相干光断层扫描仪检测视网膜神经纤维层厚度影响因素分析  

Factors affecting the retinal nerve fiber layer thickness measured with optical coherence tomography

作　　者：李晓宇[1] 潘英姿[1] 晏晓明[1] 李梅[1] 乔荣华[1] 才瑜[1] 王捷[1] 刘丽娜[1] 

机构地区：[1]北京大学第一医院眼科,在读临床博士生100034

出　　处：《中国斜视与小儿眼科杂志》2007年第3期106-112,共7页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：北京大学第一医院归国基金资助

摘　　要：目的运用相干光断层扫描仪(OCT)测量正常人视网膜神经纤维层(RNFL)厚度并探讨其影响因素。方法运有Stratus OCT 4.0测量202例不同年龄及不同屈光度正常人(年龄8～74岁,屈光度-8～+4D)各钟点、象限及平均RNEL厚度,建立多元线性回归方程探讨年龄、屈光度、性别及视盘面积对RNEL厚度的影响。结果①正常人RNFL平均厚度为108.63±9.70μm,下方象限RNFL(I):139.17±15.79μm最厚,其次为上方象限(S):134.61±17.80μm,颞侧象限(T):85.37±21.25μm,鼻侧象限(N):75.19±17.06μm最薄,即I>S>T>N。②平均及上、下、颞侧象限RNFL厚度均随年龄增长而变薄,40岁以后趋势明显,50岁以上者显著变薄,仅鼻侧象限RNFL厚度与年龄无关;平均及上、下、鼻侧象限RNFL厚度均随近视度数增加而变薄,且高度近视者显著薄于正视者。而颞侧象限RNFL厚度却随近视度数增加而变厚,高度近视者显著薄于正视者。而颞侧象限RNFL厚度却随近视度数增加而变厚,高度近视者显著厚于正视者;平均及各象限RNFL厚度除下方外均与性别无关,仅下方像限女性较男性厚;应用机器自动辨认视盘边界时,未发现RNFL厚度与视盘面积有关。结论OCT测得的正常RNFL厚度主要与年龄、屈光度有关;仅下方象限RNFL厚度与性别有关;应用机器自动辨认视盘边界时,未发现RNFL厚度与视盘面积有关;儿童可以较好地配合OCT检查并获得较为可靠的测理结果;应用规范、统一的OCT测量标准,建立人群为基础的并经相关影响因素校正的中国人RNFLJE常值数据库对青光眼的早期诊断是非常必要的。Obiective To measure the peripapillary retinal nerve fiber layer （RNFL） thickness in normal eyes with optical coherence tomography （OCT） and to identify the factors that might affect the RNFL thickness. Methods Total of 202 randomly selected normal eyes from 202 subjects of both sex with different age （8-74 years） and refraction error （-8.00 to ＋4.00 diopters） underwent Stratus OCT 4.0 examination. The average REFL thickness as well as that in the four quadrants and twelve clock hours were determined, and their variations with age, refraction, sex and optic disc area were statistically investigated by multivariate linear regression analysis. Results （1） The average RNFL thickness was 108.63±9.70μ m. The RNFL was thickest in the inferior quadrant （139.17±15.79μm）, followed by superior （134.61± 17.80μ m）,temporal （85.37±21.25μm）and nasal （75.19±17.06μm）. （2） The average RNFL thickness as well as that in the inferior, superior and temporal quadrant all decreased with age, which was obvious after 40 years old and significant after 50,while in the nasal quadrant,no correlation was found between them. Except for the temporal quadrant, the average RNFL thickness and that in the other quadrants all showed a similar decreasing trend towards increasing myopia and became significantly thinner in high myopic eyes compared with that in the temporal quadrant the RNFL showed an inverse trend and became significantly thicker in high myopic eyes. There was no significant difference in most RNFL measurements males and females except that in the inferior quadrant where RNFL were slightly thicker in females. We didn＇t found any effect on RNFL thickness by optic disc area automatically provided by OCT. Conclusions The RNFL thickness in mormal subjects was mainly affected by age and refraction. No correlation was found between sex and RNFL thickness except for the inferior quadrant. Optic disc area automatically provided by OCT didn＇t show any effect on RNFL thickness. Our result

关 键 词：相干光断层扫描仪 视网膜神经纤维层 正常人 

分 类 号：R774.1[医药卫生—眼科]