摘要
目的:应用光学相干断层扫描(Optical coherence tomography,OCT)技术,观察学龄期屈光不正儿童的眼轴及等效球镜与视盘周围视网膜神经纤维层厚度(Retinal nerve fiber layer thickness,RNFLT)之间的变化,探讨学龄期儿童屈光不正弱视视网膜结构变化特征。方法:共纳入受检儿童160例289眼,将其分为4组。A组(中低度近视组):中低度近视儿童42例78眼;B组(高度近视组):高度近视儿童45例68眼;C组(高度近视弱视组):高度近视弱视儿童33例63眼;D组(对照组):视力正常健康儿童40例80眼。通过OCT检查视盘周围平均RNFLT及其上、下、鼻、颞侧的RNFLT,分别测量其屈光度和眼轴长度。分析屈光度和眼轴长度与视盘周围RNFLT的相关性。结果:C组中视盘上方RNFLT最厚,其次分别为颞侧、下方及鼻侧;B组和C组比较除颞侧外,视盘上方、下方及鼻侧RNFLT均比A组和D组变薄,差异有统计学意义(P<0.05);C组视盘平均RNFLT及下方RNFLT与其余3组对应位置比较,RNFLT明显变薄,差异有统计学意义(P<0.05),而其颞侧RNFLT与其他3组比较差异无统计学意义(P>0.05);各组视盘周边平均RNFLT和各象限RNFLT与受检者性别、年龄比较,差异均无统计学意义(P>0.05);C组视盘颞侧RNFLT与眼轴长度(Axial Length,AL)呈正相关(r=0.503,P<0.05);视盘下方RNFLT与AL呈负相关(r=-0.364,P<0.05)。B组视盘颞侧RNFLT与AL正相关(r=0.462,P<0.05)。眼轴长度与等效球镜度数比较呈显著正相关(r=0.752,P<0.001)。结论:学龄期儿童高度近视弱视视盘厚度在高度近视视网膜变薄的基础上进一步变薄。推测随着屈光状态的改变,这个年龄段高度近视性弱视视网膜结构在发育中可能出现了异常。
Objective : With optical coherence tomography(OCT) technology, tostudy the characteristics of retinal structure changes in school-age children with ametropia and amblyopia byobserving the changes of ocular axis and equivalent spherical lens in school-age ametropic children andretinal nerve fiber layer thickness(RNFLT). Methods : A total of 289 eyes of 160 cases were enrolled and divided into 4 groups. There were78 eyes of 42 caseswith moderate and low myopia in group A, 68 eyes of 45 cases with highmyopia in group B, 63 eyes of 33 caseswith high myopia and amblyopiain group C,and 80 eyes of 40 cases with normal vision in group D. Mean RNFLT around the optic disc, and RNFLT at the upper, lower, nasal and temporal sides were examined by OCT. Diopter and axial length were measured respectively.The correlation of diopter and axial length with PERI optic disc RNFLT was analyzed. Results : In group C, RNFLT was thickest above the optic disc, followed by temporal, inferior and nasal side. Compared with group A and group D, the RNFLT of the other three directions in group B and group C were thinner than those in group A and group D, and the differences were statistically significant(P<0. 05). Compared with the other three groups, the mean RNFLT and lower RNFLT in group C had significantly thinner RNFLT(P<0. 05), but there was no significant difference in temporal RNFLT between group C and the other three groups(P>0. 05). There were no significant differences in perioptic disc RNFLT and quadrants RNFLT between each group and the gender and age of the subjects(P>0. 05). There was a positive correlation between the temporal RNFLT and Axial Length(AL) in group C(r=0. 503, P<0. 05). RNFLT was negatively correlated with AL(r=-0. 364, P<0. 05). RNFLT was positively correlated with AL in group B(r=0. 462, P<0. 05).The axial length was positively correlated with the spherical equivalent(r=0. 752, P<0. 001). Conclusion : The thickness of optic disc in school-age children with high myopic amblyopia becomes thinner on the basis of the thinning of high myopic retina. It is speculated that with the change of refractive state, there may be abnormal retinal structure in the development of high myopic amblyopia in this age group.
作者
谢静
王燕霞
王葳
周婷
XIE Jing;WANG Yan-xia;WANG Wei;ZHOU Ting(Department of Ophthalmology,The First Affiliated Hospital of Gannan Medical University;Gannan Medical University,Ganzhou,Jiangxi 341000)
出处
《赣南医学院学报》
2022年第12期1252-1256,共5页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
基金
江西省教育厅科学技术研究项目(170857)
江西省卫生计划生育委员会科技计划项目(20181113)
赣州市科技计划项目(赣市科发202060号)。
关键词
光学相干断层扫描
高度近视
弱视
视网膜神经纤维层厚度
儿童
Optical coherence tomography
High myopia
Amblyopia
Retinal nerve fiber layer thickness
Children
作者简介
谢静,女,硕士,副教授,副主任医师,硕士生导师,研究方向:儿童眼科、眼表疾病、眼眶眼整形方向。E-mail:xiejing503@163.com。;王燕霞,赣南医学院2020级硕士研究生;王葳,赣南医学院2021级硕士研究生。
