7～18岁近视青少年视网膜神经纤维层厚度及其影响因素的分析  

Evaluation of factors associated with variability in retinal nerve fiber layer thickness in myopic juveniles aged 7-18 years

作　　者：陈伟[1] 傅培[1] 杨琦[1] 陶然[1] 刘颜[1] 伍友春[1] 陆秋萍[1] 

机构地区：[1]北京大学深圳医院眼科,518032

出　　处：《中华眼科杂志》2010年第11期1011-1015,共5页Chinese Journal of Ophthalmology

基　　金：深圳市科技计划项目（201003065）

摘　　要：目的 探讨近视青少年视乳头旁视网膜神经纤维层厚度（RNFLT）的变异程度与年龄、屈光度、眼轴长度、性别及眼别的关系.方法 横断面调查研究.应用Stratus相干光断层扫描（OCT）仪的快速扫描程序,测量154例（154只眼）7～18岁近视青少年的视乳头旁全周和各象限平均RNFLT,并用A超测定眼轴长度.在进行影响因素分析时先行双变量直线回归分析,对差异有统计学意义的因素再进行多元线性逐步回归分析.结果 154只眼的全周平均RNFLT为（114.106±11.473）μm.按象限划分RNFLT从厚到薄依次为上方（145.468±19.064）μm,下方（138.091±20.464）μm,颞侧（94.396±18.544）μm,鼻侧（7 8.558±16.981）μm.双变量简单直线回归分析显示患者全周和上方RNFLT与其年龄（r=0.129,0.014）、屈光度数（r=0.006,0.123）、眼轴长度（r=-0.067,-0.141）、性别（r=-0.095,0.025）、眼别（r=-0.148,0.095）均无相关性（P＞0.05）.多元线性逐步回归分析,显示患者颞侧RNFLT与其等效球镜度数呈负相关（r=-0.465,P＜0.05）;鼻侧RNFLT与其眼轴长度（r=-0.327）和眼别（r=-0.327）均呈负相关（P＜0.05）;下方RNFLT与其眼轴长度（r=-0.276,P＜0.05）呈负相关,但与其年龄呈正相关（r=0.276,P＜0.05）.结论 在评价青少年的全周及各象限RNFLT时,需考虑其年龄、近视程度、等效球镜度数、眼轴长度及眼别的影响.Objective To evaluate the relationship between retinal nerve fiber layer thickness （RNFLT） measured by optical coherence tomography （OCT） and age, spherical equivalent （SE）, axial length, and gender in myopic juveniles. Methods Cross-sectional observational study. One hundred and fifty-four juveniles （age range, 7-18 years） underwent ophthalmic examinations. Peripapillary Fast RNFL scans were performed by Stratus OCT with a nominal diameter of 3.46 mm centered on the optic disc on one randomly selected eye of each subject. Axial length was measured by A-ultrasound. The effects of several factors （age, SE, axial length, gender and eye） on RNFLT were investigated in univariate and multivariate stepwise regression analyses. Results The mean global RNFLT （-x ± s） was （ 114. 106 ± 11. 473） μm. The RNFLT was thickest superiorly （145.468 ±19.064） μm and inferiorly （138.091 ±20.464） μm, thinner temporally （94. 396 ± 18. 544） μm, and thinnest nasally （78. 558 ± 16. 981 ） μm. Both global and superior peripapillary RNFLT had no significant relationship with age（r =0. 129,0. 014;P 〉0. 05）, SE（r =0. 006,0. 123 ;P 〉0. 05）, axial length（r = -0. 067, -0. 141 ;P 〉0. 05）, gender（r = -0. 095,0. 025 ;P 〉0. 05）and laterality（ r = - 0. 148,0. 095; P 〉 0. 05 ）. In multivariate stepwise regression analyses, there was significant inverse linear correlation between temporal RNFLT and SE （ r = - 0. 465, P 〈 0. 05 ）. There was significant inverse linear correlation between nasal RNFLT and axial length and laterality（ r = -0. 327, P 〈0. 05）. There was significant inverse linear correlation between inferior RNFLT and axial length （r =-0. 276,P 〈0. 05）, and direct linear correlation between inferior RNFLT and age （r =0. 276,P 〈0. 05）.Conclusions When we assess the RNFLT in myopic juveniles, we should consider the influence of age,refraction, axial length, spherical equivalent and laterality comprehensively.

关 键 词：体层摄影术 光学相干 近视 视网膜 神经纤维 人体测量术 

分 类 号：R686[医药卫生—骨科学]