基于学校的健康儿童青少年视网膜OCT数据  

Normative Values of Macular and Optic Nerve Head Parameters in Childhood:A School-Based Study with Optical Coherence Tomography

作　　者：余宗榕 林政桦 潘仑 温龙波 李晓柠 蓝卫忠 杨智宽 Zongrong Yu;Zhenghua Lin;Lun Pan;Longbo Wen;Xiaoning Li;Weizhong Lan;Zhikuan Yang(Aier School of Ophthalmology,Central South University,Changsha 410208,China;Aier Eye Hospital,Jinan University,Guangzhou 510000,China)

机构地区：[1]中南大学爱尔眼科学院,长沙410208 [2]暨南大学附属广州爱尔眼科医院,广州510000

出　　处：《中华眼视光学与视觉科学杂志》2020年第11期801-808,共8页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：湖南省杰出青年基金(2019JJ20034);湖南省科技厅重点研发项目(2019SK2051);爱尔眼科医院集团临床研究所科研基金资助(AR1903D1,AR1903D3)。

摘　　要：目的:探讨健康儿童青少年经光学相干断层成像(OCT)测得的黄斑区以及视盘区相关参数的正常值范围,并分析个体因素对OCT主要参数的可能影响。方法:横断面研究。本研究为爱尔儿童青少年屈光发育队列研究的一部分内容,在2019年3─6月期间,使用OCT对湖南醴陵市及湖北宜昌市3所学校的913名中小学生(5~15岁)眼球黄斑区及视盘区进行扫描,以OCT自带软件导出视盘形态学指标、视盘及黄斑区视网膜厚度和神经纤维层厚度(RNFL),分别以P2.5~P97.5及均值±1.96标准差定义其正常值范围,并通过Spearman相关和多元线性回归模型分析年龄、性别、屈光度和眼轴长度对OCT主要参数的影响。结果:糖尿病早期治疗研究小组黄斑部格子分区(EDTRS)中,黄斑中心区视网膜厚度及RNFL的正常值范围分别为193.72~262.68μm和0.67~8.18μm。内环区视网膜厚度依次为上方(288.07~340.29μm)>鼻侧(283.89~340.53μm)及下方(283.85~337.21μm)>颞侧(275.32~326.32μm),RNFL依次为下方(24.40~33.01μm)及上方(24.52~33.24μm)>鼻侧(20.89~28.35μm)>颞侧(20.54~24.45μm);外环区视网膜厚度依次为鼻侧(266.97~323.27μm)>上方(254.81~305.03μm)>下方(241.54~292.42μm)>颞侧(238.45~286.59μm),RNFL依次为鼻侧(42.38~63.03μm)>下方(36.35~53.74μm)及上方(36.19~53.64μm)>颞侧(21.37~26.52μm)。视盘视网膜厚度依次为上方(286.13~378.29μm)及下方(283.20~375.82μm)>颞侧(256.90~325.30μm)>鼻侧(235.40~309.79μm),RNFL依次为下方(122.07~193.79μm)>上方(113.48~188.28μm)>颞侧(71.51~146.15μm)>鼻侧(45.99~112.26μm)。视盘面积(DA)、盘沿面积(RA)、视杯容积(CV)、杯盘面积比(CDAR)、线性杯盘比(LCDR)、垂直杯盘比(VCDR)分别为1.37~3.16 mm 2、0.79~2.64 mm 2、0.01~0.51mm 3、0.03~0.64、0.17~0.80、0.15~0.78。多元线性回归分析显示等效球镜度与黄斑中心区、黄斑外环鼻侧、视盘鼻侧及视盘下方RNFL厚度和DA、CV、VCDR具有相关性(r=-0.197、-0.317、4.458Objective:To determine the normative values of macular and optic nerve head parameters measured by optical coherence tomography(OCT)in healthy schoolchildren and to analyze the possible influence of individual factors on the main parameters of OCT.Methods:This cross-sectional study was part of a cohort study on refractive development in children and adolescents.Nine hundred thirteen students from the age of five to fifteen were recruited at three schools in Liling City,Hunan Province,and Yichang City,Hubei Province.Retinal thickness,retinal nerve fiber thickness(RNFL)and optic nerve head parameters were measured by OCT(DRI OCT Triton,Japan,Topcon).The normal value range was defined by P2.5-P97.5 or Mean±1.96 SD.Then the relationships between age,sex,refractive error,axial length and the main parameters were analyzed by a Spearman's correlation and multiple linear regression analysis.Results:The EDTRS for the foveal region,the normal values of retinal thickness and RNFL thickness in the central area were 193.72-262.68μm and 0.67-8.18μm,respectively.In the inner ring region,the retina was thickest in the superior quadrant(288.07-340.29μm),followed by the nasal(283.89-340.53μm)and inferior quadrants(283.85-337.21μm),then the temporal quadrant(275.32-326.32μm),while the RNFL was thickest in the inferior(24.40-33.01μm)and superior quadrants(24.52-33.24μm),followed by the nasal(20.89-28.35μm)and temporal quadrants(20.54-24.45μm).In the outer ring region,the retina was thickest in the nasal quadrant(266.97-323.27μm),followed by the superior(254.81-305.03μm)and inferior quadrants(241.54-292.42μm),then the temporal quadrant(238.45-286.59μm),while the RNFL was thickest in the nasal quadrant(42.38-63.03μm),followed by the inferior(36.35-53.74μm)and superior quadrants(36.19-53.64μm),then the temporal quadrant(21.37-26.52μm).In the optic disc,the retina was thickest in the superior(286.13-378.29μm)and inferior quadrants(283.20-375.82μm),followed by the temporal quadrant(256.90-325.30μm),then the nasal qu

关 键 词：光学相干断层扫描 视网膜神经纤维层厚度 全层视网膜厚度 视盘形态学指标 正常参考值 儿童青少年 

分 类 号：R774[医药卫生—眼科]