视网膜三维形态影响儿童近视发病的队列研究

The refractive status of peripheral retina is found to be associated with myopia development in animal models, but the results remain inconsistent in epidemiologic studies. Currently, the measurements of peripheral refraction have unavoidable limitations, leading to large measurement biases. Peripheral refraction is mainly determined by the retinal shape. Therefore, accurate quantization of the retinal shape and understanding its effect on incident myopia is crucial for elucidating the mechanism of myopia development. We have designed an approach on the segmentation of eyeballs from MRI images based on our own software platform and have completed the preliminary analyses on quantifying the three-dimensional parameters of the retinal shape. The current study plans to selected the study participants from three established myopia cohorts on children, follow them up for three years and collect the refractive data longitudinally. The study aims 1) to determine the longitudinal association of three-dimensional parameters of the retinal shape and incident myopia among children; 2) to understand the changing patterns of three-dimensional parameters of the retinal shape during myopia development; 3) to identify the most predictive three-dimensional parameter related to incident myopia and 4) to assess the concomitant relationship between changes in retinal shape and other myopia-related ocular parameters such as retinal thickness and lens thickness. The implementation of the study would provide new clues to the mechanism of myopia development and help to optimize the strategies regarding myopia prevention.

视网膜周边屈光状态在动物实验中被发现与近视的形成有关，而在流行病学研究中结果一致性较差。目前周边屈光度的测量方法有无法避免的局限性，测量的误差较大。视网膜周边屈光状态主要由其形态所决定，因此准确量化视网膜形态并探讨其对于近视发病的影响对于明确近视的致病机理至关重要。我们在自行搭建的软件平台上设计了从MRI图像上分割眼球的算法并初步量化了视网膜三维形态参数。本项目拟从已建立的三个儿童近视研究队列中选取研究对象并对研究对象进行三年随访，前瞻性地收集屈光发育数据，旨在：1）确定视网膜三维形态参数与儿童近视发病风险的纵向联系；2）明确在近视形成过程中儿童视网膜三维形态的变化规律；3）筛选出对儿童近视发病有较高预测价值的视网膜三维形态参数；4）阐明视网膜形态变化和其他近视相关的眼球参数变化（如：视网膜厚度、晶状体厚度）的伴行性。本课题可为探讨近视形成的机制提供新的线索，也可有助于优化近视防控策略。

本项目通过建立儿童青少年人群队列进行流行病学研究，对我国儿童青少年视网膜三维形态参数和其他近视相关行为生活方式如何影响近视发病风险这一关键科学问题展开了较为深入的研究。本项目首先在自行搭建的软件平台上设计了从MRI图像上分割眼球的算法并量化了视网膜三维形态参数。其次本项目阐明视网膜三维形态参数与儿童近视发病风险的纵向联系以及在近视形成过程中儿童视网膜三维形态的变化规律。我们的研究发现近视眼的眼球总体来说比正视眼要大，尤其是在轴长维度方向更为明显。此外，正视眼视网膜呈扁圆状，但扁圆度随着近视度数的加深而降低。本项目的完成为我国儿童青少年近视的早期预防提供了实践新思路和潜在新方法，也为探讨近视形成的机制提供新的线索。本项目研究成果发表SCI论文13篇。项目负责人被欧洲Expertscape机构评为世界屈光不正领域前0.1%学者并被聘为国家卫健委儿童青少年视力健康管理专家咨询委员会委员；项目组成员共参加国内学术会议6人次；培养博士研究生1名,硕士研究生3名。完成了项目的预期目标。