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カップ対ディスク比の大きい子供の近視シフト中の視床とOCTパラメータの長期的変化
Long term change of the optic disc and OCT parameters during myopic shift in children with large cup to disc ratio.
PMID: 32678824 DOI: 10.1371/journal.pone.0235621.
抄録
目的:
この観察的症例シリーズは、カップ対ディスク比（CDR）が大きい眼の長期的な視床の変化を明らかにし、小児期の近視シフトによって誘発された変化を正常対照眼と比較することを目的とした。
PURPOSE: This observational case series was to determine long term optic disc changes in eyes with large cup to disc ratio (CDR) and compare the changes induced by myopic shift during childhood with normal control eyes.
方法:
3年間の最小間隔で連続した視床写真とスペクトルドメイン(SD)-光干渉断層撮影(OCT)画像で近視を発症した15歳未満の子供たちを評価しました。SD-OCT画像の平均CDRが0.6以上の子供を大CDRと分類した。視床の形態変化を定量化するために垂直円板径（VDD）、水平円板径（HDD）、最大毛乳頭周囲萎縮（PPA）幅（PPW）の比を測定し、SD-OCTパラメータ、例えば、毛乳頭周囲網膜神経線維層（RNFL）の厚さと黄斑神経節細胞と内側叢状層（GCIPL）の厚さを測定した。
METHODS: Children under 15 years of age who developed myopia with serial optic disc photographs and spectral domain (SD)-optical coherence tomography (OCT) images with a minimal interval of three years were evaluated. Children with average CDR ≥ 0.6 on SD-OCT were classified as having large CDR. The ratios of vertical disc diameter (VDD), horizontal disc diameter (HDD), and maximum peripapillary atrophy (PPA) width (PPW) were measured to quantify morphologic changes of optic discs and SD-OCT parameters, such as peripapillary retinal nerve fiber layer (RNFL) thickness and macular ganglion cell and inner plexiform layer (GCIPL) thickness were measured.
結果:
解析した82眼（患者82人）のうち，42眼が大きなCDRを有し，40眼が正常対照であった。初診時の平均年齢と屈折異常は群間で差がなかった（それぞれP=0.33、P=0.76）。追跡期間中のHDD/VDD比、PPW/VDD比の変化は、群間で有意差は認められなかった（それぞれP＝0.45、P＝0.62）。また、RNFLとGCIPL厚さの変化には、両群間で統計的有意差は認められなかった（それぞれP＝0.74、P＝0.79）。
RESULTS: Of the 82 eyes (82 patients) analyzed, 42 eyes had large CDR and 40 eyes were normal controls. The mean age and refractive error at initial examination were not different between groups (P = 0.33, P = 0.76, respectively). The changes in HDD/VDD and PPW/VDD ratios during follow-up showed no significant difference among the groups (P = 0.45, P = 0.62, respectively). No statistical significance was found in changes in RNFL and GCIPL thickness between the two groups (P = 0.74, P = 0.79, respectively).
結論:
CDRが拡大した小児では、近視移行期に正常児と同様の視床形態の変化とRNFL/GCIPL厚さの変化が認められた。
CONCLUSIONS: Children with enlarged CDR showed changes in optic disc morphology and RNFL/GCIPL thickness similar to normal children during myopic shift.