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目的用MRI研究轴性高度近视眼4条直肌pulley的功能位置,探讨轴性高度近视继发性眼球运动障碍的病因。方法轴性高度近视12例(22眼)根据眼屈光度、眼轴长度以及有无眼球运动受限分为A、B两组。A组无眼球运动受限;B组有眼球运动受限。应用动态MRI技术,获取眼球原在位及上转、下转、内转、外转位时的冠状位MRI图象。应用计算机图像处理软件测量各层面MRI图像眼球垂直方向转动时水平直肌、眼球水平方向转动时垂直直肌的横截面质心,根据其坐标值建立直线回归方程,统计求得眼球垂直转动时内、外直肌径路及眼球水平转动时上、下直肌径路直线回归曲线斜率变化最大的一点(直肌pulley的位点),将A组、B组、正常对照组进行比较。结果A组与正常对照组4条直肌pulley的位点比较无显著差异(P>0.05);B组与正常对照组内直肌、上直肌、下直肌pulley的位点比较无显著性差异(P>0.05);B组外直肌pulley的位点较正常对照组向颞下移位(P<0.01);A组与B组内直肌、上直肌、下直肌pulley的位点比较无显著性差异(P>0.05);B组较A组外直肌pulley位点向颞下移位(P<0.05)。结论外直肌pulley的位点向颞下移位可能是引起轴性高度近视眼继发性眼球运动障碍的主要病因之一。
Objective To study the functional location of 4 rectus abdominis muscles in axial high myopia with MRI and to explore the etiology of secondary ocular motility disorders with axial high myopia. Methods Axial high myopia in 12 cases (22 eyes) according to the diopter, axial length and the presence or absence of eye movement is divided into A and B groups. Group A had no eye movement limitation; Group B had limited eye movement. Dynamic MRI was used to obtain the coronal MRI images of the original eyeball and the upward rotation, downward rotation, internal rotation and external rotation. The transverse rectus abscess of horizontal rectus muscle and vertical rectus femoris muscle were measured by computer image processing software. The linear regression equation of vertical rectus muscle was established according to the coordinate value of the horizontal rectus muscle during the vertical rotation of the eyeball. In the rectus abdominis path and the horizontal rotation of the eyeball, the curve of the upper and lower rectus muscle showed the largest change (the position of the rectus abdominis pulley). The A, B and normal control groups were compared. Results There was no significant difference in the position of the rectus abdominals between the two groups (P> 0.05). There was no significant difference between the rectus abdominis muscle, superior rectus muscle and lower rectus muscle in group B and the control group (P> 0.05). The position of lateral rectus pulley in group B was more inferior to that of normal control group (P <0.01). In group A and group B, the position of rectus muscle, superior rectus muscle and inferior rectus muscle There was no significant difference between the two groups (P> 0.05). In group B, the lateral rectus abdominis muscle shifted to the inferior temporal artery (P <0.05). Conclusions The shift of the lateral rectus abdominus to the inferior temporal axis may be one of the major causes of secondary ocular motility disorder in axial myopia.