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中华眼科医学杂志(电子版) ›› 2025, Vol. 15 ›› Issue (01) : 6 -12. doi: 10.3877/cma.j.issn.2095-2007.2025.01.002

论著

真性小眼球眼部生物学参数与临床特征的临床研究
陶靖1, 曹凯2, 王进达1,   
  1. 1. 100730 首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室
    2. 100005 首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所,眼科学与视觉科学北京市重点实验室
  • 收稿日期:2025-01-20 出版日期:2025-02-28
  • 通信作者: 王进达
  • 基金资助:
    国家自然科学基金项目(30700920)北京市科技新星计划资助项目(2005B50)

Analysis of biological parameters and clinical features of nanophthalmos

Jing Tao1, Kai Cao2, Jinda Wang1,   

  1. 1. Beijing Tongren Eye Center,Beijing Tongren Hospital,CapitalMedical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China
    2. Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100005,China
  • Received:2025-01-20 Published:2025-02-28
  • Corresponding author: Jinda Wang
引用本文:

陶靖, 曹凯, 王进达. 真性小眼球眼部生物学参数与临床特征的临床研究[J/OL]. 中华眼科医学杂志(电子版), 2025, 15(01): 6-12.

Jing Tao, Kai Cao, Jinda Wang. Analysis of biological parameters and clinical features of nanophthalmos[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2025, 15(01): 6-12.

目的

探讨真性小眼球(NNO)患者的眼部生物学参数与临床特征。

方法

收集2003年1月至2024年12月于首都医科大学附属北京同仁医院眼科中心就诊的NNO患者54例(100只眼)。其中,男性27例(51只眼),女性27例(49只眼);年龄1~67岁,平均年龄(39.3±16.5)岁。询问或检测NNO患者病史、眼部生物学参数及并发症。其中,生物学参数包括眼轴(AL)、最佳矫正视力(BCVA)、等效球镜屈光度(SE)、眼压(IOP)、角膜横径(TCD)、中央角膜厚度(CCT)、前房深度(ACD)、晶状体厚度(LT)、黄斑中心凹视网膜厚度(FRT)、脉络膜厚度(SFCT)及前巩膜厚度(AST)等均符合正态分布,采用¯x±s进行描述。NNO主要并发症包括高度远视、弱视、闭角型青光眼(ACG)及葡萄膜渗漏综合征(UES)等,其发生的占比情况采用例数(眼数)和百分比进行描述。采用Spearman秩相关进行生物学参数之间的相关性分析。

结果

全部NNO患者54例(100只眼)的AL、LogMARBCVA、SE、IOP、TCD、CCT、ACD、LT、FRT、SFCT及AST等眼部生物学参数的检测结果分别为(16.22±1.31)mm、1.11±0.78、(14.1±2.74)D、(25.3±13.3)mmHg(1mmHg=0.133kPa)、(10.32±0.79)mm、(561±37)μm、(2.54±0.42)mm、(4.89±0.55)mm、(381±133)μm、(375±85)μm及(0.74±0.08)mm。各生物学参数之间的相关性分析结果分别为AL与LT呈正相关,与SE及FRT呈负相关,其相关性具有统计学意义(r=0.365,-0.474,-0.500;P<0.05);ACD与TCD及FRT呈正相关,与IOP、CCT及LT呈负相关,其相关性具有统计学意义(r=0.380,0.506,-0.281,-0.315,-0.276;P<0.05);AST与FRT呈正相关,与SFCT呈负相关,其相关性具有统计学意义(r=0.503,-0.557;P<0.05)。NNO并发症占比分别为高度远视入组34例(61只眼),患病34例(61只眼),占100%;弱视入组52例(96只眼),患病52例(93只眼),占96.88%;ACG入组50例(92只眼),患病35例(62只眼),占67.39%;UES入组50例(91只眼),患病33例(59只眼),占64.83%。UES病情由轻到重表现分别为睫状体脱离入组41例(73只眼),患病31例(55只眼),占75.34%;脉络膜脱离入组36例(65只眼),患病16例(28只眼),占43.08%;渗出性视网膜脱离入组39例(70只眼),患病18例(32只眼),占45.71%。

结论

NNO呈现视力低下、高度远视、眼轴短、前房浅、巩膜增厚及视网膜脉络膜异常等临床特征。NNO常并发ACG和UES且比例接近,UES以睫状体脱离为主。UBM为测量前巩膜厚度提供了新的选择。NNO生物学参数之间存在相关性,生物测量可为NNO及其并发症的诊断和随访提供依据。

Objective

To investigate the ocular biological parameters and clinical characteristics of a rare ocular disease nanophthalmos(NNO).

Methods

A total of 54 patients(100 eyes)with NNO who visited the Ophthalmology Center of Beijing Tongren Hospital affiliated with Capital Medical University from January 2003 to December 2024 were collected.Among them,there were 27 males(51 eyes)and 27 females(49 eyes)with an average age of(39.3±16.5)years(ranging from 1 to 67 years).The clinical data of NNO patientswere analyzed,includingmedical history,ophthalmic examination results,ocular biological parameters,

Results

The ocular biological parameter measurements of NNO patients showed that AL,BCVA,SE,IOP,TCD,CCT,ACD,LT,FRT,SFCT,and ASTwere(16.22±1.31)mm,(1.11±0.78)logarithm of theminimum angle of resolution(logMAR),(14.1±2.74)D,(25.3±13.3)mmHg(1 mmHg=0.133 kPa),(10.32±0.79)mm,(561±37)μm,(2.54±0.42)mm,(4.89±0.55)mm,(381±133)μm,(375±85)μm,and(0.74±0.08)mm,respectively.The correlation analysis of biological parameters showed that AL was positively correlated with LT and negatively correlated with SE and FRT,with statistically significant correlations(r=0.365,-0.474,-0.500;P<0.05);ACD was positively correlated with TCD and FRT and negatively correlated with IOP,CCT,and LT,with statistically significant correlations(r=0.380,0.506,-0.281,-0.315,-0.276;P<0.05);AST was positively correlated with FRT and negatively correlated with SFCT,with statistically significant correlations(r=0.503,-0.557;P<0.05).The analysis results of the proportion of NNO complicationswere:high hyperopia was included in 34 cases(61 eyes),with 34 cases(61 eyes)affected,accounting for 100%;amblyopia was included in 52 cases(96 eyes),with 52 cases(93 eyes)affected,accounting for 96.88%;ACG was included in 50 cases(92 eyes),with 35 cases(62 eyes)affected,accounting for 67.39%;UES was included in 50 cases(91 eyes),with 33 cases(59 eyes)affected,accounting for 64.83%.The severity of UES ranged from mild to severe as follows:ciliary body detachmentwas included in 41 cases(73 eyes),with 31 cases(55 eyes)affected,accounting for75.34%;choroidal detachmentwas included in 36 cases(65 eyes),with 16 cases(28 eyes)affected,accounting for 43.08%;exudative retinal detachment was included in 39 cases(70 eyes),with 18 cases(32 eyes)affected,accounting for 45.71%.

Conclusions

NNO presents clinical features such as reduced visual acuity,high hyperopia,short ocular axis,shallow anterior chamber,scleral thickening,and abnormalities in the retina and choroid.NNO often coexists with ACG and UES at a similar rate,with UES primarily characterized by ciliary body detachment.UBM offers a new option formeasuring the thickness of the anterior sclera.There is a correlation between the biological parameters of NNO,and biometry can provide a basis for the diagnosis and follow-up of NNO and its complications.

图1 具有典型临床特征真性小眼球患者的检查图像 图A为眼前节彩色照像,图中显示前房极浅,虹膜膨隆;图B为超声生物显微镜检查图像,图中显示并发睫状体脱离的患者可见睫状体上腔积液(箭头),前房角狭窄;图C为眼底彩色照像,图中显示患者呈现视盘拥挤色红边界不清(白色箭头),视网膜血管迂曲扩张,视盘与黄斑间视网膜皱褶(蓝色箭头);图D为光学相干断层扫描检查图像,图中示黄斑中心凹无血管区发育不全,伴黄斑区视网膜皱褶(箭头)
表1 真性小眼球眼部生物学参数检测数据汇总
表2 真性小眼球眼部生物学参数之间的相关性分析结果
指标 统计值 BCVA IOP SE TCD CCT ACD LT AL FRT AST
IOP 0.208*
<0.05
SE 0.090 -0.365*
>0.05 <0.05
TCD -0.005 -0.278 -0.213
>0.05 >0.05 >0.05
CCT -0.083 0.528* -0.407* -0.450
>0.05 <0.05 <0.05 >0.05
ACD -0.115 -0.281* 0.217 0.380* -0.315*
>0.05 <0.05 >0.05 <0.05 <0.05
LT 0.055 -0.006 -0.477* -0.465* 0.631* -0.276*
>0.05 >0.05 <0.05 <0.05 <0.05 <0.05
AL -0.149 -0.020 -0.474* -0.311 0.270 0.077 0.365*
>0.05 >0.05 <0.05 >0.05 >0.05 >0.05 <0.05
FRT 0.216 -0.031 0.199 0.945* -0.490 0.506* -0.744* -0.500*
>0.05 >0.05 >0.05 <0.05 >0.05 <0.05 <0.05 <0.05
AST -0.141 -0.075 0.019 -0.223 0.018 -0.204 0.021 -0.104 0.503*
>0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 <0.05
SFCT -0.233 0.100 -0.494 1.000* 0.349 -0.099 0.643 0.126 -0.400 -0.557*
>0.05 >0.05 >0.05 <0.05 >0.05 >0.05 >0.05 >0.05 >0.05 <0.05
表3 真性小眼球主要并发症的占比情况
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