广州医药 ›› 2025, Vol. 56 ›› Issue (1): 18-25.DOI: 10.20223/j.cnki.1000-8535.2025.01.003

• 眼科专题:近视防控 • 上一篇    下一篇

广州荔湾区398例儿童FTD和PPA与眼轴长相关性研究

张旭1,2, 江瑜1,2, 李宁凤1,2, 邹新瑞3, 高宗银1,2, 冷云霞1,2   

  1. 1 华南理工大学附属第二医院(广州市第一人民医院)眼科(广东广州 510180)
    2 广州医科大学附属市一人民医院(广东广州 510180)
    3 广东医科大学第一临床学院(广东湛江 524023)
  • 收稿日期:2024-09-11 出版日期:2025-01-20 发布日期:2025-02-13
  • 通讯作者: 冷云霞,E-mail:eylengyx@scut.edu.cn
  • 基金资助:
    广州市科技计划项目(2023A03J0961,2024B03J1255,2023A04J0619); 广州市卫生健康科技项目(20241A011021); 广州地区临床高新技术项目(2023C-GX03)

Study on the correlation between FTD and PPA with axial length in 398 children from Liwan district,Guangzhou

ZHANG Xu1,2, JIANG Yu1,2, LI Ningfeng1,2, GAO Zongyin3, LENG Yunxia1,2   

  1. 1 Department of Opthalmology, the Second Affiliated Hospital of South China University of Technology,Guangzhou First People's Hospital,Guangzhou 510180,China
    2 Guangzhou First People's Hospital,Guangzhou Medical University,Guangzhou 510180,China
    3 The First Clinical Medical College,Guangdong Medical University,Zhanjiang 524023,China
  • Received:2024-09-11 Online:2025-01-20 Published:2025-02-13

摘要: 目的 探讨眼底豹纹斑密度(FTD)及视盘旁萎缩弧(PPA)与眼轴长(AL)的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组:A组(AL<23 mm);B组(23 mm≤AL<24 mm);C组(24 mm≤AL)。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1%。三组组间AL、AL/CR和SE比较均有统计学差异(P<0.05)。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异(P<0.05),C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异(P<0.05),Spearman相关性分析表明,AL与PPA(r=0.443)和FTD(r=0.322)呈正相关(P<0.001)。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关(P=0.028),B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关(P<0.05),C组仅PPA与AL呈正相关(P=0.005)。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。

关键词: 近视, 眼底豹纹斑密度, 视盘旁萎缩弧, 眼轴, 儿童

Abstract: Objective To investigate the correlation between fundus tessellated density(FTD)and peripapillary atrophy(PPA)with axial length(AL),providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children.Methods This study randomly selected third-grade students from two primary schools in Liwan District,Guangzhou City,as research subjects.Axial length(AL),corneal radius(CR),and fundus color photographs were collected simultaneously during the school vision screening process.AI software was utilized to perform quantitative analysis on the fundus color photographs,with quantification indicators including the area size of PPA and FTD in different regions and ranges.Subjects were divided into three groups based on axial length:Group A(AL<23 mm);Group B(23 mm≤AL<24 mm);Group C(AL≥24 mm).Results A total of 398 right eyes were included in the statistical analysis,with an age range of 8 to 11,a median age of 9,and 55.1% were male.There were significant statistical differences in AL,AL/CR,and spherical equivalent(SE)among the three groups(P<0.05).Compared with Group B,Group A showed significant statistical differences in FTD in the overall posterior pole,the 3 mm diameter area centered on the fovea,and the superior area of the 3 mm foveal center(P<0.05).Compared with Group B,Group C showed significant differences in PPA area and FTD in the overall posterior pole,the 4.5 mm diameter area centered on the optic disc,and the 3 mm and 6 mm diameter areas centered on the fovea(P<0.05).Spearman correlation analysis indicated that AL was significantly positively correlated with PPA(r=0.443)and FTD(r=0.322)(P<0.001).Subgroup correlation analysis showed that in Group A,only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL(P=0.028).In Group B,PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL(P<0.05).In Group C,only PPA was significantly positively correlated with AL(P=0.005).Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children.PPA and FTD show significant positive correlations with AL,with varying degrees of correlation in different regions and ranges of FTD with AL.The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis.FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation,while PPA primarily manifests as a biomarker in the later stages of elongation.

Key words: myopia, fundus tessellated density, peripapillary atrophy, axial length, children