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1.
Invest Ophthalmol Vis Sci ; 60(14): 4792-4802, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31743936

RESUMO

Purpose: The purpose of this study was to describe the normative values, distribution patterns, and correlated factors of macular ganglion cell-inner plexiform layer (GCIPL), ganglion cell complex (GCC), and outer retinal layer (ORL) thicknesses in Chinese children. Methods: A sample of 3000 healthy children with different refractive status aged 6 to 19 years was consecutively examined. Demographics were recorded, and a comprehensive ophthalmic examination including refractive error and axial length (AL) was taken from all participants. The GCIPL, GCC, and ORL thicknesses were measured using swept source-optical coherence tomography (OCT), and multiple linear regression was used to determine which factors were associated with the thickness of each layer. Results: The average thickness was 77.00 ± 4.78 µm (95% confidence interval [CI]: 69.56-84.56 µm) in the GCIPL, 107.68 ± 5.95 µm (95% CI: 98.45-117.21 µm) in the GCC, and 178.57 ± 9.02 µm (95% CI: 164.33-192.56 µm) in the ORL. Multiple regression analysis indicated that GCIPL thickness was associated with sex (ß = 0.168, P < 0.001), age (ß = 0.126, P < 0.001), axial length (ß = -0.181, P < 0.001), and refractive error (ß = 0.233, P < 0.001). Age (ß = 0.154, P < 0.001), sex (ß = 0.102, P < 0.001), and refractive error (ß = 0.149, P < 0.001) were associated independently with GCC thickness after adjusting for the other factors. Furthermore, age (ß = 0.100, P < 0.001), sex (ß = 0.163, P < 0.001), AL (ß = -0.283, P < 0.001), and refractive error (ß = 0.207, P < 0.001) were the independent factors associated with ORL thickness. Conclusions: The present study established a normative pediatric database for macular layer thicknesses in healthy Chinese children, advancing the ability of OCT in diseases diagnosis and monitoring among children.

2.
Acta Ophthalmol ; 97(3): 287-295, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30714353

RESUMO

PURPOSE: The aim of the present study was to investigate age-specific normative retinal oxygen saturation values and explore the associated factors in healthy Chinese school-aged children with different refractive statuses. DESIGN: Population-based observational cross-sectional study. METHODS: Children aged 7-19 years were enrolled. Each participant underwent a series of comprehensive ocular examinations, including axial length (AL), cycloplegic refraction and Oxymap T1 imagery following cycloplegia. The acquired oximetry images were measured, and the values of the retinal oxygen saturation parameters were calculated. The independent factors of the retinal oxygen saturation were analysed using multiple linear regression. The oxygen saturation of retinal arteries (SaO2 ) and veins (SvO2 ) as well as the differences between the arteries and veins (AVD) were measured as the main outcomes. RESULTS: In total, 1461 participants were included in the study. The mean age of the participants was 12.1 ± 3.2 years, and 53.0% were boys. The mean SaO2 , SvO2 and AVD values were 83.7 ± 6.4%, 50.1 ± 5.4% and 33.6 ± 5.4%, respectively, and the values increased with age. Girls had higher SvO2 and lower AVD than boys (p < 0.05). The Pearson correlation coefficients among spherical equivalent (SE) and SaO2 , SvO2 and AVD were -0.372, -0.203 and -0.240, respectively (all p < 0.001), while the correlations between AL and SaO2 , SvO2 and AVD were 0.276, 0.106 and 0.221, respectively (all p < 0.001). The myopia group had significantly higher SaO2 , SvO2 and AVD than the emmetropia and hyperopia groups (p < 0.001), but the high myopia group had lower SaO2 and SvO2 than the moderate myopia group. When age, gender, body mass index (BMI), intraocular pressure (IOP) and axial length (AL) were included as factors in the multiple regression, older age was associated with higher SaO2 , SvO2 and AVD, while longer AL was associated with higher SaO2 and AVD. Gender was an independent factor predicting SvO2 , while gender and BMI were the independent factors predicting AVD. Age explained more variance than AL in SaO2 , SvO2 and AVD. CONCLUSIONS: Our population-based study provides age-specific profiles of retinal oxygen saturation in Chinese children and adolescents. Older age and longer AL were important independent factors of increased retinal oxygen saturation.


Assuntos
Consumo de Oxigênio/fisiologia , Oxigênio/metabolismo , Retina/metabolismo , Vasos Retinianos/fisiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Oximetria , Valores de Referência , Refração Ocular/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Retina/diagnóstico por imagem , Adulto Jovem
3.
Retina ; 39(6): 1091-1099, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29517579

RESUMO

PURPOSE: To elucidate the development of the choroid and retina in children, and to explore changes in these during myopic shift. METHODS: A total of 118 children aged 7 to 12 years participated in this 1-year longitudinal study. Children underwent several examinations at baseline and follow-up, including cycloplegic refraction, axial length measurement, and swept-source optical coherence tomography. Thickness changes in the choroid and retina were compared among children with or without myopic shift. RESULTS: Eighty-eight children (74.6%) developed a myopic shift after 1 year, and their central foveal choroid was significantly attenuated (P < 0.01). No significant change was observed in choroids of children without myopic shift (P = 0.83). Choroidal thickness decreased in all subfields during myopic shift, whereas the thickness of the retinal layers increased or were unchanged in most subfields. Axial length increase and central foveal choroidal thinning were associated with myopic shift (R = 0.157, P < 0.01), but axial length increase was not significantly related to choroidal thinning (P > 0.05). CONCLUSION: Choroidal thinning occurs early in myopic progression. Axial length increase and choroidal thinning are independently associated with myopic shift.

4.
Acta Ophthalmol ; 97(3): e410-e418, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30178606

RESUMO

PURPOSE: To explore the subfoveal thickness of sclera (SST), choroid (SCT) and retina (SRT) as well as their relationship in healthy Chinese children with varying levels of refractive error. METHODS: A total of 810 healthy Chinese schoolchildren and adolescents underwent a series of comprehensive ocular examinations, as well as swept-source optical coherence tomography (OCT) after induced cycloplegia. The thicknesses of the sclera, choroid and retina below the central fovea were measured manually, and each measurement was compared across different refractive statuses. Independent factors associated with the thickness of each layer were analysed. RESULTS: The mean SST, SCT and SRT were 524 ± 57 µm, 195 ± 49 µm and 224 ± 19 µm, respectively. The SSTs and SCTs of myopes were significantly thinner than those of emmetropes and hyperopes (all p < 0.001). Although the choroid seemed to be thicker in hyperopes (225 ± 46 µm) than in emmetropes (211 ± 45 µm), no statistically significant difference was observed between emmetropes and hyperopes in the sclera and choroid. Thinner SSTs and SCTs were associated with greater levels of myopia, whereas the SRT was similar in children with different myopic levels. SST (p < 0.001) and SCT (p = 0.003) as well as age (p < 0.001), sex (p < 0.001) and axial length (p < 0.001) were independently associated with spherical equivalent refraction (SER). Older age (p = 0.013), myopic-shifted SER (p < 0.001), thicker SCT (p < 0.001) and thinner SRT (p = 0.012) were independently associated with a thinner SST. CONCLUSION: The subfoveal sclera and choroid were thinner in myopes than in emmetropes and hyperopes, while the retina remains constant. Age, refractive error and choroidal and retinal thicknesses are related to subfoveal scleral thickness.


Assuntos
Refração Ocular/fisiologia , Erros de Refração/diagnóstico , Esclera/patologia , Tomografia de Coerência Óptica/métodos , Adolescente , Criança , China/epidemiologia , Corioide/patologia , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Erros de Refração/epidemiologia , Erros de Refração/fisiopatologia , Reprodutibilidade dos Testes , Fatores de Risco , Índice de Gravidade de Doença
5.
Sci Rep ; 7: 45059, 2017 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-28327553

RESUMO

The purpose of the cross-sectional study is to describe the values and distribution of choroidal thickness and to explore its related factors, especially age, in Chinese children. A total of 3001 Chinese school children aged 6 to 19 years underwent comprehensive ophthalmic examinations, including axial length and cycloplegic refraction. Choroidal thickness was measured by swept-source optical coherence tomography (SS-OCT). There was a greater difference in the more central regions between the myopes and emmetropes. Multiple regression analysis was performed to determine the associated factors of choroidal thickness. The results demonstrated that age was independently positively related to choroidal thickness for emmetropes (ß = 3.859, p < 0.001), and mild myopes with spherical equivalent greater than -2.00 D (-1.25 D < spherical equivalent ≤ -0.50 D: ß = 3.476, p = 0.006; -2.00 D < spherical equivalent ≤ -1.25 D: ß = 3.232, p = 0.020). However, no significant relationship between age and choroidal thickness was found in children with spherical equivalent ≤ -2.00 D, suggesting that the protective effect of physiologic choroidal growth with age against rapid axial elongation disappeared while axial elongation becomes the dominant determinant of choroidal thickness among children with myopia worse than -2.00 D.


Assuntos
Corioide/citologia , Corioide/diagnóstico por imagem , Tomografia de Coerência Óptica , Adolescente , Grupo com Ancestrais do Continente Asiático , Criança , China/epidemiologia , Corioide/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Vigilância em Saúde Pública , Tomografia de Coerência Óptica/métodos , Adulto Jovem
6.
Invest Ophthalmol Vis Sci ; 57(14): 6188-6196, 2016 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-27842160

RESUMO

Purpose: We assessed changes in age-specific prevalence of refractive error at the time of starting school, by comparing preschool and school age cohorts in Shanghai, China. Methods: A cross-sectional study was done in Jiading District, Shanghai during November and December 2013. We randomly selected 7 kindergartens and 7 primary schools, with probability proportionate to size. Chinese children (n = 8398) aged 3 to 10 years were enumerated, and 8267 (98.4%) were included. Children underwent distance visual acuity assessment and refraction measurement by cycloplegic autorefraction and subjective refraction. Results: The prevalence of uncorrected visual acuity (UCVA), presenting visual acuity, and best-corrected visual acuity in the better eye of ≤20/40 was 19.8%, 15.5%, and 1.7%, respectively. Among those with UCVA ≤ 20/40, 93.2% could achieve visual acuity of ≥20/32 with refraction. Only 28.7% (n = 465) of children with UCVA in the better eye of ≤20/40 wore glasses. Prevalence of myopia (spherical equivalent ≤-0.5 diopters [D] in at least one eye) increased from 1.78% in 3-year-olds to 52.2% in 10-year-olds, while prevalence of hyperopia (spherical equivalent ≥+2.0 D) decreased from 17.8% among 3-year-olds to 2.6% by 10 years of age. After adjusting for age, attending elite "high-level" school was statistically associated with greater myopia prevalence. Conclusions: The prevalence of myopia was lower or comparable to that reported in other populations from age 3 to 5 years, but increased dramatically after 6 years, consistent with a strong environmental role of schooling on myopia development.


Assuntos
Refração Ocular/fisiologia , Erros de Refração/epidemiologia , Acuidade Visual , Pessoas com Deficiência Visual , Distribuição por Idade , Fatores Etários , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Prognóstico , Erros de Refração/fisiopatologia , Erros de Refração/reabilitação , Fatores de Risco , Testes Visuais
8.
Am J Ophthalmol ; 168: 164-176, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27189931

RESUMO

PURPOSE: To investigate the choroidal and retinal thickness in myopic, emmetropic, and hyperopic Chinese children by swept-source longer-wavelength optical coherence tomography. DESIGN: Cross-sectional study. METHODS: Two-hundred and seventy-six schoolchildren aged 7-13 years underwent comprehensive ophthalmic examinations, including cycloplegic refraction, and swept-source optical coherence tomography measurements. The thickness of the choroid, retina, ganglion cell layer, and nerve fiber layer were compared among children of different refractive status. The topographic variation and factors related to the thickness of the choroid and retinal layers were analyzed. RESULTS: Compared to emmetropic subjects, those with myopia had a significantly thinner choroid in all regions (P < .01), and hyperopic subjects had a thicker choroid in most regions (P < .05). The myopic retinas were thinner than those of emmetropic or hyperopic subjects in the superior parafoveal and all 4 perifoveal subfields (P < .05), but no other subfields differed significantly among different refractive groups (P > .05). The axial length and refractive diopters were independently related to central foveal choroidal thickness (R(2) = 0.17, P < .01), while age and intraocular pressure were independently associated with central fovea retinal (R(2) = 0.15, P < .01) and ganglion cell layer thicknesses (R(2) = 0.10, P < .01) after adjustment for other systematic and ocular factors. Central foveal choroidal and retinal thickness were unrelated in children of different refractive status (P > .05). CONCLUSIONS: Choroidal thickness, but not retinal thickness, correlated closely with axial length and refractive diopters in Chinese children. Choroid thinning occurs before retina thinning early in myopic progression.


Assuntos
Corioide/patologia , Emetropia/fisiologia , Hiperopia/patologia , Miopia/patologia , Retina/patologia , Adolescente , Comprimento Axial do Olho/anatomia & histologia , Comprimento Axial do Olho/patologia , Criança , Corioide/anatomia & histologia , Estudos Transversais , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Retina/anatomia & histologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos
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