高度近视性弱视儿童视盘周围视网膜神经纤维层厚度分析

摘要

目的：分析高度近视性弱视儿童视盘周围视网膜神经纤维层厚度特点,并探讨与眼轴、年龄的关系。　　方法：选择收集2014-01/07间在我院眼科门诊就诊的儿童35例59眼,平均年龄9.59±2.90岁,所有受检眼排除眼底的疾病和眼前节的病变。根据扩瞳验光的结果,分成高度近视性弱视组(22眼)、高度近视组(15眼)、正视眼组(22眼),运用频域OCT对视盘周围视网膜神经纤维层进行检测,通过A超测量出所有受检者眼轴长度。对各组视盘周围各方位视网膜神经纤维层厚度进行比较分析,探讨视盘周围各方位视网膜神经纤维层与眼轴、年龄的关系。　　结果：高度近视性弱视组视盘颞侧RNFL厚度薄于高度　　近视组,厚于正视眼组；视盘鼻侧、上方、下方、周围平均RNFL厚度与高度近视组、正视眼组相比均最薄,其中视盘下方及周围平均RNFL厚度与高度近视组相比变薄,有统计学差异(P<0.05),视盘鼻侧、上方、下方、周围平均RNFL厚度与正视眼组相比明显变薄,有统计学差异( P<0.01)。高度近视组视盘颞侧RNFL厚度与正视眼组相比明显增厚,视盘鼻侧、上方、下方、周围平均RNFL厚度与正视眼组相比均明显变薄,有统计学差异(P<0.05)。高度近视性弱视组视盘下方RNFL厚度与眼轴呈负相关性( R=0.474, R2=0.225, F=4.933, P=0.040)。高度近视组视盘上方RNFL厚度与眼轴呈负相关性(R=0.642, R2=0.412,F=9.104,P=0.010)。高度近视性弱视组、高度近视组、正视眼组各方位RNFL厚度与年龄均无明显相关性。　　结论：高度近视性弱视儿童视网膜结构存在异常。%AIM: To research the peripapillary retinal nerve fiber layer ( RNFL ) thickness change in high myopia amblyopic children and to discuss the relationships among RNFL thickness, axial length and age. METHODS:Thirty-five Chinese children (59 eyes) with a mean age of ( 9. 59 ±2. 90 ) years were recruited. All eyes were ruled out the pathological changes of fundus diseases and front section. By atropine optometry after they were divided into: high myopia amblyopia group (22 eyes), high myopia group (15 eyes), normal group (22 eyes) . RNFL scans were obtained for all eyes using optical coherence tomography and axial length was also surveyed by A - ultrasound. Statistical analyses were performed to evaluate RNFL thickness at each location with axial length and age. RESULTS:The peripapillary RNFL thickness in temporal of high myopia amblyopia group was thinner than that in high myopia group, and thicker than that in normal group. The peripapillary RNFL thickness in nasal, superior, inferior and the average thickness of high myopia amblyopia group were thinner than those in high myopia and normal gruops. The peripapillary RNFL thickness in inferior and average thickness of high myopia amblyopia group were significantly thinner than those of high myopia (P<0. 05). The peripapillary RNFL thickness in nasal, superior, inferior and the average thickness of high myopia amblyopia group were significantly thinner than those of normal (P<0. 01). The peripapillary RNFL thickness in temporal of high myopia group was significantly thicker, and in nasal, superior, inferior and the average thickness were significantly thinner than those of normal (P<0. 05). The thickness of peripapillary RNFL in inferior showed a negative correlation with axial length in high myopia amblyopia group (R=0. 474, R2=0. 225, F=4. 933, P=0. 040). The thickness of peripapillary RNFL in superior showed a negative correlation with axial length in high myopia group (R=0. 642, R2=0. 412, F=9. 104,P=0. 010). These were no correlation between the peripapillary RNFL thickness and age in high myopia amblyopia, myopia amblyopia and normal. CONCLUSION:There are significant abnormalities of retinal structure in high myopia amblyopia.