隐匿性近视儿童黄斑区视网膜厚度及相关因素的纵向临床研究  

A longitudinal clinical study on macular retinal thickness and related factors in children with occult myopia

作　　者：陈兴玉 石晶[1] 谭小波[1] 杨洁[1] 郝佳颖[1] 米若宁 Chen Xingyu;Shi Jing;Tan Xiaobo;Yang Jie;Hao Jiaying;Mi Ruoning(Department of Ophthalmology,The Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院眼科,承德067000

出　　处：《中华眼底病杂志》2022年第6期456-461,共6页Chinese Journal of Ocular Fundus Diseases

基　　金：河北省自然科学基金(H2020406019);承德市科学技术研究与发展计划项目(202006A038)。

摘　　要：目的观察并分析隐匿性近视儿童黄斑区视网膜厚度变化及其相关因素。方法前瞻性纵向对照研究。2021年2月至2022年2月于承德医学院附属医院眼科初次就诊(初诊)且未经任何相应近视矫正治疗的儿童60例120只眼纳入研究。其中, 男性32例64只眼, 女性28例56只眼;年龄4~6岁。初诊时及初诊后3、6、9、12个月受检眼均行视力、医学验光、角膜地形图、频域光相干断层扫描(OCT)检查以及眼轴长度(AL)测量。受检儿童根据视力、等效球镜度(SE)、AL、角膜曲率(CC)情况分为隐匿性近视组、对照组, 各组均为30例60只眼。采用频域OCT的加强深部成像技术测量受检眼黄斑中心凹视网膜厚度。根据糖尿病视网膜病变治疗研究的分区方法将黄斑中心6 mm范围内视网膜划分为以黄斑中心凹为中心的3个同心圆, 分别是直径为1 mm的中心凹区、1~3 mm的内环区、3~6 mm的外环区, 在内外环分别由2条放射线将其分为上方、下方、鼻侧、颞侧, 共计9个区域。对比观察隐匿性近视组、对照组受检眼AL、CC、SE、黄斑区视网膜厚度的差异, 以及各相关因素随时间的变化情况。两组受检眼SE、AL、CC以及黄斑区不同区域视网膜厚度比较采用重复测量方差分析。两两比较, 不同测量时间点组内采用最小显著差法t检验;相同测量时间点组间采用独立样本t检验。结果初诊及初诊后不同时间, 隐匿性近视组受检眼SE (F=783.710)、AL (F= 742.192)以及黄斑中心凹(F=330.292 )、外环下方和颞侧(F=158.250、108.295)视网膜厚度比较, 差异均有统计学意义(P<0.01);对照组受检眼SE (F=1 793.976)、AL (F=457.362)以及黄斑中心凹(F=31.029 )、外环下方和颞侧(F=7.405、77.245)视网膜厚度比较, 差异均有统计学意义(P<0.01)。两组受检眼均随初诊后时间延长, SE逐渐增加, AL逐渐变长, 黄斑中心凹、外环下方和颞侧视网膜厚度逐渐变薄。对相同测量时�Objective To observe and analyze the changes of macular retinal thickness and related factors in children with occult myopia.Methods A prospective longitudinal control study.From February 2021 to February 2022,120 eyes of 60 children who first visited Department of Ophthalmology of The Affiliated Hospital of Chengde Medical College without any corresponding myopia correction treatment were included in the study.There were 32 males(64 eyes)and 28 females(56 eyes),with the age of 4-6 years.Visual acuity,medical optometry,corneal topography,spectral-domain optical coherence tomography(OCT)and axial length(AL)were measured at the first visit and 3,6,9 and 12 months.The children were divided into occult myopia group with 60 eyes of 30 cases and control group with 60 eyes of 30 cases according to visual acuity,equivalent spherical refraction(SE),AL and corneal curvature(CC).The macular fovea retinal thickness was measured by spectral-domain OCT enhanced deep imaging technique.According to the treatment and study of diabetic retinopathy,the retina within the 6 mm of the macular center was divided into three concentric circles with the macular fovea as the center,the central fovea of 1 mm,the inner ring of 1-3 mm and the outer ring of 3-6 mm.In the inner ring and outer ring,the retina was divided into 4 areas,upper and lower,left and right,with a total of 9 regions.The four regions of the inner ring and the outer ring were superior,inferior,nasal and temporal,respectively.The differences of AL,CC,SE,macular retinal thickness and the changes of related factors with time were compared between the occult myopia group and the control group.SE,AL,CC and retinal thickness in different macular regions of the two groups were compared by repeated measurement analysis of variance.In pairwise comparison,the minimum significant difference t test was used in different measurement time points,and the independent sample t test was used between groups at the same measurement time points.Results At first diagnosis and after diagnosis,the

关 键 词：儿童 近视 体层摄影术 光学相干 视网膜厚度 

分 类 号：R778.11[医药卫生—眼科]