屈光异常弱视矫正治疗预后不良患儿风险因素及RNFL表现特点分析  

ANALYSIS OF RISK FACTORS AND RNFL PERFORMANCE CHARACTERISTICS IN CHILDREN WITH POOR PROGNOSIS AFTER AMETROPIA AND AMBLYOPIA CORRECTION

作　　者：熊燕 王玉梅 何光华 廖俊 杨必 XIONG Yan;WANG Yumei;HE Guanghua;LIAO Jun;YANG Bi(Chengdu Aidi Eye Hospital,Sichuan,Chengdu 610071,China)

机构地区：[1]四川省成都市爱迪眼科医院,610071 [2]成都市龙泉驿区第一人民医院 [3]四川大学华西医院

出　　处：《中国煤炭工业医学杂志》2023年第2期194-199,共6页Chinese Journal of Coal Industry Medicine

基　　金：四川省卫生健康委员会科研课题(编号:18PJ084);成都市卫生健康委员会科研课题(编号:2022183)。

摘　　要：目的 探讨屈光异常弱视患儿视盘周围视网膜神经纤维层(RNFL)厚度变化及矫正治疗效果的影响因素。方法 本研究选取该院2019年2月—2020年2眼科门诊收治的80例屈光异常弱视患儿作为研究对象,根据矫正视力治疗前后患儿视力测量结果变化分为有效组52例(视力提升≥2行)、无效组28例(视力提升<2行),对比二组患儿矫正治疗前的视盘周围RNFL厚度,对比二组患儿的一般临床资料、屈光参差程度、弱视程度、治疗依从性等指标,采用logistics回归模型分析各项指标与屈光异常弱视患儿治疗效果的影响因素。结果 治疗有效组的视盘鼻侧、视盘上方、视盘下方、视盘周围RNFL厚度平均值均显著高于无效组患者,差异均具有统计学意义(P<0.05);治疗有效组和无效组患者的视盘颞侧RNFL厚度测定值比较,差异无统计学意义(P>0.05);治疗有效组的年龄构成、性别、父母近视率与无效组比较,差异均无统计学意义(P>0.05);治疗有效组的治疗依从性显著高于无效组,差异有统计学意义(P<0.05);治疗有效组的屈光异常类型、遮盖治疗占比与无效组比较,差异均无统计学意义(P>0.05);治疗有效组的弱视程度、是否单眼弱视患儿占比与无效组比较,差异有统计学意义(P<0.05);logistics回归模型,视盘鼻侧、视盘上方、视盘下方、视盘周围RNFL厚度降低是屈光异常弱视患儿矫正治疗效果不佳的独立危险因素(P<0.05),患儿治疗依从性差或依从性一般、呈重度弱视是屈光异常弱视患儿矫正治疗效果不佳的独立危险因素(P<0.05)。结论 矫正治疗无效的屈光异常弱视患儿RNFL变薄更为明显相较于治疗有效患儿,同时,RNFL变薄、治疗依从性不好、重度弱视是屈光异常弱视患儿治疗效果不佳的危险因素。Objective To investigate the changes in the thickness of the retinal nerve fiber layer(RNFL) around the optic disc in children with refractive abnormal amblyopia and the influencing factors of the corrective treatment effect. Methods In this study, Eighty children with refractive abnormalities and amblyopia who were admitted to our hospital from February 2019 to 2020 in 2 ophthalmic outpatient clinics were selected as the research objects.According to the changes in the visual acuity measurement results of the children before and after corrective vision treatment, they were divided into the effective group of 52 cases(visual acuity improvement ≥ 2 lines) and 28 cases in the ineffective group(visual acuity improvement2 lines),the RNFL thickness around the optic disc before correction treatment was compared between the two groups, and the general clinical data, anisometropia, amblyopia, and treatment compliance were compared between the two groups.Sex and other indicators were used, and logistic regression model was used to analyze the influencing factors of each indicator and the treatment effect of children with refractive abnormal amblyopia. Results The mean RNFL thicknesses on the nasal side of the optic disc, above the optic disc, below the optic disc and around the optic disc in the effective group were significantly higher than those in the ineffective group, and the differences were statistically significant(P<0.05).There was no significant difference in the measured values of lateral RNFL thickness(P<0.05);there was no significant difference in age composition, gender, parental myopia rate between the effective group and the ineffective group(P<0.05);the treatment was effective The treatment compliance of the treatment group was significantly higher than that of the invalid group, and the difference was statistically significant(P<0.05);the degree of amblyopia and the proportion of children with monocular amblyopia in the effective group were significantly different from those in the ineffective group(P<

关 键 词：屈光异常 弱视 视盘 视网膜神经纤维层 影响因素 

分 类 号：R75[医药卫生—皮肤病学与性病学]