Effect of Optical Defocus on Choroidal Thickness in Healthy Adults With Presbyopia
Effect of Optical Defocus on Choroidal Thickness in Healthy Adults With Presbyopia
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DOI：
10.1167/iovs.18-24815
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发表时间：
2018-10-01
影响因子：
4.4
通讯作者：
Phillips, John R.
中科院分区：
文献类型：
--
作者：
Chiang, Samuel T-H;Chen, Tzu-Lan;Phillips, John R.
目的。探讨成人老花眼视网膜离焦引起的中央凹下脉络膜厚度（SFCT）变化。37例低屈光不正（+0.08 +/- 1.09 Diopters [D]）的健康老花眼受试者（年龄57.74 +/- 4.06岁）分别两次观看远处目标（6 m视频）60分钟，同时每20分钟用光学相干断层扫描监测SFCT。在每一种情况下，两只眼睛都被最佳地矫正了距离：一只眼睛作为对照，而另一只（实验）眼睛通过一个额外的眼科透镜观察：一个+2.00 D透镜施加近视离焦，另一个-2.00 D透镜施加远视离焦。实验眼和对照眼的基线SFCT无差异（226 +/- 72 μ m vs. 232 +/- 75 μ m; P 1/4 0.28）。近视离焦导致离焦眼SFCT显著（P < 0.001）升高20分钟（60分钟时+10 +/- 5 μ m升高，P < 0.001），而远视离焦导致SFCT显著降低20分钟（60分钟时-10 +/- 5 μ m降低，P < 0.001），对照组无变化。在老花眼受试者中，强加的近视视网膜离焦导致SFCT增厚，而远视离焦导致SFCT变薄。这意味着未矫正的老花眼，与近距离物体的远视性视网膜离焦有关，在发展中国家非常普遍，可能与脉络膜变薄和脉络膜血流量减少有关。
PURPOSE. To investigate changes in subfoveal choroidal thickness (SFCT) induced by retinal defocus in presbyopic adults.METHODS. Thirty-seven healthy presbyopic subjects (age 57.74 +/- 4.06 years) with low refractive errors (+0.08 +/- 1.09 Diopters [D]) viewed a distant target (video movie at 6 m) for 60 minutes on two occasions while SFCT was monitored with optical coherence tomography every 20 minutes. On each occasion, both eyes were optimally corrected for distance: one eye acted as control, while the other (experimental) eye viewed through an additional ophthalmic lens: a +2.00 D lens imposing myopic defocus on one occasion and a -2.00 D lens imposing hyperopic defocus on the other occasion.RESULTS. Baseline SFCT was not different between experimental and control eyes (226 +/- 72 mu m vs. 232 +/- 75 mu m; P 1/4 0.28). Myopic defocus caused a significant (P < 0.001) increase in SFCT in the defocused eye by 20 minutes (and +10 +/- 5-mu m increase at 60 minutes: P < 0.001), while hyperopic defocus caused a significant decrease in SFCT by 20 minutes (and -10 +/- 5-mu m decrease at 60 minutes: P < 0.001) with no change in control eyes.CONCLUSIONS. In presbyopic subjects, imposed myopic retinal defocus caused thickening of SFCT, while hyperopic defocus caused thinning of SFCT. This implies that uncorrected presbyopia, which is associated with hyperopic retinal defocus for near objects and which is highly prevalent in the developing world, would likely be associated with choroidal thinning and possibly reduced choroidal blood flow with prolonged periods in a near visual environment.