,对此人群进行系统眼底视网膜结构和功能状态的检测有益于视网膜黄斑病变的临床前症状体征的早期发现。
Objective To observe the distribution of optic nerve function in the central part of the retina of high myopia patients with -10 ° ~30 ° retinal light sensitivity in order to establish the method of monitoring the visual function in the central part of the retina of high myopia and provide the basis for preventive treatment of macular degeneration. Methods The central visual acuity (OCTOPUS101) central visual acuity program (C08 and M2) in 373 eyes was used to evaluate the retinal central visual function in patients with high myopia of 373 eyes. The average light sensitivity of the retina at 10 ° to 30 °, the light sensitivity at 4 quadrants, Lacking point for qualitative and quantitative detection, respectively, and high myopia retinal detachment in 149 eyes, low and middle myopia retinal detachment in 51 eyes, normal 108 eyes were compared. Results (1) The mean optical sensitivity at 30 ° in high myopia was (27.60 ± 6.26) dB and the visual acuity was 0.57 ± 0.39. The height of myopic retinopathy was (28.51 ± 4.95) dB and the visual acuity was 0.62 ± 0.39. The moderate and low myopia retinal detachment (28.45 ± 6.53) dB, visual acuity of 0.87 ± 0.25, normal control eye (34.05 ± 2.29) dB and visual acuity of 1.13 ± 0.28. There was no significant difference between high myopia group and contralateral eye group (P> 0.05). The average total light sensitivity and average 4-quadrant photosensitivity in high myopia group and high myopia retinal detachment contralateral eye, low There was no significant difference in contralateral eye between degree myopia and retinal detachment (P> 0.05). (2) The mean missing point in 30 ° field of high myopia was (1.76 ± 7.16), the number of contralateral eye (0.50 ± 2.58) in high myopia retinal detachment and the number of contralateral eye in middle and low myopia retina (0.88 ± 4.16) were normal Control eyes (0.04 ± 0.38). There was no significant difference in the mean visual field loss between the contralateral eye and the contralateral eye in the high myopia group and the high myopia retina with contralateral and inferior myopia retinal detachment (P> 0.05), and the difference was statistically significant (P> P <0.05). However, in addition to the upper quadrant and normal eye differences were statistically significant, the remaining three quadrants no significant difference between groups. CONCLUSIONS: There is a significant central retinal photic sensitivity impairment in high myopia, but similar to that in normal eyes before retinal detachment. According to the mechanism of retinal degenerative changes in high myopia centers and Center retinal light sensitivity decline in the relationship between the population of the fundus retinal structure and functional status of the test is beneficial for the early detection of pre-clinical signs and symptoms of macular degeneration.