单眼弱视患者双眼黄斑区视网膜厚度的Meta分析  

Macular thickness in unilateral amblyopia as measured by optical coherence tomography： a meta analysis

作　　者：陈思[1] 刘括[2] 董宁[1] 肖林[1] 金恩忠[1] 任骁方[1] 

机构地区：[1]北京大学第九临床医学院首都医科大学附属北京世纪坛医院眼科,100038 [2]北京大学公共卫生学院流行病与卫生统计学系

出　　处：《中华眼科杂志》2014年第7期504-510,共7页Chinese Journal of Ophthalmology

摘　　要：目的 评价单眼弱视人群双眼黄斑厚度差异,为应用OCT探讨弱视发病机制及指导弱视诊断提供线索.方法 Meta分析.检索万方、PubMed等中英文数据库并通过Google Scholar搜索引擎进行文献补充,对有关单眼弱视对象双眼黄斑区OCT检查的临床研究进行筛选、评估和数据提取,将弱视患者双眼黄斑中心凹最小厚度、黄斑中心凹1 mm直径区域厚度纳入研究.应用RevMan5.02软件进行Meta分析.结果 应用时域OCT的研究纳入4篇文献,纳入对象均为屈光参差性弱视患者,黄斑中心凹最小厚度仅纳入1项研究,弱视眼比对侧眼厚（P =0.045）;Meta分析结果提示弱视眼黄斑中心凹1 mm直径区域比对侧眼厚6.82 μm（P＜0.05,95％可信区间为2.81～10.83）.应用频域OCT的研究纳入5篇文献,Meta分析结果提示弱视眼与对侧眼黄斑中心凹最小厚度差异及各亚组差异无统计学意义（P=0.50）;弱视眼黄斑中心凹1 mm直径区域厚度高于对侧眼7.38 μm（P＜0.05,95％可信区间为3.13 ～11.63）,亚组分析提示屈光参差性弱视亚组弱视眼高于对侧眼而斜视性弱视亚组双眼差异无统计学意义.结论 单眼弱视患者弱视眼黄斑中心区域厚度高于对侧非弱视眼,提示弱视患者黄斑厚度研究可以为弱视发病的外周机制提供佐证.Objective To offer a clue for the etiology of amblyopia by systematically comparing the macular thickness measured by optical coherence tomography （OCT） between the amblyopic eye and the fellow normal eye in patients with unilateral amblyopia.Methods Databases including Wanfang,PubMed and others were searched,and data were extracted after quality assessment,then the Meta analysis was preformed by the RevMan 5.02 software.Results Four studies using the time-domain OCT （TD-OCT） were enrolled in the analysis and all those were anisometropic amblyopic patients.The only one study showed that the foveal minimum thickness is thicker in the amblyopic eyes than the fellow ones （P =0.045）.The meta analysis indicated the amblyopic eyes were 6.82 μm （P 〈 0.05,95% CI：2.81-10.83） thicker in the fovea （1 mm diameter region）.Five trials using the spectral-domain OCT （SD-OCT） were included in the analysis.It showed no significant difference in the foveal minimum thickness between amblyopic and fellow eyes.Also,no significant difference were detected in either anisometropic or strabismic subgroup （P =0.50）.Amblyopic eyes were 7.38 μm thicker in the fovea （1 mm diameter region） （P 〈0.05,95% CI：3.13-11.63）and significant difference in the anisometropic subgroup while no significant difference in the strabismic subgroup were detected.Conclusions The macular fovea is thicker in the amblyopic eyes than the fellow ones by the use of OCT,so it is effective to measure the macular thickness of amblyopia in searching evidence for the etiology of amblyopia.

关 键 词：弱视 黄斑 光学相干断层扫描 META分析 人体测量术 

分 类 号：R777.44[医药卫生—眼科]