三维光学相干断层扫描在检测近视儿童黄斑及视网膜神经纤维层厚度中的应用  

Macular and retinal nerve fiber layer thickness in myopic children by three-dimensional OCT

作　　者：夏哲人[1] 应靖璐[2] 张佳[3] 郑穗联[1] 

机构地区：[1]温州医学院附属第二医院眼科,325027 [2]浙江大学附属邵逸夫医院眼科 [3]温州医学院附属眼视光医院

出　　处：《中华医学杂志》2013年第45期3573-3576,共4页National Medical Journal of China

摘　　要：目的 探讨近视儿童黄斑厚度及视网膜神经纤维层厚度变化.方法 选择2010年9月至2012年3月在温州医学院附属第二医院眼科就诊的近视儿童48例,共96眼,根据近视程度分为低度近视组、中度近视组、高度近视组.同时选择正视儿童19名共33只眼作为健康对照组.利用三维光学相干断层扫描（OCT）记录3组近视患者各个区域黄斑厚度及视网膜神经纤维层（RNFL）厚度,分别与正常对照组进行比较.结果 高度近视组在黄斑外环区颞侧、上方及下方区域的平均厚度分别为276、294、285 μm,低于正常对照组（P〈0.05）;低度近视组及中度近视组在黄斑外环区上方平均厚度分别302、301 μm,两组在黄斑外环区下方平均厚度分别为288、283 μm,均低于正常对照组（P〈0.05）.高度近视组RNFL在颞侧区域比正常对照组厚,而在其余6个区域均比对照组薄（P〈0.05）.近视患者中央1 mm区域、内环上方区域、外环颞侧及上方区域,黄斑厚度与等效球镜度正相关（P〈0.05）.近视患者颞侧区域,RNFL厚度与等效球镜度负相关;在中央区、鼻侧、鼻上、鼻下、颞上、颞下区域,RNFL厚度与球镜度正相关（P〈0.05）.结论 近视儿童随着度数增加,尽管眼底或许尚无可见的变化,黄斑厚度及RNFL厚度已经发生了重新分布.Objective To investigate the variations of macular thickness and peripapillary retinal nerve fiber layer （RNFL） thickness in myopic children. Methods A total of 96 eyes from 48 myopic children at department of Ophthalmology, Second Affiliated Hospital of Wenzhou Medical College from September 2010 to March 2012 were enrolled in this study and divided into three groups （low, moderate and high myopia group） according to the severity of myopia. Another 33 eyes from 19 emmetropic children were recruited as control group. The macular thickness and peripapillary RNFL thickness of the myopic children measured by optical coherence tomography were compared with that of the control group. Results The mean thickness of nasal, superior and inferior regions of outer-ring macular in the high myopia group were 276 p.m, 294 p,m, 285 μm respectively, which were significantly lower than that in the control group （P 〈 0. 05 ）. The mean thickness of superior of outer-ring macular in the low and moderate groups were 302 μm, 301 μm respectively, and the inferior of outer-ring ones were 288 μm, 283 μm respectively, which were significantly lower than that in the control group （ P 〈 0. 05 ）. The temporal region of peripapillary RNFL thickness was significantly greater, and the other six regions of RNFL thicknesses were significantly lower in the high group than in the control group （P 〈 0. 05 ）. The central-1 mm, superior region of inner-ring, temporal and superior region of outer-ring macular thickness had positive correlations with spherical equivalent （SE） （P 〈 0. 05 ）. There was a negative correlation between the temporal peripapillary RNFL thickness and SE, while positive correlations were found between other regions of peripapillary RNFL thickness and SE （P 〈 0. 05 ）. Conclusions The thicknesses of macular and peripapillary RNFL of myopic children have already redistributed before apparent changes of funds.

关 键 词：光学相干断层扫描 近视 黄斑 视网膜神经纤维层 

分 类 号：R778[医药卫生—眼科]