3D-OCT评价近视患者视盘周围视网膜神经纤维层厚度的变化  

Peripapillary retinal nerve fiber layer thickness distribution in myopia patient measured by 3D-OCT

作　　者：庄文娟 赵静静[2] 李珊珊 杨学秋[2] 向伟[2] 

机构地区：[1]宁夏人民医院宁夏眼科医院,银川750001 [2]宁夏医科大学,银川750004 [3]银川市卫生监督所,750001

出　　处：《中华实验眼科杂志》2014年第12期1117-1121,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：宁夏医科大学基金项目（XT201014）

摘　　要：背景 视盘周围视网膜神经纤维层（RNFL）厚度的检测已经成为诊断青光眼患者是否出现结构性损害的一个重要方法,而近视作为原发性开角型青光眼的一个重要危险因素,研究RNFL厚度与近视之间的关系不仅有利于探讨不同屈光度近视患者RNFL的变化特点,而且可用于鉴别伴有近视的早期青光眼患者的眼部损害. 目的 采用3D-光学相干断层扫描（3D-OCT）测量不同屈光度近视眼的RNFL厚度,探讨近视对视盘周围RNFL厚度的影响. 方法 收集2010年12月至2012年2月于宁夏医科大学总医院就诊的近视患者258例258眼,任取一眼进行研究.将受检眼按等效球镜度（SE）的不同分为低度近视组42眼（-0.5D≤SE≤-3.0D）、中度近视组120眼（-3.0 D＜SE≤-6.0D）、高度近视组58眼（-6.0 D＜SE≤-8.0D）、超高度近视组38眼（SE＞-8.0 D）.受检眼视盘周围按象限分为上方、鼻侧、下方、颞侧区域,按照不同钟点分为1：00、2：00、3：00、4：00、5：00、6：00、7：00、8：00、9：00、10：00、11：00、12：00方位.利用3D-OCT分别测量受检眼视盘周围上述区域的RNFL厚度,比较4个组间受检眼各部位RNFL厚度的变化,分析RNFL厚度与SE和眼轴长度的关系.结果 随着近视SE的增加,受检眼视盘周围上方、鼻侧、下方和平均RNFL值均逐渐下降,4个组间的总体差异均有统计学意义（F=10.48、15.60、3.31、8.98,P＜0.05）,颞侧象限的RNFL随着SE的增加而逐渐增厚,4个组间的总体差异有统计学意义（F=2.92,P=0.03）;其中高度近视组和超高度近视组上方、鼻侧、下方和视网膜平均RNFL值均较低度近视组明显下降,差异均有统计学意义（P＜0.05）.不同程度近视组间受检眼1：00、2：00、3：00、4：00、5：00、6：00、8：00、12：00方位视盘周围RNFL厚度随着近视程度的增加而变薄,差异均有统计学意义（P＜0.05）,而各组间7：00、9：00、10：00、11：00方位RNFL�Background As assessment of the peripapillary retinal nerve fiber layer （RNFL） has been an important approach for detecting structural damage in patients with glaucoma and myopia is a vital risk factor of primary open glaucoma,it is urgent to establish the correlation between RNFL thickness and myopia,not only for understanding the characteristics of RNFL with the change of the degree of myopia,but also for identifying those myopic patients with the early stage of glaucoma.Objective This study was to assess the influence of myopia for the thickness of RNFL measured by 3D optical coherence tomography （3D-OCT）.Methods Two hundred and fifty-eight eyes of 258 myopic subjects from General Hospital of Ningxia Medical University were recruited.The myopic eyes were divided into low myopia group （42 eyes,-0.5 D ≤ SE ≤-3.0 D）,middle myopia group （120 eyes,-3.0 D＜SE≤-6.0 D）,high myopia group （58 eyes,-6.0 D＜SE≤-8.0 D） and extreme high myopia group （38 eyes,SE ＞-8.0 D）.The peripapillary RNFL thickness profile including temporal,superior,nasal and inferior quadrants and each of the 12 clocks was measured by 3D-OCT.The measured values were compared among different degrees of myopia,and the correlations between spherical equivalent （SE） and axial length with RNFL thickness were analyzed using linear regression equation.Results The RNFL thickness was gradually declined with the increase of SE and elongation of axis,showing significant differences among the 4 groups in the superior,nasal and inferior quadrants and mean RNFL thickness （F=10.48,15.60,3.31,8.98,all at P＜0.05）,but temporal RNFL thickness was increased with the SE rise,with markedly difference among the 4 groups （F =2.92,P =0.03） ; and RNFL thicknesses in the superior,nasal,inferior quadrants and mean RNFL thickness were evidently declined in the high and extreme high myopia group in comparison with low myopia group （all at P＜0.05）.The overall RNFL parameters at 1：00,2：00,3：00,4：00,5：00,6：00,8：00,

关 键 词：光学相干断层扫描 近视 视网膜神经纤维 

分 类 号：R778.11[医药卫生—眼科]